Exparel achieves significant reductions in opioid use, hospital stay and total hospitalization costs following knee replacement surgery. Pacira Pharma

Pacira Pharmaceuticals, Inc.announced new data on the use of Exparel (bupivacaine liposome injectable suspension) to manage postsurgical pain following total knee arthroplasty (TKA). The findings show that patients receiving Exparel had a significant reduction in opioid use, hospital length of stay (LOS), and total hospitalization costs compared to TKA patients who did not receive Exparel. Patients receiving Exparel also had increased likelihood to be discharged home rather than a skilled nursing facility.

The results of the study, Impact of treatment with liposomal bupivacaine on hospital costs, length of stay, and discharge status in patients undergoing total knee arthroplasty at high-use institutions, were published in The Journal of Medical Economics. This retrospective analysis utilized hospital chargemaster data from the Premier Healthcare Database from January 2011 through April 2017 for the ten hospitals in the United States with the highest number of primary TKA procedures using Exparel. Patients undergoing TKA who received Exparel were matched in a one-to-one ratio to a control group of patients whose pain management strategy did not include Exparel. The study population included 20,907 Medicare-insured TKA patients and 12,505 TKA patients with commercial insurance.

Results showed that patients undergoing TKA who received Exparel demonstrated a significant: Decrease in opioid consumption, expressed in oral morphine equivalent dosing (MED), when controlled for LOS in both the Medicare and commercial insurance groups (69 mg MED and 64 MED reductions, respectively; P<0.0001). decrease in average hospital los by 0.6 days in both the medicare and commercial insurance groups (p><0.0001). decrease in total hospitalization costs in both the medicare and commercial insurance groups (�$616 and �$775, respectively; p><0.0001). increase in likelihood to be discharged home in both the medicare and commercial insurance groups (1.58 times more likely and 1.63 times more likely, respectively; p><0.0001).>

�TKA is a painful surgical procedure, and inadequate pain control can delay recovery and increase hospital length of stay, opioid consumption and total hospitalization costs,� said Carl Asche, PhD, Research Professor l and Director of the Center for Outcomes Research at the University of Illinois College of Medicine at Peoria and lead author on the study publication. �Our analysis provides strong evidence that Exparel plays an essential role in not only reducing opioid consumption and recovery time, but also improving clinical and economic outcomes for hospitals conducting TKA procedures.�

Results of this study are consistent with findings from several retrospective studies and randomized controlled trials with high internal validity, including the PILLAR trial, which found that Exparel demonstrated a 78 percent decrease in opioid consumption and significantly better pain control with infiltration of Exparel plus bupivacaine versus bupivacaine alone.

See-Carl V. Asche, Simon Dagenais, Amiee Kang, Jinma Ren & Brian T. Maurer (2018) Impact of treatment with liposomal bupivacaine on hospital costs, length of stay, and discharge status in patients undergoing total knee arthroplasty at high-use institutions, Journal of Medical Economics, DOI: 10.1080/13696998.2018.1543190.