The Other Propofol Issue: When Insurance Should Pay for It

Published On: August 6th, 2009

Abuse of propofol, the sedative that may have played a role in Michael Jackson’s death, is rising among medical professionals, the WSJ reports today. That’s led to pressure for the government to restrict the drug, sold under the brand-name Diprivan, as a controlled substance.

Meanwhile, another fight over propofol has been going on for years: Whether insurers should pay for the drug to be used to sedate patients undergoing colonoscopies. Use of the drug can add several hundred dollars to the cost of the procedure, particularly if an anesthesiologist is present to administer it.

Last year, Aetna announced a plan to cut back on its coverage of propofol for colonoscopies — then retreated from the plan a few weeks later. This issue goes at least as far back as 2005, when the WSJ reported that WellPoint, which owns several Blue Cross plans, was changing its policies on the subject.

The issue may ultimately be resolved by technology: In May, an FDA advisory committee recommended approval of a J&J device called Sedasys, which is supposed to allow the administration of propofol without an anesthesiologist.

Photo: Associated Press

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The Other Propofol Issue: When Insurance Should Pay for It

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