Optilume for treating recurrent bulbar urethral strictures

Resource impact summary report

Optilume is recommended as an option to treat recurrent bulbar urethral strictures in adults only if comparative data is collected on:

• patient-reported outcome measures
• reintervention rates.

The cost of a single use Optilume device is £1,350 per unit (excluding VAT). If use of Optilume results in reducing the number of repeat interventions, savings could be greater than the additional cost of treatment with Optilume compared with standard endoscopic procedures.

Expert clinical opinion is that savings could be further increased if Optilume is used in an outpatient setting which could also reduce waiting lists. However, the committee felt long-term data on recurrence is needed to improve the certainty of the cost savings associated with Optilume.

The company offers free training which includes an online education program, representative support and peer to peer training at an experienced Optilume user centre (if requested).

The potential benefits of implementing the guidance are that the use of Optilume may:

• provide an alternative minimally invasive treatment option
• reduce the frequency of stricture recurrence and the need for further treatment which could also reduce waiting lists
• delay or prevent the need for open surgical treatment (urethroplasty) in selected patients and be cost saving compared to urethroplasty
• be a preferred treatment option because it does not require a hospital stay, it has a reduced recovery time and may avoid using general anaesthesia
• be done as a day case and in an outpatient setting which could also reduce waiting lists
• be carried out in secondary care as opposed to urethroplasty which is carried out in tertiary care.

Due to the variability of current and future use of the treatment options and the uncertainty of potential reductions in healthcare resource interventions, a local resource impact template has been developed to allow users to estimate potential costs and benefits at a local level. The resource impact considers both the cash and non-cash impact of implementing the guidance given that not all the potential savings will be cash releasing.

Urology services are commissioned by integrated care systems. NHS England commissions urethroplasty. Potential savings as a results of using Optilume rather than urethroplasty will therefore benefit NHS England specialised commissioning.

Providers are NHS hospital trusts.