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Aetna Stops Coverage of Morcellation

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Aetna, Inc. has announced that the company officially stopped covering routine use of the laparoscopic power morcellator on May 15, according to a report in the Wall Street Journal.

What are Power Morcellators?

Power morcellators are minimally invasive tools used to remove common uterine growths known as fibroids during procedures such as hysterectomies. The devices can cut the sometimes large, bulky growths into smaller pieces so that they can be removed through small incisions.

However, because deadly cancers can appear as benign tumors and there is no conclusive way to diagnose uterine cancer before using morcellator devices, when the tissue is ground up, any undetected uterine cancer cells can be spread, leading to rapid upstaging of the disease. As a result, power morcellation has come under growing scrutiny and prompted numerous power morcellator lawsuits.

Morcellation Use Restricted

In 2014, the U.S. Food and Drug Administration (FDA) warned that patients undergoing hysterectomies or fibroid removal surgery have an estimated 1 in 350 risk of harboring dangerous cancers known as sarcomas, a significantly higher rate than was previously known. In November, the FDA recommended that power morcellators not be used on most female patients, and asked device companies to add a black box warning concerning the risks.

Hartford, Connecticut-based Aetna is the third-largest health insurance provider in the U.S. with about 23 million members. The company plans to require doctors to obtain prior approval for any procedure that would involve morcellation. Doctors will be able to request exemptions for premenopausal women who want to preserve fertility and have no other effective surgical option.

Although many clinics and hospitals have discontinued or limited the use of morcellators and Johnson & Johnson, the largest former manufacturer of power morcellators, left the market in 2014, the devices remain available through other companies. The FDA decided not to completely ban morcellators, but doctors are understandably moving away from their use as other health insurers are starting to follow Aetna’s lead.