Cost and Value

EXPAREL is available in 133 mg (10 mL) dose for $189.37 and 266 mg (20 mL) dose for $344.20. 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.

Gynecologic Oncology Robotic-Assisted Hysterectomy: Medical center in Minnesota

Study Methods

  • 60 adult patients undergoing robotic-assisted hysterectomy: 30 received a transversus abdominis plane block with EXPAREL, and 30 did not receive a TAP block
  • Retrospective observational study
  • All patients received intraoperative and postsurgical opioids

Safety Outcomes

  • 3.3% of patients in the TAP block EXPAREL group had a postsurgical complication, compared with 20% in the group of patients who did not receive a TAP block

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • Significantly

    less pain

    (P=0.05)
    over first 24 hours after infiltration

    • 5 vs 7 on 11-point scale*
  • 16.2 hours

    shorter LOS

    • 11.5 vs 27.7 hours (P>0.0001)
  • 63%

    fewer occurrences
    of nausea or
    vomiting

    • 20% vs 53.3% (P=0.02)
 

HYSTERECTOMY WITHOUT TAP BLOCK (n=30)

  • Intraoperative and postsurgical opioid-based analgesia regimen

HYSTERECTOMY WITH TAP BLOCK AND EXPAREL (n=30)

  • Intraoperative and postsurgical opioid-based analgesia regimen
  • A subcostal TAP block was performed under ultrasound guidance with a 22-gauge 30º beveled needle. After the needle pierced the transversus abdominis fascia, three 10-mL syringes of local anesthetic were injected. The first syringe contained 10 mL of 0.25% bupivacaine with epinephrine (1:200,000), and the other 2 syringes each contained 5 mL of EXPAREL and 5 mL of 0.9% preservative-free normal saline
    • This process was repeated on the contralateral side

*Difference in pain scores remained statistically significant after adjustments for potential confounders (P=0.004).

The use of EXPAREL in combination with epinephrine is not part of the approved label.

TAP, transversus abdominis plane; LOS, length of stay.