SNMMI recommends Aetna reverse 2 PET coverage decisions

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) has issued a statement recommending Aetna reverse its decision not to cover the use of gallium Ga 68 dotatate PET or fluciclovine F18 PET for treating cancer patients.

The group composed two separate letters to Aetna, one focused on gallium Ga 68 dotatate PET and the other focused on fluciclovine F18 PET.

SNMMI’s letter regarding gallium Ga 68 dotatate PET is available here. The letter details why the group’s members don’t believe Aetna’s decision—that the radiopharmaceutical is “experimental and investigational for neuroendocrine tumors and for all other indications”—lines up with recent evidence recognized by both the FDA and the National Comprehensive Cancer Network. (NCCN).

SNMMI’s letter regarding fluciclovine F18 PET is available here. The letter details why the group’s members don’t believe Aetna’s decision—that the PET imaging agent is “experimental and investigational for prostate cancer and for all other indications”—lines up with recent evidence recognized by, again, the FDA and the NCCN.

“We know that Aetna wants to be known for allowing its beneficiaries access to state-of-the-art care, and we believe the company will modify this coverage policy in that spirit,” SNMMI said in its statement.

The Aetna policy statement in question can be read on the insurance company’s website.