Hysterectomies and fibroid removal surgeries that involve the use of a power morcellator have been on the decline since U.S. health regulators first warned that the surgical tools might cause the spread of undiagnosed uterine cancers. But now a new Wall Street Journal report suggests that the trend will continue, and possibly accelerate, as a growing list of health insurers consider new coverage limits for uterine morcellation.
As the April 2nd article points out, power morcellation was once a popular option for women in need of hysterectomies or myomectomies, as the devices allow tissue to be removed via a small incision in the abdomen. Patients who underwent these minimally-invasive surgeries could expect less scarring and much shorter recovery times than those who underwent traditional, open procedures. However, in April 2014, the U.S. Food & Drug Administration (FDA) discouraged doctors from using power morcellators in gynecological surgeries due to their potential to spread undetected cancer cells that are sometimes present in uterine tissue in and fibroids. In November 2014, the FDA issued a second alert, warning that power morcellators should not be used in the vast majority of women who require a hysterectomy or myomectomy.
The concerns over power morcellators and cancer soon had insurers rethinking their coverage. According to the Journal, United Health Group, Highmark, Inc., UPMC Health Plan all ended coverage for uterine morcellation in the wake of the FDA’s first alert. Medicaid Insurer AmeriHealth Carita deemed power morcellator use investigational and not medically necessary as of January 1st. Other insurers considering coverage limits include Aetna, Cigna and Health Care Services Group. In total, insurance companies covering about 93 million Americans have restricted power morcellation or are considering their own limits.
Since the devices began attracting scrutiny, numerous power morcellator lawsuits have been filed in U.S. courts on behalf of patients or their survivors, all which accuse manufacturers of failing to warn that morcellation could disseminate undetected cancer cells and greatly reduce a woman’s chances of long-term survival. Court documents pending in the U.S. District Court, Eastern District of Pennsylvania, indicate that the first jury trial involving such a lawsuit is scheduled to begin in November 2015. The case, which names LINA Medical as a defendant, was filed by a Pennsylvania man who lost his wife to metastatic leiomyosarcoma, a rare and aggressive form of uterine cancer. She was diagnosed with the disease after undergoing uterine morcellation in 2013.