New IDEAS for Alzheimer’s Treatment

This post was contributed by Barry A. Siegel, MD, FACR, professor of radiology at Washington University, St. Louis, MO; co-chair of the National Oncologic PET Registry (NOPR); and co-chair of the IDEAS (Imaging Dementia—Evidence for Amyloid Scanning) Study.

SiegelBarry_MD_2_6x9In 2009 and 2013, CMS expanded coverage for PET for clinical applications in oncology. This was due, in part, to the successful evidence-based research from the National Oncologic PET Registry (NOPR).

Radiologists played a leading role in working with CMS in setting up that national registry that allowed for expanded access to PET.

Similarly, radiologists are playing a lead role with the Imaging Dementia—Evidence for Amyloid Scanning (IDEAS) study.

The IDEAS Study will follow nearly 19,000 Medicare beneficiaries to determine the clinical value of a PET scan to detect the hallmark brain amyloid accumulation of Alzheimer’s disease in diagnosing and managing treatment in patients ages 65 and older with mild cognitive impairment (MCI) or dementia of uncertain cause. It’s being carried out by more than 500 referring physician practices and 300 PET imaging facilities in the United States.

IDEAS is a national CMS-approved coverage with evidence development study being funded and managed by the Alzheimer’s Association and the ACR. The sources of funding for these organizations include their own funds, support from the three industry vendors of FDA-approved amyloid imaging agents (Eli Lilly and Company, GE Healthcare and Piramal) and from the fees that will be paid by participating PET facilities. Medicare will be paying for the PET scans as a covered service.

Early findings show that amyloid PET scans can have a large impact on how Alzheimer patients are managed. These results were released during the Alzheimer’s Association International Conference in July.

Among the first 3,970 enrolled patients, clinical management changed in nearly 68 percent with MCI and nearly 66 percent of those with atypical dementia. The PET scans prompted adjustments in Alzheimer’s drugs and related medications, as well as counseling recommendations.

Gil Rabinovici, MD, the IDEAS Study principal investigator and associate professor of neurology at Memory and Aging Center, University of California, San Francisco (UCSF), had expected the early findings to show amyloid PET scans might change medical management in 30 percent of cases. Personally, I’m encouraged that the final trial results will show that this technology may make a real difference for patients.

The hope is that strong positive results like these will encourage CMS and private insurers to cover the scans in the future.

  • Based on these initial results, do you believe that CMS and other third-party payers should cover amyloid PET scans?

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