I received an email from Dr.Sardi in regards to the fact that CIGNA insurance no longer considers cytoreduction surgery and HIPEC for PMP (jelly belly) experimental and will pay for the procedure now. It is a victory! They had previously refused to cover the procedure as they deemed it experimental.
I was a bit disappointed, though, that they will only cover it for PMP (mucinous tumors), though CRS/HIPEC are used with good results for several other peritoneal surface malignancies (cancers that have spread into the abdomen), including primary peritoneal, ovarian, gastric and colon cancers. It will not cover appendix cancer tumors that are not mucous producing. Part of why they will not cover these procedures was stated on their site. In referring to other clinical trials, they stated:
” It was noted that patient selection criteria differed between centers and individual trials. Also each treatment center prescribed different chemotherapy regimens and varied in the amount of detail reported.”
Again, we need all of the surgeons to be on the same page, to agree on a standardized treatment protocols and to use the same techniques and procedures. Insurance companies want one standard of care to be proven effective in trials before they will provide coverage. That is the purpose of the American Society of Peritoneal Surface Malignancies, to standardize CRS and HIPEC.
For what it’s worth, it would probably be a good thing if you are looking for a surgeon to choose one that belongs to this organization, many of the prominent HIPEC surgeons are members. I have the list of members for the ASPSM here. The list is international, I have my own list and I need to edit it to separate US vs. international members, but for now this is the list on the ASPSM site (note though I am not a surgeon, I am listed as a member! And proud of that! :).