Friday, December 28, 2007

Aetna to End Payment for a Drug in Colonoscopies

Talk about a pain in the rear (bad pun intended)...

Posted by JoshMD | link | Comments (11) | Submit Aetna to End Payment for a Drug in Colonoscopies to del.icio.us Submit Aetna to End Payment for a Drug in Colonoscopies to digg Submit Aetna to End Payment for a Drug in Colonoscopies to reddit Submit Aetna to End Payment for a Drug in Colonoscopies to StumbleUpon


Comments:
Am I missing something? I've had several colonoscopies, always using fentanyl and Versed (wonderful stuff). Is there some reason why those are not acceptable alternatives? The article makes it sound like it's this drug or nothing. Are they really proposing doing colonoscopies on fully conscious patients rather than paying for this drug, or did I misunderstand?
# posted by Blogger LisaMarie : 3:01 PM
 
Conscious sedation doesn't work for me, once you hit my ileum. Not covering propofol would be enough to cause me to drop them like a bad habit. A hot knife slowly working its way through my insides is not something I need to experience again.

Lucky for me, Aetna is not my insurer. :)
# posted by Anonymous Dustball : 5:02 PM
 
The US rate of cancer deaths took an even more rapid decline last year than expected, with early treatment of colon cancer being the main factor in this spectacular improvement. Aetna, a notorious third rate insurance company, takes its lead seemingly from the British National Health Service, with its worst in Europe level of cancer prevention/treatment and horrific survival rates.

There is no way I would have my next colonoscopy without
A) propofol (dirt cheap)
B) an anesthesiologist (worth every penny)

Ed Sodaro MD
# posted by Anonymous Anonymous : 8:12 PM
 
I have had multiple endoscopies and colonoscopies with just Versed, never with propofol or an anesthesiologist. I don't either are necessary in most cases, however I am not opposed to people being able to pay out of pocket if they desire such and there is not a medical indication.
# posted by Anonymous Anonymous : 2:22 PM
 
I dont even know what this drug is.I have EGDs every 3 months (barrett's and dysplasia) and colonoscopies every 2 years. I have always had versed and demerol and have not ever had a problem with them. My GI doc administers them.

Now, if they stop all sedation whatsoever then I guess I will die of cancer, because i absolutely would not be having these tests with NO sedation.
# posted by Anonymous Anonymous : 1:04 AM
 
I don't think propofol is being used for my patients having colonoscopy either (I practice GIM in WA state). They don't c/o pain due to the procedure (leading me to conclude that the gastroenterologists doing these procedures are pretty good), they just hate the prep (that's pretty universal). I say that if a patient wants propofol let him/her pay for it! It's not just the drug that costs something, it may also be associated monitoring and administrative fees.
# posted by Blogger janemariemd : 12:03 PM
 
I had one done with NO sedation at all and it was the worst pain I have ever experienced. I thought my abdomen was about to explode. I thought it was just standard procedure since it was my first one (I'm 26) until a friend had one a month later with a different doc and he sedated. Later I found out the other GI docs in town thought my doc was a sadist.
# posted by Anonymous Anonymous : 12:57 AM
 
The Times corrects, to its credit, a misclassification of Versed as a narcotic instead of a sedative. Then they let stand this dumbs**t statement: "In the traditional colonoscopy, patients are given a combination of a sedative, like Versed, and a tranquilizer, like Valium." If they are not given propofol, they are given a sedative, such as Versed, and a narcotic, such as fentanyl. They can't get much of anything right, and they expect people to believe anything that they publish. Sad.
# posted by Anonymous Anonymous : 9:05 AM
 
Generally speaking, conscious sedation works for older folks more effectively than it does for people in their mid-20s (like myself) and for folks who don't need ileocolonoscopies.

I wouldn't wish conscious sedation on my worst enemy if s/he had terminal ileitis. (Or the nursing staff.) I distinctly remember trying to claw my way off the table, and biting the (large) nurse who held me down.

Conscious sedation is really not an option for me, and for a small percentage of folks. So I don't have a problem with restricting the usage of propofol (CRNAs aren't cheap), but I don't think Aetna should be outright not covering this because it would cause a lot of folks to not have these *preventative* procedures.

A CRNA for a 20 minute procedure costs far less than treating advanced colorectal cancer.
# posted by Anonymous RJS : 1:06 PM
 
It is true that younger people do seem to have more anxiety than, say, an elderly vet. My first colonoscopy (to the distal ileum) in my late 20's I had versed (4mg) and demerol. I was relatively comfortable and watched the procedure on the video moniter, at least as much as I remember.

Speaking of vets, "I distinctly remember trying to claw my way off the table, and biting the (large) nurse who held me down." reminds me of a recent experience my cat had at the vet!
# posted by Anonymous Anonymous : 11:23 PM
 
After my previous double endoscopy with fentanyl, I barfed for the next 12 hours, which really, really helped the gastritis for which I had the upper endoscopy (not). Unfortunately repeated colonoscopies are in my future due to polyps. This time I had propofol and had no problem. Another medical indication the insurance companies "forgot." They should have to have one themselves, then maybe they'd see the light.
# posted by Anonymous bev : 1:29 AM
 
Post a Comment