Nurse and patient smiling as patient is discharged from hospital post-nerve block surgery

Clinical and economic value outcomes with EXPAREL

Cost & Value

EXPAREL is available in 133 mg (10 mL) for $180.35 and 266 mg (20 mL) doses for $334.18. 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 length of stay (LOS). These, in turn, can lead to fewer patient complications and reduced hospital costs per patient.

Total Shoulder Arthroplasty or Rotator Cuff Repair1-3: 17 international study sites

Study Methods

  • 140 patients undergoing TSA or RCR who received EXPAREL (n=69) or placebo (n=71)
  • Phase 3 clinical trial

Safety Outcomes

  • 4 patients (3 in the EXPAREL group and 1 in the placebo group) experienced adverse events that were deemed unrelated to the study medication

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia
  • Significantly

    better pain control

    (P<0.0001)
    through 48 hours
    after surgery

    • Median time to return of sensory function with EXPAREL was 36 hours, which was significantly longer than placebo (P<0.0001), and median time to return of motor function was 24 hours with both EXPAREL and placebo
  • 78%

    reduction in opioid
    use through 48 hours
    (P<0.0001)

  • 13%

    of patients opioid free compared with 1% with placebo at 48 hours
    (P=0.008)

 

TSA OR RCR

  • Preoperative regimen
    • Low-dose aspirin for cardioprotection and oral or intravenous acetaminophen 1000 mg every 8 hours
    • Patients randomized 1:1:1 to EXPAREL 266 mg, EXPAREL 133 mg, or matching placebo (20 mL total volume for each). Randomization to EXPAREL 266 mg stopped after sufficient patients (n=15) were selected for pharmacokinetic assessment
  • Postsurgical regimen
    • Rescue medication only given based on patient request
      • Oral immediate-release oxycodone ≤10 mg every 4 hours or as needed and 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

RCR, rotator cuff repair; TSA, total shoulder arthroplasty.