HCFA's review of positron emission tomography imaging for Alzheimer's should take into account psycho-social benefits of the procedure in addition to its diagnostic capability, according to the executive committee (EC) of the Medicare Coverage Advisory Committee.

"The value...of prognostic information should be considered...because of the impact on patient well-being," Alan Garber, MD, Stanford University, said in summarizing the executive committee's consensus at the June 14 meeting in Baltimore.

HCFA convened the meeting in part to provide guidance to the Agency for Healthcare Research and Quality for conducting a technology assessment of PET imaging for diagnosing Alzheimer's disease(¹ Also see "AHRQ Alzheimer's Diagnosis Technology Assessment To Focus On PET" - Medtech Insight, 18 June, 2001.).

Garber's comments were made in response to concerns raised by AHRQ Director of Technology Assessment Deborah Zarin, MD, as to whether or not PET's ability to provide prognostic information should be evaluated within the context of the report.

"Determining diagnostic accuracy is...the easy part," Zarin suggested. "The question I have for MCAC is the linkage of that to treatment."

Citing the example of patients already diagnosed with dementia, "PET imaging could determine which kind of dementia the patient is suffering from...[thereby] refining the differential diagnosis process," Marilyn Albert, MD, National Alzheimer's Association, pointed out in testimony before the panel.

"There is a lot of enthusiasm for PET and imaging in general if not to diagnose the disease, at least to evaluate the course of the disease," Albert noted.

Current medical therapy for Alzheimer's causes regression of the disease for about six months, a measure that EC members considered appropriate for determining whether a PET scan uncovered an improvement in the patient's health outcomes.

"Six months [regression] is a non-trivial increment in the treatment of this disease," Barbara McNeil, MD, Harvard Medical School, noted.

PET Technology Review For Alzheimer's To Look At Prognostic Benefits

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