Monday, May 18, 2015

Power Morcellators: Insurance Companies No Longer Covering the Procedures

Aetna, the nation's third-largest health insurer, announced that as of May 15, it will curb coverage of laparoscopic power morcellation in hysterectomies or for removing uterine fibroids "because the safety and efficacy of this approach has not been demonstrated." The procedure involves using a tube shaped tool to remove uterine fibroids or the entire uterus in less-invasive surgeries than standard abdominal procedures. Surgeons use the tools to grind and shred uterine tissue so it can be removed through a small incision in the abdomen.

Aetna will make limited exceptions for the procedure including for pre-menopausal women who want to maintain their fertility and for those that other treatment would be a life threatening risk.
The danger is that occasionally, a cancerous growth is undetected and seemingly benign when it is removed. Slicing up the growth into small pieces could disperse cancerous flesh in a woman's body, decreasing the likelihood a woman could survive the cancer in the long run.

In November of 2014, the FDA issued a warning against using laparoscopic power morcellators in removing a uterus or removal of fibroids. In its warning, the FDA estimated one in 350 women undergoing hysterectomy or myomectomy for the treatment of fibroids has "unsuspected uterine sarcoma," a type of cancer that appears to be a benign growth.

Some regional health insurers have stopped covering hysterectomies and myomectomies by power morcellation altogether. For example, Blue Cross Blue Shield in Massachusetts stopped covering the procedures on September 1, 2014.

A number of lawsuits have been filed throughout the country on behalf of women who claim to have been injured by this procedure. An MDL has not been set up yet, but depending on if the number of filed claims grows, one could be on the horizon. A number of different pharmaceutical companies who manufacture morcellators including Johnson & Johnson, Richard Wolf Medical Instruments, and Gyrus ACMI have been named as defendants.