The slippery slope of off-label promotion

November 6, 2008 The slippery slope of off-label promotion -- By Greg Freiherr When it comes to drugs, there is a huge gulf between off-label prescription and off-label promotion. One is legal, the other is not. For the most part, medical imaging doesn't get involved in either, although there are exceptions. Contrast-enhanced MR angiography is one. The first MR contrast agents were approved two decades ago, specifically to enhance cancer tumors of the central nervous system. Since then, their use has evolved beyond that narrow indication. In the absence of a commercially available blood pool contrast agent, radiologists began using CNS products to enhance MR angiograms. Their use has become so widespread, and so accepted, that third-party payers reimburse for these applications and equipment manufacturers optimize scanners to perform them.

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