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 Joint Arthroplasty Study1,2: Medicare and Commercial

Background

Two studies analyzed the impact that EXPAREL, as part of an ERAS pathway, had on same-day discharge. The Medicare-focused study analyzed the outcome and feasibility of same-day discharge using an ERAS protocol in the inpatient setting, while the commercial insurance-focused study analyzed outcomes in an ASC.

  • Medicare: Orthopedic center in Oregon
  • Commercial: ASC in Oregon

Study Methods

  • Medicare and Commercial: Retrospective chart review
  • Medicare: 601 unique patients who underwent primary TKA (n=337) or THA (n=308) with the use of EXPAREL
  • Commercial: 220 unique patients who underwent primary TKA (n=113) or THA (n=138) with the use of EXPAREL in a freestanding ASC

Safety Outcomes

  • Medicare: Within 30 days after surgery, 1.1% of patients experienced a severe AE and 0.5% of patients experienced a minor AE
  • Commercial: Within 30 days after surgery, 6 patients experienced a severe AE and 1 patient experienced a minor AE

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia
  • Same-day discharge

    Medicare

    • 84% of patients were discharged on the day of surgery

    Commercial

    • 100% of patients were discharged on the day of surgery
  • High pain management satisfaction

    Medicare

    • 98.3% of patients were “very much” or a “good amount” satisfied with pain management

    Commercial

    • 99.3% of patients were “very much” or a “good amount” satisfied with pain management
  • Postsurgical opioid use

    Medicare

    • 84.2% of patients did not require an opioid prescription beyond the initial 7-day prescription provided at discharge*
 

TJA: MEDICARE (N=601) AND COMMERCIAL (N=220)

  • Individualized preoperative opioid analgesia protocol
  • Non-opioid analgesia protocol consisting of acetaminophen, meloxicam, or celecoxib utilized 1 week before surgery and for 6 weeks after surgery
  • Spinal anesthesia
  • Periarticular infiltration with EXPAREL 266 mg, bupivacaine HCl, and adjuncts
  • Restricted intravenous opioids during surgery

THA: MEDICARE (n=308) AND COMMERCIAL (n=138)

  • Anterior lateral femoral cutaneous nerve field block with EXPAREL 266 mg and bupivacaine HCl

TKA: MEDICARE (n=337) AND COMMERCIAL (n=113)

  • Adductor canal block with bupivacaine HCl

AE=adverse event; ASC=ambulatory surgery center; ERAS=enhanced recovery after surgery; THA=total hip arthroplasty; TJA=total joint arthroplasty; TKA=total knee arthroplasty.
*The clinical benefit of the decrease in opioid consumption was not demonstrated in pivotal trials.