[MOL] Medicare will pick up most PET SCANs Cost.... [00596] Medicine On Line

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[MOL] Medicare will pick up most PET SCANs Cost....

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----- Original Message -----
From: "Croft, Barbara (NCI)" <croftb@dtpepn.nci.nih.gov>
To: <pet_mail@wfubmc.edu>
Sent: Monday, December 18, 2000 7:36 AM
Subject: pet_mail Washington Post, Saturday, December 16, 2000

> (submitted:  Mon, 18 Dec 2000 09:37:05 -0500)
> Medicare to Pay for Cancer Scan
> By David Brown
> Washington Post Staff Writer
> Saturday, December 16, 2000 ; Page A02
> The Medicare program said yesterday it will begin paying for an
> expensive
> test called positron emission tomography (PET) for
> use in the diagnosis of nearly half the cases of cancer each year in
> America's elderly.
> The decision could add hundreds of millions of dollars to the cost of
> the
> Medicare program. Each PET scan, which detects
> increased metabolic activity in cancerous tissue, costs about $2,000.
> The Health Care Financing Administration (HCFA), which oversees
> Medicare,
> had been heavily lobbied to add broad use of
> PET scanning to its menu of benefits. Early this month, 19 members of
> the
> Senate signed a letter to Donna E. Shalala, secretary
> of health and human services, urging expanded coverage of the
> technology.
> Yesterday's decision was a compromise between two extreme positions:
> giving
> doctors a blank check to use PET, or approving
> it only for the handful of uses in which its benefit has been proved
> beyond
> any doubt.
> The decision, whose details purposefully weren't released until after
> the
> stock market closed for the week, will take effect no
> later than next July.
> The University of California at Los Angeles last summer asked the HCFA
> to
> approve PET scanning in 20 different cancers, as
> well as in Alzheimer's disease and ischemic heart disease. Given the
> prevalence of those conditions in people over age 65, such
> broad coverage might quickly make PET scanning commonplace in the
> Medicare
> population.
> The HCFA approved PET for use in only six of the 20 cancers. However,
> within
> an approved cancer, a physician will basically
> be free to order it as he or she sees fit. The agency said it would pay
> for
> PET scanning as a backup diagnostic test in heart
> disease, and referred the Alzheimer's indication to an advisory
> committee
> for further study.
> "I'm ecstatic. This is really fantastic," said Michael Phelps, a chemist
> at
> UCLA, who invented PET in the 1970s and helped
> prepare the university's application.
> The chairman of the Medicare Coverage Advisory Committee, a group
> consisting
> mostly of academic physicians that provided
> general advice to the agency, also praised the ruling.
> "I think the folks at HCFA tried very hard to do this in the most
> scientifically sound way, under very pressing time circumstances
> . . . I think they did well," said Harold C. Sox, chairman of medicine
> at
> Dartmouth-Hitchcock Medical Center.
> PET scans do something that CAT and MRI scans don't. PET reveals
> function as
> well as anatomic shape and location of tissue.
> Specifically, it identifies tissue that absorbs radioactively labeled
> glucose molecules--glucose being the main fuel of living cells.
> No matter what organ they arise in, cancer cells consume glucose at
> roughly
> 20 times the rate of normal tissue. Because of that,
> malignant tumors "light up" on PET, often when they're still invisible
> in
> other scans.
> Medicare had previously agreed to pay for PET for very specific use in a
> few
> cancers where its benefit to patients had been
> proved by well-designed studies. Proponents said it was time to assume
> would be useful in virtually all cancers. They said
> Medicare should not wait for studies proving benefit in literally
> hundreds
> of different clinical scenarios.
> The HCFA concluded that if a well-designed study proved PET useful for a
> specific purpose in a specific cancer, then the
> agency would cover PET for other uses in that same cancer. For example,
> a
> study showed that PET helped doctors decide
> whether lung cancer patients were candidates for surgery. That was
> enough to
> persuade the HCFA to pay for PET scans for
> other reasons in lung cancer patients--for example, to look for
> recurrent
> cancer after surgery.
> The agency approved broad use of the technology in these cancers: lung,
> esophagus, colon and rectum, lymphoma, melanoma,
> and mouth and throat.
> Sean Tunis, a physician at the HCFA, said the agency had trouble
> determining
> when PET was of actual benefit to patients
> because research on that question was rarely done, or rarely done well.
> "As we increase our investment in producing new biomedical innovations,
> it
> really needs to be matched by a parallel increase in
> investment in good studies evaluating the clinical utility of those
> innovations," he said.
>                                       2000 The Washington Post
> Barbara Y. Croft, Ph.D.
> Biomedical Imaging Program
> National Cancer Institute
> 6130 Executive Blvd., EPN 6064
> Rockville, MD 20892-7440
> FedEx ZIP: 20852
> Phone: 301-496-9531
> FAX: 301-480-3507
> E-mail: bc129b@nih.govBarbara_Croft@nih.gov
> BIP Web Site: http://cancer.gov/bip
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We invite you to take a look at our Album.                                               
  ( Very informational, good tips, Molers pictures, art work and much more....