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 Illinois

Study Methods

  • Adult patients (N=90) undergoing mastectomy and immediate implant-based breast reconstruction with or without lymph node dissection. All patients had the same postsurgical pain control regimens with hydromorphone hydrochloride PCA or morphine PCA, were transitioned to oral narcotics on the first postsurgical day, and received the same postsurgical orders, including as-needed antinausea medications, pruritus medications, and scheduled cyclobenzaprine. Patients were divided into 3 groups based on analgesia:
    • Patients who received EXPAREL
    • Patients who received NDB in a pain pump
    • Patients in the control group who received IV PCA or oral narcotics
  • Retrospective chart review
  • Multiple linear regression analyses were performed to assess how identified factors impacted LOS

Safety Outcomes

  • No complications were noted in the EXPAREL group

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • Significantly

    better pain control

    (P<0.01) 4, 8, 12,
    16, and 24 hours postsurgery*

    • Significantly lower pain versus NDB and PCA

  • 67%

    patients discharged home after 1 day

    • EXPAREL group: 20 of 30 (67%)
    • NDB group: 13 of 30 (43%)
    • Control group: 9 of 30 (30%)
 

BREAST RECONSTRUCTION WITH EXPAREL (n=30)

  • 20 mL of EXPAREL were infiltrated in unilateral breast reconstruction
  • 20 mL of EXPAREL were expanded with 10 mL of saline in bilateral breast reconstruction, with 15 mL total infiltrated into each breast
  • Included 6 unilateral and 24 bilateral procedures
  • Patients who received implantation of an ADM had an additional 3 mL of EXPAREL infiltrated around the suture sites. All patients in this group received an ADM

BREAST RECONSTRUCTION WITH NDB PUMP (n=30)

  • Pain pump placed in subpectoral plane underneath implant in a pocket separate from the drain
  • Included 14 unilateral and 16 bilateral procedures

BREAST RECONSTRUCTION WITH PCA/ORAL NARCOTICS CONTROL GROUP (n=30)

  • No regional anesthesia or intraoperative lidocaine or bupivacaine
  • IV PCA or oral narcotics
  • Included 14 unilateral and 16 bilateral procedures

*All pain was measured with the visual analog scale.

ADM, acellular dermal matrix; IV, intravenous; NDB, non-depot bupivacaine; PCA, patient-controlled analgesia; LOS, length of stay.

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