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EXPAREL Access

Clinical and economic updates are improving patient access to non-opioids like EXPAREL.

Why EXPAREL? Why Now?

Established Clinical Benefits
  • EXPAREL uses pMVL technology to control postsurgical pain for up to 96 hours1-7
  • EXPAREL is proven to reduce opioid use2,3,8*
  • EXPAREL established reductions in the need for rescue pain medications, supporting a faster and more comfortable recovery2,3,8
  • EXPAREL demonstrated superiority vs bupivacaine HCl in 2 LENB pivotal trials and a phase 4 local infiltration study in total knee arthroplasty (TKA)2,3,5†
Improved Economic Value
  • A permanent J-code (J0666) supports predictable reimbursement in ASC and HOPD settings9-11
  • Recent real-world studies reinforce the economic benefits of EXPAREL for both inpatient and outpatient surgeries12-14
  • Separate reimbursement for both Medicare patients (via the NOPAIN Act) and major national commercial plans provides additional cost offsets9-11,15
  • GPO contracts and 340B pricing further reduce overall costs

For additional scientific information regarding EXPAREL, please visit medinfo.pacira.com or call (855) 793-9727.

*The clinical benefit of the decrease in opioid consumption was not demonstrated in the pivotal trials.
†EXPAREL showed superiority to bupivacaine in the adductor canal nerve block pivotal trial and the sciatic nerve block in the popliteal fossa pivotal trial.

ASC, ambulatory surgical center; GPO, group purchasing organization; HCl, hydrochloride; HOPD, hospital outpatient department; LENB, lower-extremity nerve block; NOPAIN, Non-Opioids Prevent Addiction in the Nation; pMVL, proprietary multivesicular liposome; TKA, total knee arthroplasty.

References
  1. Dagenais S, et al. Exp Opin Drug Safety. 2018;17(6):545-552. https://doi.org/10.1080/14740338.2018.1474200;
  2. Schwartz G, et al. J Clin Anesth. 2024;94:111402. doi:10.1016/j.jclinane.2024.111402;
  3. Gadsden J, et al. Poster presented at: 48th Annual Regional Anesthesiology and Acute Pain Medicine Meeting; April 20, 2023; Hollywood, FL. Poster 4381.
  4. Patel MA, et al. Pain Med. 2020;21(2):387-400. doi:10.1093/pm/pnz103;
  5. Mont MA, et al. J Arthroplasty. 2018;33(1):90-96. doi:10.1016/j.arth.2017.07.024;
  6. Golf M, et al. Adv Ther. 2011;28(9):776-788.
  7. Gorfine SR, et al. Dis Colon Rectum. 2011;54(12):1552-1559.
  8. Dobson A, et al. J Med Econ. 2021;24(1):9931001. doi:10.1080/13696998.202.1963100;
  9. Consolidated Appropriations Act 2023. Accessed October 31, 2024. https://www.congress.gov/117/bills/hr2617/BILLS-117hr2617enr.pdf;
  10. CMS.gov. 2024. Accessed June 4, 2024. https://www.cms.gov/medicare/payment/fee-forservice-providers/part-b-drugs/average-drug-sales-price;
  11. CMS.gov. Published October 10, 2024. Accessed January 30, 2025. https://www.cms.gov/files/document/2024-hcpcs-applicationsummaryquarter-3-2024-drugs-and-biologicals-posted-10-02-2024.pdf;
  12. Tran J, et al. J Surg Res. 2022;272:175-183. doi:10.1016/j.jss.2021.12.002;
  13. Mont MA, et al. AMCP Nexus 2025: October 27–30, 2025; National Harbor, MD.
  14. Abboud Poster presented at the AMCP Nexus 2025; October 27–30, 2025; National Harbor, MD.
  15. Data on File. 15043. Parsippany, NJ: Pacira BioSciences, Inc.; July 2025.

EXPAREL is separately reimbursed for >[XX] million lives nationwide

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Important Safety Information

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia
Important Safety Information
Important Safety Information

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia
  • Do not admix lidocaine or other non-bupivacaine local anesthetics with EXPAREL. EXPAREL may be administered at least 20 minutes or more following local administration of lidocaine
  • EXPAREL is not recommended to be used in the following patient populations: patients <6 years old for infiltration, patients younger than 18 years old for nerve blocks, and/or pregnant patients
  • Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease

Warnings and Precautions Specific to EXPAREL

  • Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL
  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks other than interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and adductor canal block, or intravascular or intra-articular use
  • The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration depending on the site of injection and dosage administered and may last for up to 5 days, as seen in clinical trials

Warnings and Precautions for Bupivacaine-Containing Products

  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesia. CNS reactions are characterized by excitation and/or depression
  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability, which may lead to dysrhythmias, sometimes leading to death
  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients
  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use
  • Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use

Please refer to full Prescribing Information.