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.

Laparoscopic Colorectal Surgery: Medical center in Texas

Study Methods

  • 140 patients undergoing laparoscopic colorectal surgery: 70 received an ERP alone, and 70 received an ERP with EXPAREL
  • Retrospective observational study
  • All patients received the same ERP

Safety Outcomes

  • 2.8% of patients in the ERP with EXPAREL group experienced a complication, compared with 7.8% of patients in the ERP-alone group

Clinical and Economic Outcomes

Patients who received ERP with EXPAREL to manage pain after surgery

  • Experienced

    significantly better pain control

    (P=0.001)
    in the PACU*

    • 1.92 vs 4.71

  • 65%

    fewer opioids consumed over 3 days†

    • Day 0: 1.16 vs 3.56 (P<0.001)
    • Day 1: 1.31 vs 2.86 (P=0.031)
    • Day 2: 1.28 vs 4.91 (P=0.02)
    • Day 3: 0.86 vs 2.06 (P<0.001)

  • had 1 day

    shorter LOS

    • 2.96 days vs 3.93 days (P=0.003)

  • Incurred

    $746

    lower overall costs to the hospital‡

    • $11,555.66 vs $12,302.08 (P=0.72)
 

ERP ALONE (n=70)

  • Multimodal perioperative protocol with as-needed postsurgical opioids for analgesia

ERP WITH EXPAREL (n=70)

  • Multimodal perioperative protocol with as-needed postsurgical opioids for analgesia
  • Local wound infiltration with EXPAREL at the laparoscopic port site at the end of the procedure
    • 20 mL vial of EXPAREL expanded with 20 mL of normal saline and 20 mL of 0.25% regular bupivacaine to a total volume of 60 mL

*Pain was measured using a visual analog scale (0 to 10).

†The clinical benefit of the decrease in opioid consumption was not demonstrated in pivotal trials. Opioid utilization was measured using the World Health Organization’s defined daily dose (DDD), converting each opioid used into the respective DDD (intravenous fentanyl [1 DDD = 100 mcg], intravenous dilaudid [1 DDD = 2 mg], oral dilaudid [1 DDD = 4 mg], oral oxycodone [1 DDD = 20 mg], and hydrocodone [1 DDD = 10 mg]).

‡Costs were defined as the actual per-patient total costs for the entire inpatient episode.

ERP, enhanced recovery protocol; PACU, post-anesthesia care unit; LOS, length of stay.

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