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Insurance Decision Expands Access to Prostatic Urethral Device for Treating BPH

July 7, 2016 By NeoTract, Inc.

Medicare, Medicaid and some commercial insurance companies have decided to expand coverage access to NeoTract, Inc.’s UroLift prostatic urethral lift as a covered benefit, expanding availability of the device to  men in more than a dozen states.

The minimally invasive implant is designed as an early treatment option for men who don’t respond well to medical therapy for some enlarged prostate issues. 

The positive coverage decision was issued by Medicare administrative contractor National Government Services, Inc. for beneficiaries in the states of Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont and Wisconsin.

The UroLift system was also made available to beneficiaries of independent networks, such as Kaiser Permanente and SelectHealth, as well as numerous Blue Cross Blue Shield plans, such as CareFirst, Highmark, Louisiana, Nebraska and South Carolina.

Benign prostatic hyperplasia (BPH), also known as enlarged prostate, affects more than 37 million men in the United States alone. Much more prevalent than prostate cancer, BPH occurs when the prostate gland that surrounds the male urethra becomes enlarged with advancing age and begins to obstruct the urinary system.

The device, which does not require cutting, heating or removal of the prostate tissue, lifts and holds the enlarged prostate tissue out of the way so it no longer blocks the urethra.

Symptoms of BPH often include sleepless nights and urinary problems, and can cause loss of productivity, depression and decreased quality of life. Medication is often the first-line therapy for enlarged prostate, but relief can be inadequate and temporary.

Side effects of medication treatment can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using the drugs. For those patients, the classic alternative is surgery that cuts, burns or ablates prostate tissue to open the blocked urethra.

While current surgical options can be very effective in relieving symptoms, they can also leave patients with permanent side effects such as urinary incontinence, erectile dysfunction and retrograde ejaculation (dry orgasm).

The FDA-cleared UroLift permanent implants, delivered during a minimally invasive transurethral outpatient procedure, relieve prostate obstruction and open the urethra directly.

Clinical data from a pivotal 206-patient randomized controlled study showed that patients with enlarged prostate receiving UroLift implants reported rapid and durable symptomatic and urinary flow rate improvement without compromising sexual function. Patients also experienced a significant improvement in quality of life.

The most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure, according to NeoTract, Inc. 

The system is available in the U.S., Europe, Australia and Canada.

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