Pacira BioSciences presents real-world data on Exparel showing lower total healthcare costs in outpatient total hip and knee arthroplasty procedures
Pacira BioSciences Inc. presented data from three real-world studies supporting the economic value of Exparel (bupivacaine liposome injectable suspension) in total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures performed in hospital outpatient department (HOPD) settings at the Academy of Managed Care Pharmacy (AMCP) Annual 2026 Meeting, taking place April 13-16 in Nashville, Tennessee. Across the analyses, Exparel use was associated with lower or comparable total healthcare costs and reduced opioid utilization in certain patient populations over follow-up periods of up to six months.
Select findings include:
- • In one study, the use of Exparel for Total Hip Arthroplasty (THA) in hospital outpatient departments (HOPDs) was associated with lower total healthcare costs over 3 and 6 months of post-surgical follow-up.
- ▫ More pronounced cost savings for patients with lower back pain as well as reduced opioid usage compared to patients who did not receive liposomal bupivacaine (non-LB) were also observed.
- • In the second assessment ,Exparel use during HOPD Total Knee Arthroplasty (TKA) was associated with comparable or lower healthcare costs, particularly in teaching hospitals.
- • The third assessment was a three-year budget impact analysis, that found that EXPAREL use was associated with a projected cumulative absolute cost difference of −$117,868 per 1 million members by year 3 compared to ropivacaine in the HOPD Commercial and Medicare Advantage settings, with higher pharmacy acquisition costs offset by reductions in total healthcare expenditures.
“These real-world data continue to demonstrate the economic value that EXPAREL can deliver across outpatient orthopedic procedures,” said Brendan Teehan, Chief Commercial Officer of Pacira Biosciences. “By helping reduce total healthcare costs, lowering opioid use, and supporting more efficient recovery in real-world settings, these data reinforce our commitment to advancing non-opioid pain management solutions that benefit patients, providers, and payers alike. We believe these findings further support the role of EXPAREL in improving access to effective and best-practice opioid-sparing pain control while addressing the broader challenges of affordability and opioid stewardship.”
Pacira Presentations at AMCP 2026:
- Real-World Assessment of Healthcare Expenditures and Opioid Intake Following Total Hip Arthroplasty in Medicare Advantage Beneficiaries” (Poster #363)
This retrospective, real-world analysis evaluated the association between liposomal bupivacaine (LB) use and healthcare expenditures and opioid utilization over 6 months following total hip arthroplasty (THA) performed in hospital outpatient department (HOPD) settings among Medicare Advantage beneficiaries.
LB use was associated with lower total healthcare costs at 3 months ($7,332 vs $8,153; P=0.007) and 6 months ($13,022 vs $15,081; P<0.001) following surgery compared with non-LB. These differences were primarily driven by lower outpatient costs at 3 months ($2,161 vs $2,472; P=0.015) and 6 months ($4,421 vs $5,897; P<0.001).
In a subgroup of patients with a history of low back pain, LB use was associated with lower total healthcare costs at 1 month ($3,997 vs $5,250; P<0.001), 3 months ($7,604 vs $9,696; P=0.004), and 6 months ($13,614 vs $18,652; P<0.001). LB use was also associated with numerically lower opioid utilization at 3 months (26 fewer morphine milligram equivalents [MMEs]; P=0.171) and significantly lower opioid utilization at 6 months (51 fewer MMEs; P=0.027) compared with non-LB use.
Presenter: Haiyan Li, Senior Manager, Medical Economics Research, Health Outcomes Ecom Res & RWE, Pacira BioSciences
Poster Number: 363
Date & Time: April 14, 4:30-5:30 pm - “Postoperative Pain Management in Association with Total Cost of Care Among Patients Undergoing Total Knee Arthroplasty in the Hospital Outpatient Department: A Real-World Retrospective Cohort Assessment” (Poster #365)
This retrospective, real-world cohort study evaluated the association between liposomal bupivacaine (LB) use and total healthcare costs among patients undergoing total knee arthroplasty (TKA) in hospital outpatient department (HOPD) settings, including subgroup analyses in teaching hospitals.
Among 7,840 matched patients (3,920 per cohort), LB use was associated with numerically lower adjusted mean total healthcare costs compared with non-LB use across evaluated time points. At the surgical visit, adjusted mean costs were $15,600 for the LB cohort and $15,719 for the non-LB cohort (adjusted difference [AD]: −$119; 95% CI, −$477 to $221). At 7 days since surgery, costs were $15,692 versus $15,805 (AD: −$113; 95% CI, −$460 to $218), and at 30 days since surgery, $15,949 versus $16,056 (AD: −$108; 95% CI, −$489 to $262).
In a subgroup analysis of teaching hospitals, LB use was associated with lower adjusted costs at all evaluated time points, with statistically significant differences observed at the surgical visit (AD: −$1,527; 95% CI, −$2,292 to −$725), 7 days since surgery (AD: −$1,511; 95% CI, −$2,314 to −$656), and 30 days since surgery (AD: −$1,511; 95% CI, −$2,323 to −$753).
Pharmacy costs on the day of surgery in teaching hospitals were lower in the LB cohort compared with the non-LB cohort ($1,031 vs $2,872, respectively).
Presenter: Jennifer Lin, Senior Director, Epidemiology, Health Outcomes Ecom Res & RWE
Poster Number: 365
Date & Time: April 14, 4:30-5:30 pm - “Budget Impact of Liposomal Bupivacaine in the Commercial and Medicare Advantage Hospital Outpatient Department Setting for Total Knee Arthroplasty” (Poster #364)
This impact model evaluated the projected economic impact of liposomal bupivacaine (LB) compared with ropivacaine for total knee arthroplasty (TKA) in the hospital outpatient department (HOPD) setting from the perspective of Commercial and Medicare Advantage payers over a 3-year time horizon, using a simulated 1-million member health plan.
By year 3, LB use was associated with a projected cumulative cost difference of −$117,868 per 1 million members, corresponding to a relative budget impact of −0.07% and per-member-per-month (PMPM) savings of −$0.003 compared with ropivacaine.
Sensitivity analyses varying standard errors demonstrated consistent model results, with projected annual budget impact ranging from −$124,745 to −$111,018 and stable PMPM estimates over the 3-year period. Additional sensitivity analyses using ±30% parameter variation yielded a projected range of −$154,846 to −$81,644 in annual budget impact.
In a scenario analysis incorporating opioid addiction, LB use was associated with projected cost differences of −$189 per patient per year compared with ropivacaine.
Overall, the model suggests that, within the parameters and assumptions evaluated, LB use may be associated with a budget-neutral impact compared with ropivacaine in the HOPD setting, with higher pharmacy acquisition costs offset by reductions in total healthcare expenditures.
Presenter: Jennifer Lin, Senior Director, Epidemiology, Health Outcomes Ecom Res & RWE
Poster Number: 364
Date & Time: April 14, 4:30-5:30 pm
