Imaging industry seeks more coverage for cancer scans
The medical imaging industry called for the Medicare government health plan to broaden its coverage of PET scans to additional cancer types, asking an advisory panel on Wednesday to recommend wider payments.
Representatives of the Academy of Molecular Imaging and other groups said that data collected from a nationwide patient registry showed positron emission tomography (PET) scans helped doctors adjust their treatment plans for roughly one-third of enrolled patients.
“This is a broadly applicable technique to cancers in general,” Dr. David Mankoff, a University of Washington radiologist, said on behalf of several industry associations.
The groups, which also include several medical societies, initially had asked Medicare to lift restrictions on payments for nine cancers: brain, cervical, bladder, small-cell lung, ovarian, testicular, prostate, kidney and pancreatic cancers.
Medicare, which covers 44 million elderly and disabled Americans, said in 2005 it would cover the nine cancers if patients were enrolled in the registry. In March, the groups said they had enough information to support easing the policy by allowing routine coverage without registration.
The government agency is seeking advice from outside medical advisers before deciding whether to broaden payments or otherwise change the current program.
Some panelists questioned the data’s ability to support so many cancer uses, especially after several researchers commissioned by Medicare said the quality of available studies was poor to moderate.
“I don’t see how you make the leap,” said panel member and consumer representative Linda Bergthold “The quality of the data … was really stunningly poor.”
Eliminating the patient registration requirement would allow greater use of PET among Medicare patients, in part because it would be easier for doctors to order the scans.
That could be a boost for PET scan makers such as General Electric Co, Siemens AG and Philips Electronics NV.
More than 2 million PET scans are given in the United States each year, according to Philips. The companies do not break out PET scan sales figures, and a spokeswoman for Medicare said data on how much the agency has spent for the test was not readily available.
There has been disagreement over the effectiveness of PET scans compared to other imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) scans in detecting cancer cells.
With PET, patients are injected with radioactive sugars that collect in metabolically active parts of the body, which could signal growth and possibly cancer.
The ability to pinpoint biologically active areas is a key difference between PET and CT scans or MRI scans. While PET can find some cancers that CT and MRI miss, its images can be less detailed or trigger false positives.
Medicare is expected to make a draft decision in January and a final ruling in April.