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Aetna Ends Coverage of Procedure

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From Reuters

Aetna U.S. Healthcare, a unit of insurance giant Aetna Inc., said Wednesday that it will end coverage of bone marrow transplants for patients with breast cancer unless they are in a federal research study.

The transplants are done as part of a last-ditch therapy in which the body is blitzed with extremely high doses of toxic drugs. This is meant to kill the cancer, but it also kills off the bone marrow.

It has always been controversial and became more so after the South African researcher who did a study supporting the approach admitted he had made up some data.

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The South African research was “completely fabricated, and it has put a damper on that concept that this was an effective treatment,” said Dr. Joseph Carver, senior medical director at Aetna U.S. Healthcare in Blue Bell, Penn.

Four other studies, released in April, found no difference in survival between breast cancer patients who underwent the procedure and those who tried less risky treatment. Those findings prompted top cancer specialists to conclude that, at least for patients with advanced breast cancer, a bone marrow transplant is not a good option.

“This appears to be a reasonable decision given the lack of evidence that bone marrow transplant is a benefit,” said Dr. Harmon Eyre, chief medical officer of the American Cancer Society.

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Bone marrow transplants usually cost at least $100,000.

The insurer will continue to pay for bone marrow transplants for other illnesses such as leukemia, in which studies have proved their effectiveness.

Shares of Hartford-based Aetna rose $1.38 to close at $41.38 on the New York Stock Exchange.

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