Cost and Value

EXPAREL is available in 133 mg (10 mL) dose for $227.63 and 266 mg (20 mL) dose for $376.12. The 133 mg (10 mL) and 266 mg (20 mL) doses of EXPAREL are available in cartons of 4 and 10 vials. For more information please visit How to order EXPAREL.

Information below helps review the value of EXPAREL in a multimodal pain management protocol that can lead to fewer opioids,* better pain control, and shorter LOS. These, in turn, can lead to fewer patient complications and reduced hospital costs per patient.

Total Hip Arthroplasty: ASCs in Tennessee

Study Methods

  • 145 outpatient THAs in 125 patients performed with the use of EXPAREL by a single surgeon in 2 separate stand-alone ASCs
  • Retrospective chart review

Safety Outcomes

  • 1 recognized intraoperative fracture, which did not compromise same-day discharge
  • 5 unanticipated complications (3.4%) in global period postsurgery

Clinical and Economic Outcomes

In patients who received EXPAREL to manage pain after surgery

  • Complication rates

    compared favorably

    with those reported
    after standard
    inpatient THA

  • 99.3%

    of cases did not require a
    transfer to the hospital
    for transfusion

    • 0% of patients required other direct admissions to the hospital or ED

  • Average surgical time was

    71 minutes

    and total LOS was
    10.8 hours

  • 98%

    of cases did not require
    surgical intervention
    within a 90-day period

    • Persistent drainage 6 weeks postsurgery that required debridement/irrigation with head/liner exchange
    • Periprosthetic fracture from a same-level fall at home 7 days postsurgery that required revision surgery
    • Outpatient superficial wound revision, 4 weeks postsurgery
 

THA (N=145)

  • Preoperative regimen
    • Oral celecoxib 400 mg, gabapentin 300 mg, oxycodone 10 or 20 mg, and oral or intravenous acetaminophen 1000 mg
  • Intraoperative regimen
    • 0.75% bupivacaine with 8.25% dextrose 10 to 15 mg spinal, EXPAREL 266 mg infiltrated into wound, and intravenous dexamethasone 4 to 8 mg
  • Postsurgical regimen
    • Oral celecoxib 200 mg 4 times daily or meloxicam 7.5 mg 2 times daily, oral gabapentin 300 mg 2 times daily, oral tramadol 50 mg every 6 hours, oral acetaminophen 1000 mg every 8 hours, and oral oxycodone 5 to 10 mg every 4 to 6 hours as needed
  • Spinal anesthesia was used in 132 procedures with bupivacaine (10.5-15 mg) and general endotracheal anesthesia was used in 13 patients due to previous spinal fusion, preexisting neuropathy, or intraoperative conversion secondary to unsuccessful spinal anesthesia
  • Included 105 unilateral procedures and 20 bilateral procedures

*The clinical benefit of the decrease in opioid consumption was not demonstrated in the clinical trials.

ASC, ambulatory surgery center; ED, emergency department; LOS, length of stay; THA, total hip arthroplasty.

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