Laborie's Optilume® Drug-Coated Balloon Gains Coverage from BCBSM
Laborie Medical Technologies has announced a significant development in patient care with the newly approved medical policy by Blue Cross Blue Shield of Michigan (BCBSM) effective July 1, 2025. The policy extends coverage for the
Optilume® Urethral Drug-Coated Balloon under the CPT code 52284, specifically for eligible Commercial HMO members, marking a vital step towards improving outcomes for those suffering from urethral strictures.
Understanding Urethral Strictures
Urethral strictures are conditions characterized by the narrowing of the urethra, which can lead to various complications such as weak urine flow, frequent urination, painful urination, recurrent infections, and even damage to the bladder or kidneys. Patients with this condition have historically faced limited options for effective treatment. With the endorsement of laborie's innovative Optilume® technology, those affected now have access to a proven and effective solution.
BCBSM's Medical Policy Statement
The BCBSM medical policy reflects a thorough evaluation of the Optilume®'s effectiveness, stating,
“The use of a drug-coated balloon catheter system (i.e., Optilume®) is considered established. The evidence is sufficient to determine that the technology results in an improvement in net health outcomes.” This highlights the confidence that BCBSM has in this cutting-edge treatment, reinforcing its commitment to providing quality care options for its members.
Clinical Evidence Supporting Optilume®
The decision for coverage is bolstered by robust evidence from the
ROBUST I and
ROBUST III clinical trials. These studies have demonstrated that Optilume® not only provides a minimally invasive alternative to traditional treatment methods but also shows significant improvements in patient outcomes. The results from these trials affirm that Optilume® is a durable solution for recurrent bulbar urethral strictures, showcasing its capacity to enhance patients’ overall health results.
Dr. Jason Hafron, CMO of Michigan Institute of Urology, expressed,
“Optilume appears to offer a safe and superior alternative to previous stricture treatments for our patients.” This treatment aligns seamlessly with BCBSM and the Michigan Institute of Urology’s dedication to delivering the highest quality of patient care.
Adhering to Urology Guidelines
Notably, the inclusion of Optilume® in BCBSM’s coverage also aligns with the latest guidelines from the
American Urological Association (AUA) and the
European Association of Urology (EAU). The AUA conditionally recommends drug-coated balloons for urethral strictures smaller than 3 cm, while the EAU supports their usage, especially after multiple unsuccessful endoscopic treatments. Such endorsements reflect the medical community's collective recognition of Optilume®'s benefits, thus warranting its coverage in various medical policies.
Impact on Patient Care
Dr. Jason Evans of Urological Services, P.C. in Flint, MI, emphasized the importance of such coverage, stating,
“Blue Cross Blue Shield of Michigan's decision to cover this procedure significantly enhances our ability to care for patients with urethral strictures.” This policy change eases access to superior treatment options, ultimately helping to mitigate the complications associated with untreated strictures.
Getting More Information
For those interested in understanding more about the new policy, providers are encouraged to review the BCBSM policy details, confirm patient eligibility, and reach out to BCBSM Provider Services for further assistance. For additional information on the Optilume® device, prospective patients and healthcare providers can visit
Optilume’s official website.
About Laborie Medical Technologies
Laborie Medical Technologies is a prominent global player headquartered in
Portsmouth, New Hampshire, specializing in medical products for Urology, Urogynecology, and related fields. They are committed to developing high-quality diagnostic and therapeutic solutions aimed at restoring patient dignity and improving lives. As a portfolio company of
Patricia Industries, they continue to lead in clinical education, providing robust support for both practitioners and hospitals alike.
In conclusion, this policy update from
BCBSM resonates as a meaningful milestone in urological care and reflects the ongoing commitment to leveraging advanced medical technologies for enhanced patient outcomes.