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 Shoulder Arthroplasty or Rotator Cuff Repair: 16 international study sites

Study Methods

  • 140 patients undergoing TSA or RCR who received EXPAREL (n=69) or placebo (n=71)
  • Phase 3 clinical trial

Safety Outcomes

  • 4 patients (3 in the EXPAREL group and 1 in the placebo group) experienced adverse events that were deemed unrelated to the study medication

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia

  • Significantly

    better pain control

    (P<0.0001)
    through 48 hours
    after surgery

    • Median time to return of sensory function with EXPAREL was 36 hours, which was significantly longer than placebo (P<0.0001), and median time to return of motor function was 24 hours with both EXPAREL and placebo

  • 78%

    reduction in opioid
    use through 48 hours
    (P<0.0001)*

  • 13%

    of patients opioid free compared with 1% with placebo at 48 hours
    (P=0.008)

 

TSA OR RCR

  • Preoperative regimen
    • Low-dose aspirin for cardioprotection and oral or intravenous acetaminophen 1000 mg every 8 hours
    • Patients randomized 1:1:1 to EXPAREL 266 mg, EXPAREL 133 mg, or matching placebo (20 mL total volume for each). Randomization to EXPAREL 266 mg stopped after sufficient patients (n=15) were selected for pharmacokinetic assessment
  • Postsurgical regimen
    • Rescue medication only given based on patient request
      • Oral immediate-release oxycodone ≤10 mg every 4 hours or as needed and intravenous morphine 2.5 to 5 mg or hydromorphone 0.5 to 1 mg every 4 hours or as needed if oral medication was not tolerated

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

RCR, rotator cuff repair; TSA, total shoulder arthroplasty.

ASP, average sales price; CMS, Centers for Medicare and Medicaid Services.

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