Aetna Ends Coverage for Anesthetic Used in Colonoscopies
Effective April 1, 2008, Aetna (NYSE: AET) will no longer cover an anesthetic commonly used during colonoscopies, a diagnostic tool used to detect colorectal cancer. Similar exclusions have already been implemented by WellPoint (NYSE: WLP) and Humana (NYSE: HUM).
The drug propofol, marketed under the trade name Diprivan, is used to thoroughly sedate patients so they won’t experience pain or discomfort during the procedure. Because a qualified anesthesiologist must be present to administer propofol, the drug typically adds about $400 to a colonoscopy’s total cost.
Several less expensive alternatives to propofol are already in use, but their effects can take hours longer to wear off meaning a longer recovery time for patients.
Doctors are expressing different ideas about what impact the coverage change will have on patient care. As their statements demonstrate, some believe it is a prudent cost-cutting measure while others are concerned the insurance companies overstepped their boundaries when they labeled the drug “medically unnecessary” for colonoscopies.
“Since this does not affect the great majority of patients who are having this done – painlessly and without recollection for the procedure I might add – this is not a bad thing as long as they cover it for the select few who need it. The money saved could be used to screen more individuals.”
Donald David, MD, FACG
Director of Gastroenterology
City of Hope National Medical Center
“I have had two colonoscopies, one with the usual moderate sedation. I was hung over for four to six hours afterward. The second was with propofol, and I was awake and fully aware within 15 minutes and went shopping with my wife right after we left the facility. That is the entire difference.”
Dr David Posner
Chief of Gastroenterology
Mercy Medical Center
Source: ABC News
Related Links: chicagotribune.com; Medicare
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Tags: AstraZeneca; general anesthesia; Medical University of South Carolina
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