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.
