The U.S. government is set to decide this month whether federal health insurance should cover the cost of a $3,000 test that for the first time accurately identifies the signature brain plaques of Alzheimer’s disease.
Those in favor of coverage say the brain scan will reduce anguish and lower medical costs for families struggling to determine appropriate care for a relative suffering from memory loss. The test could help create a broad base of early Alzheimer’s patients for research purposes, they say. Opponents counter that coverage would be a waste of money because Alzheimer’s remains incurable and knowing whether a person has the disease is of little or no benefit.
“The science on this one is so early,” said Sean Tunis, the founder and director of the Center for Medical Technology Policy in Baltimore. “So it’s hard to make a case from a clinical point of view that the diagnosis will make a difference. It will tilt on political dynamics more than the science.”
The test, approved last year by U.S. regulators, uses Eli Lilly’s Amyvid imaging agent to trace a brain protein linked to a disease that affects 5 million Americans, a number that patient advocates say could double by 2050.
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Differentiating between those who suffer from Alzheimer’s and others who have lesser forms of dementia is key for determining proper treatment, said Robert Berenson, a fellow at the Urban Institute. One kind of illness frequently mistaken for Alzheimer’s is called multi-infarct dementia. For this condition, doctors can use blood thinners to keep the disease from progressing.
Memory loss can also be caused by tumors or dietary deficiencies, conditions that can be reversed before they become too damaging, said Dean Hartley, director of scientific initiatives for the Alzheimer’s Association.
Amyvid, the first drug of its kind, was approved for sale last year by U.S. regulators, and in January in Europe.
A panel of the Centers for Medicare and Medicaid Services said it wasn’t confident the tests would improve the health of people with Alzheimer’s. A final decision will come July 9.