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 Knee Arthroplasty: 16 US centers

Study Methods

  • 139 patients who received a TKA, with 70 receiving EXPAREL and 69 who did not
  • Phase 4 clinical trial

Safety Outcomes

  • Both treatments were well tolerated, with most adverse events mild or moderate. One patient in each group experienced a serious adverse event, with both events deemed unrelated to the study medication

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • Significantly

    better pain control

    (P=0.0381)
    12 to 48 hours
    after surgery*

  • 78%

    reduction in opioid
    use 0 to 48 hours
    after surgery
    (P=0.0048)†

  • 10%

    of patients
    free of opioids
    at 72 hours
    (P<0.01)‡

 

TKA (N=139)

  • Preoperative regimen
    • Acetaminophen 1000 mg, celecoxib 200 mg, oral pregabalin 300 mg, and intravenous tranexamic acid 1 g within 4 hours before surgery
  • Intraoperative regimen
    • Fentanyl or its analog
  • Postsurgical regimen
    • Oral acetaminophen 975 to 1000 mg every 8 hours, oral celecoxib 200 mg every 12 hours, rescue analgesics as needed (oral immediate-release oxycodone ≤10 mg every 4 hours or as needed, intravenous morphine 2.5 to 5 mg or hydromorphone 0.5 to 1 mg every 4 hours or as needed if oral medication was not tolerated). Rescue medications were received upon patient request for analgesia

TKA WITH EXPAREL (n=70)

  • Local infiltration with EXPAREL 266 mg/20 mL admixed with bupivacaine HCl 0.5%, 20 mL, expanded with saline to a total volume of 120 mL

TKA WITHOUT EXPAREL (n=69)

  • Local infiltration with bupivacaine HCl 0.5%, 20 mL, expanded with saline to a total volume of 120 mL

*Pain measured using visual analog scale.

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

‡Compared with 0% of patients who received bupivacaine HCl alone.

TKA, total knee arthroplasty.

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