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 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

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

AE, adverse event; ASC, ambulatory surgery center; ERAS, enhanced recovery after surgery; THA, total hip arthroplasty; TJA, total joint arthroplasty; TKA, total knee arthroplasty.

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