AbstractObjectivesWe aim to conduct an economic evaluation of the Optilume urethral drug‐coated balloon (DCB) compared with endoscopic management for the treatment of recurrent anterior male urethral stricture in England.Patients and MethodsA cohort Markov model was developed to estimate the costs and savings to the NHS over a 5‐year time horizon of adopting Optilume for the treatment of anterior urethral male stricture versus current endoscopic standard of care. A scenario analysis was conducted which compared Optilume to urethroplasty. Probabilistic and deterministic sensitivity analyses were performed to estimate the impact of uncertainties in model parameters.ResultsWhen compared with current endoscopic standard of care Optilume resulted in an estimated cost saving of £2502 per patient if introduced in the NHS for the treatment of recurrent anterior male urethral stricture. In the scenario analysis, the use of Optilume compared with urethroplasty resulted in an estimated cost saving of £243. Results were robust to changes in individual input parameters as demonstrated in the deterministic sensitivity analyses, with the monthly probability of symptom recurrence associated with endoscopic management the only exception. Probabilistic sensitivity analysis results demonstrated that Optilume was cost saving in 93.4% of model iterations, when running 1000 iterations.ConclusionOur analysis suggests that the Optilume urethral DCB treatment can be a cost‐saving alternative management option for the treatment of recurrent anterior male urethral stricture within the NHS in England.