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.

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Women's Health

Implant-Based Breast Reconstruction: Medical center in California

Study Methods

  • 12 adult patients undergoing mastectomy with EXPAREL compared with 12 adult patients undergoing mastectomy with bupivacaine
  • Prospective, randomized, single-blind trial
  • Basic statistical analyses were performed and included pain scores, opioid consumption, benzodiazepine consumption, antiemetic consumption, LOS, and hospital costs

Safety Outcomes

  • No significant adverse events were noted in either group

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • 47%

    lower opioid consumption
    during hospital stay*†

    • 0.76 vs 1.43 MED/hour
    • 22.6 vs 66.8 for entire LOS duration‡

  • 16.9

    hours shorter LOS

    • 29.8 vs 46.7 hours

  • $7804

    lower hospital
    charges

    • $10,828 vs $18,632
 

BREAST RECONSTRUCTION WITH EXPAREL (n=12)

  • Intrasurgical injection of 1.3% EXPAREL, with 10 mL (133 mg) delivered to perform a field block of each breast pocket
  • Infiltration sites included the pectoralis major muscle, along the ipsilateral parasternal line, along a line 1 cm posterior and parallel to the anterior axillary line, extending under the pectoralis major muscle in the axilla, the base of the mastectomy flaps, and any locations where deep sutures were placed to anchor acellular dermal matrices along the chest wall and pectoralis major muscle
  • Standard postoperative drug regimen for pain (hydrocodone/acetaminophen and/or hydromorphone), muscle spasms (diazepam), and nausea and vomiting (ondansetron)
  • Included 3 unilateral and 9 bilateral procedures

BREAST RECONSTRUCTION WITH BUPIVACAINE (n=12)

  • Intrasurgical injection of 0.25% bupivacaine and epinephrine (1:200,000), with 20 mL (50 mg) delivered to perform a field block of each breast pocket§
  • Infiltration sites included the pectoralis major muscle, along the ipsilateral parasternal line, along a line 1 cm posterior and parallel to the anterior axillary line, extending under the pectoralis major muscle in the axilla, the base of the mastectomy flaps, and any locations where deep sutures were placed to anchor acellular dermal matrices along the chest wall and pectoralis major muscle
  • Standard postoperative drug regimen for pain (hydrocodone/acetaminophen and/or hydromorphone), muscle spasms (diazepam), and nausea and vomiting (ondansetron)
  • Included 2 unilateral and 10 bilateral procedures

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

†Opioid consumption was noted and converted to MED per hour of hospital stay.

‡Projected value calculated using study data for each respective cohort. The EXPAREL figure is based on 0.76 MED/hour and a 29.8-hour LOS. The bupivacaine figure is based on 1.43 MED/hour and a 46.7-hour LOS.

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

LOS, length of stay; MED, morphine equivalent dosing.

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