Nation’s Third-Largest Health Insurer Restricts Power Morcellator Coverage

Published on May 6, 2015 by Sandy Liebhard

Aetna, Inc. announced yesterday that it will no longer routinely cover hysterectomies and myomectomies that involve the use of a power morcellator. With more than 23 million members, Aetna is the nation’s third-largest insurer, according to a report published by The Wall Street Journal.

Aetna Cites FDA Morcellator Warnings

In changing its coverage requirements, Aetna cited recent warnings from the U.S. Food & Drug Administration (FDA) regarding the potential for power morcellators to spread and upstage undetected uterine cancers present in tissue and fibroids. The FDA now estimates that approximately 1 in 350 women undergoing hysterectomy or myomectomy for the treatment of fibroids actually have undiagnosed uterine sarcoma, which is higher than previously thought.

Aetna’s new uterine morcellation policy will allow physicians to seek exceptions for pre-menopausal women who want to preserve fertility and have no other effective option or women for whom another type of procedure would be too risky.

According to The Wall Street Journal, Aetna is just the latest health insurer curtail coverage for power morcellator surgeries. In total, health plans covering some 93 million people have implemented changes that have contributed to a shift away from such procedures. A number of hospitals have also banned uterine morcellation, while Johnson & Johnson’s Ethicon division stopped selling the devices.

After conducting its own review, the FDA opted not to ban power morcellators. However, it has advised doctors to avoid their use in the majority of women who require hysterectomies and myomectomies. The agency also ordered morcellator manufacturers to add a black box warning to their product labels regarding their potential to spread undetected uterine cancer cells.

Morcellator Jury Trial Scheduled

A number of power morcellator lawsuits have also been filed in U.S. courts on behalf of women who allegedly experienced the spread of uterine sarcomas due to the devices. Court documents indicate that the first trial involving such a claim is scheduled to get underway this November.