After pressure from SNMMI, Aetna expands coverage of gallium-68 dotatate PET

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) announced this week that Aetna has expanded its coverage of gallium-68 (Ga-68) dotatate PET. Aetna had previously ruled that the radiopharmaceutical was “experimental and investigational” for neuroendocrine tumors, but it is now considered “medically necessary.”

The updated clinical policy bulletin (CPB) is available on Aetna’s website.

“This CPB is revised to state that gallium Ga-68 dotatate PET (NETSPOT) is considered medically necessary for diagnosis, staging and restaging of persons with primary and metastatic neuroendocrine tumors bearing somatostatin receptors when criteria are met,” Aetna said in a note accompanying the update.

SNMMI pushed for this change back in April, writing a letter that detailed why its members believed Aetna’s decision was wrong.