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 Joint Arthroplasty: Freestanding ASC in Illinois

Study Methods

  • 115 adult patients undergoing total joint arthroplasty (TJA)
    • 37 total hip arthroplasties (THAs)
    • 53 total knee arthroscopies (TKAs)
    • 25 unicompartmental knee arthroplasties (UKAs)
  • Retrospective cohort review

Safety Outcomes

  • There was 1 incident of a 30-day complication
    • Intertrochanteric femur fracture treated with nonsurgical management
  • There were 4 incidents of 90-day complications
    • 2 incidents of arthrofibrosis treated with manipulation under anesthesia
    • 1 incident of patellar tendon rupture during therapy treated with surgical repair
    • 1 incident of hematogenous infection treated with a 2-stage exchange arthroplasty
  • There were 0 incidents of intrasurgical complications, blood transfusions, hospital admissions, adverse events within the ASC, venous thromboembolisms, or readmissions for postsurgical pain

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • 100%

    discharge rate
    to home for all
    patients

  • 135 minutes

    of average recovery time for hip procedures*

  • 132 minutes

    of average recovery time for knee procedures*

  • 0

    readmissions
    for postsurgical pain

 

TJA PROTOCOL (N=115)

  • Presurgical regimen of celecoxib, when not contraindicated, hydrocodone or oxycodone based on the surgeon’s preference, and gabapentin
  • Presurgical intravenous (IV) antibiotic administration
  • General anesthesia for all patients, with regional adductor blocks for patients undergoing TKA or UKA
  • Intrasurgical pericapsular injection of EXPAREL, epinephrine, morphine, bupivacaine, and ketorolac†
  • Intrasurgical IV or topical tranexamic acid based on the surgeon’s preference
  • Postsurgical pain management included celecoxib, oxycodone, or hydrocodone based on the surgeon’s preference with a minimization of IV narcotic administration
  • Prophylaxis for venous thromboembolism included enteric-coated aspirin 325 mg twice per day and mobile calf pumps, warfarin, or enoxaparin sodium based on the surgeon’s preference

*Recovery duration started with the transfer of the patient from the operating room to the postanesthesia care unit and concluded at the discharge of the patient from the ASC.

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

TJA, total joint arthroplasty; THA, total hip arthroplasty; TKA, total knee arthroplasty; UKA, unicondylar knee arthroplasty; ASC, ambulatory surgery center.

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