Next On Medicare’s To Do List For Alzheimer’s: Coverage Of PET Scans And Genetic Testing

Medicare policymakers have felt that without an effective approved treatment, coverage of amyloid PET scans and APOE4 genetic tests was not warranted. But that is changing.

Progress In Covering Diagnostics and Testing also Will Benefit Future Treatments Like Donanemab • Source: Shutterstock

There is more to Medicare coverage for Alzheimer’s treatment than Leqembi, Eisai Co., Ltd. and Biogen, Inc.’s newly-approved amyloid-targeting monoclonal antibody. Now the program also is considering amending restrictive coverage policies for PET scans and genetic testing that help target the drug to the right patients.

Key Takeaways

  • Medicare will resume efforts to revise its restrictive national coverage policy for beta amyloid-PET scans in the near future.

Leqembi was approved 6 July by the US Food and Drug Administration, making it the first amyloid beta-directed antibody –...

Pink Sheet Podcast

Learn what's happening at the US FDA. On the go.

Derrick Gingery and the team bring you a weekly "Drug Fix".

More from Market Access

More from Pink Sheet