University of Virginia, Charlottesville, VA 22209, USA.
J Am Coll Radiol. 2012 Feb;9(2):108-14. doi: 10.1016/j.jacr.2011.10.011. Epub 2011 Dec 20.
PET and PET/CT have revolutionized the diagnosis, staging, and monitoring of treatment effect or recurrence for a wide range of cancers and shown promise for improving health outcomes for patients with cardiovascular and central nervous system diseases. However, this technology is challenged by insurance coverage policies that hinder patients' access to PET and discourage technologic innovation. Recently, the Medical Imaging & Technology Alliance (MITA), a Washington-based industry association, convened a workshop to consider new pathways for making decisions on Medicare coverage of new PET radiopharmaceuticals and imaging procedures that are currently subject to a national noncoverage decision, or "exclusionary rule." Stakeholders from the government, medical professional societies, academia, patient groups, and industry gathered to brainstorm alternatives to the national noncoverage decision and evaluate their potential to improve access and enhance innovation. Ultimately, MITA, on behalf of the PET community, expects to use the outcomes of the workshop to propose that the Centers for Medicare and Medicaid Services reconsider this current national noncoverage decision for PET and adopt a new framework for coverage.
正电子发射断层扫描（PET）和正电子发射断层扫描/计算机断层扫描（PET/CT）已经彻底改变了广泛癌症的诊断、分期和治疗效果监测或复发监测，并有望改善心血管和中枢神经系统疾病患者的健康结果。然而，该技术受到保险覆盖政策的挑战，这些政策阻碍了患者获得 PET 的机会，并抑制了技术创新。最近，总部位于华盛顿的行业协会医学影像与技术联盟（MITA）召集了一次研讨会，考虑为医疗保险对目前受国家非覆盖决定（“排除规则”）约束的新正电子放射性药物和成像程序的覆盖范围做出决策的新途径。来自政府、医学专业协会、学术界、患者团体和行业的利益相关者聚集在一起，集思广益，寻找替代国家非覆盖决定的方案，并评估其改善准入和增强创新的潜力。最终，MITA 将代表 PET 社区，希望利用研讨会的成果提议医疗保险和医疗补助服务中心重新考虑目前针对 PET 的国家非覆盖决定，并采用新的覆盖范围框架。
