Thanks to Tall_Allen I have learned about the necessity of both PSMA and FDG PET CT in screening for Pluvicto.
I got referral for my dad for both screenings and ok, there is PSMA PET CT and than on referral from oncologist for FDG it is written: PET CT with 18F - FDG.
Is this referral for FDG PET CT with 18F correct? Or it should be without fluorodeoxyglucose?
There is no experience in our country with this process so I would like to double check not to take my dad to the wrong screening.
Thank you in advance
Written by
MyDad76
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I wish I could get my MO or RO to order a FDG PET scan.
I guess it is not written in the SOC so they come up with all these excuses and it never gets ordered. Their favorite objection is that it needs pre-authorization -- but I'm on standard Medicare with full supplemental so there is no pre-authorization. But URMC is a medical school so they have a huge problem doing anything not explicitly laid out in the SOC for a particular treatment.
To my amazement they are completely unaware of the difference between private insurance, standard Medicare and Medicare Advantage (I think that means advantage to the insurance company, right?); so it's a battle over things that shouldn't be. And I'm just too tired of it all to battle again.
Based on my experiences URMC generally views patients as inconveniences to be suffered in order to get paid. SMH
I understand the argument against FDG. The VISION trial, which did not include FDG, found a benefit to PSMA alone in determining whether Pluvicto will work. Because it did not explore discordant subgroups, it is not a requirement for patient selection. OTOH, the Australians (who advocate FDG too), are saying that some patients can be spared the side effects of Pluvicto.
I’m with you and the Australians. Yes, that’s exactly right, TA. They base their decision on VISION, Phase 3. Unfortunately, many will be denied FDG here in The US
My PSMA came up negative, so my MO suggested an FDG. It picked up 4 bone mets, so I am discordant. My United HealthCare Advantage plan covered both. Still waiting on the co-pay amounts on them, but in a conversation with a UHC rep I was told the cost would only be the $105 as spelled out in their literature.
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