Bipartisan Group Moves to Expand Access to Diagnostic Radiopharmaceuticals

July 17, 2019

Legislation would restore patient access to innovative and cost-effective diagnostic tools

Reston, Virginia (July 17, 2019) – On July 16, Rep. Scott Peters (CA-52) and Rep. Bobby Rush (IL-01), along with Rep. George Holding (NC-02), introduced the bipartisan Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 (HR 3772). The bill would expand patient access to highly targeted, precision diagnostic radiopharmaceuticals that evaluate conditions such as Alzheimer’s disease, Parkinson’s disease, and some cancers—allowing patients to get the right treatment faster and saving taxpayers money.

In 2008, the Centers for Medicare and Medicaid Services (CMS) began treating diagnostic radiopharmaceuticals as supplies, bundling or “packaging” the drugs with the cost of the procedure in hospital outpatient settings. This decision created a reimbursement structure that limited patient access to innovative diagnostic tools and stifled innovation.

The new bill would ensure that hospitals receive adequate Medicare reimbursement to cover the high-value, low-volume diagnostic radiopharmaceuticals that are used in these nuclear medicine procedures, correcting a flawed payment philosophy and leaving hospitals free to perform the nuclear medicine procedures that patients need.

On July 17, 2019, SNMMI hosted a briefing on Capitol Hill with clinicians, patients, and industry representatives to discuss the importance of the bipartisan Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019.

Today SNMMI hosted a briefing on Capitol Hill with clinicians, patients, and industry representatives to discuss the importance of this legislation. Speakers included SNMMI President Vasken Dilsizian, professor of Radiology and Medicine at the University of Maryland Medical Center, and Josh Mailman, chairman of the SNMMI Patient Advocacy Advisory Board and president of NorCal CarciNET Community, as well as Terri Wilson, senior director of patient access and healthcare policy at Blue Earth Diagnostics and chair of the MITA Positron Emission Tomography Group.

“Diagnostic radiopharmaceuticals are incredibly effective in the diagnosis of a number of different diseases, including prostate cancer, Alzheimer’s and Parkinson’s disease, and others,” noted Dilsizian. “We’ve really only scratched the surface of potential with these technologies, and I expect we’ll see future improvements in these diagnostic tools if policy is adjusted to better reflect patient need.”

As a neuroendocrine tumor (NETS) patient, Mailman, offered a patient perspective on the benefits of radiopharmaceutical imaging. “Having advanced imaging available for neuroendocrine tumors patients is critical, as these advancements have helped clinicians determine the location and the extent of disease so they can better plan appropriate therapy for improved patient outcomes.”

SNMMI will begin a letter-writing campaign upon introduction of the bill and asks patients and the nuclear medicine and molecular imaging community to participate. For more information, contact Dalton Clark, manager of government affairs for SNMMI.

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About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine and molecular imaging—precision medicine that allows diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes. For more information, visit www.snmmi.org.