Medicare Coverage Decision For Amyvid Due July 2013
At Lilly’s request, CMS has agreed to consider expanding the positron imaging tomography tracers that can be covered by Medicare to include agents for imaging beta-amyloid plaques when diagnosing dementia and other neurodegenerative disease.
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“Improvement in health outcomes” standard would interpret “the statute to require both diagnosis and treatment,” Lilly says about CMS’ recent evaluation of beta-amyloid positron emission tomography in dementia and neurodegenerative disease.
Medicare would only cover beta amyloid positron emission tomography in diagnosing dementia, relying on Lilly’s imaging agent, as part of a clinical trial, according to a proposed decision memo.
Lilly executives discuss likely outcomes of a pending CMS draft decision on Medicare coverage for the beta amyloid imaging agent Amyvid, emphasizing that a decision for non-coverage or coverage with evidence development would be a major setback for research and development in Alzheimer’s disease.