Pacira BioSciences, Inc. (NSDQ: PCRX), the industry leader in its
commitment to non-opioid pain management and regenerative health
solutions, today announced that the Centers for Medicare and
Medicaid Services (CMS) has issued its proposed Hospital Outpatient
Prospective Payment System and Ambulatory Surgical Center Payment
System rule for 2025. In the proposed rule, EXPAREL® (bupivacaine
liposome injectable suspension) is one of six covered
non-opioids—two of which are specific to ophthalmology— qualifying
for separate Medicare reimbursement in both the ambulatory surgical
center (ASC) and hospital outpatient (HOPD) settings. Pending
finalization, this policy would go into effect beginning January 1,
2025.
The proposed rule reflects impending implementation of the
Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, which
mandates separate CMS payment for qualifying non-opioid drugs and
devices across HOPD and ASC settings. The law was passed as part of
the Consolidated Appropriations Act of 2023.
“Following several years of advocacy for reimbursement policy
reform to allow increased patient and provider access to
non-opioids, we are pleased to see EXPAREL included as one of only
six qualifying non-opioid drugs to treat postsurgical pain in the
proposed rule,” said Frank D. Lee, Chief Executive Officer of
Pacira. “As the only covered single-dose product approved for both
local and regional analgesia across surgical procedures, we believe
this new reimbursement—pending finalization—will offer clinicians
increased ability to utilize a best-in-class option for achieving
long-lasting non-opioid pain control with an increased ability to
transition to the outpatient environment.”
Proposed Medicare payment rates for covered non-opioid drug
products—as outlined in the proposed rule—equate to average sales
price (ASP) + 6% in the HOPD and ASC environments.
The six products and associated reimbursement rates included in
the rule are as follows:
Non-Opioid Drug |
Proposed Separate CMS Payment Rate (Per Billing
Unit)* |
EXPAREL |
$1.41 |
Zynrelef |
$0.73 |
Xaracoll |
$0.85 |
Ketorolac tromethamine injection |
$0.702 |
Dextenza |
$117.01 |
Omidria |
$97.12 |
*Payment rates given in the proposed rule are subject to change
and may not be the same payment rate listed in the final rule later
this year.
EXPAREL is indicated to produce postsurgical local analgesia via
infiltration in patients aged 6 years and older and regional
analgesia in adults via an interscalene brachial plexus nerve
block, sciatic nerve block in the popliteal fossa, and an adductor
canal block. Safety and efficacy have not been established in other
nerve blocks. It has been used in over 14 million patients across
the United States to date.
To view the preliminary rule in its entirety, visit the Federal
Register.
About Pacira BioSciences Pacira BioSciences,
Inc. (Nasdaq: PCRX) is committed to providing a non-opioid option
to as many patients as possible to redefine the role of opioids as
rescue therapy only. The company is also developing innovative
interventions to address debilitating conditions involving the
sympathetic nervous system, such as cardiac electrical storm,
chronic pain, and spasticity. Pacira has three commercial-stage
non-opioid treatments: EXPAREL® (bupivacaine liposome injectable
suspension), a long-acting, local analgesia currently approved for
postsurgical pain management; ZILRETTA® (triamcinolone acetonide
extended-release injectable suspension), an extended-release,
intra-articular, injection indicated for the management of
osteoarthritis knee pain; and ioveraº®, a novel, handheld device
for delivering immediate, long-acting, drug-free pain control using
precise, controlled doses of cold temperature to a targeted nerve.
To learn more about Pacira, including the corporate mission to
reduce overreliance on opioids, visit www.pacira.com.
About EXPAREL® EXPAREL (bupivacaine liposome
injectable suspension) is indicated to produce postsurgical local
analgesia via infiltration in patients aged 6 years and older, and
postsurgical regional analgesia via an interscalene brachial plexus
block in adults, a sciatic nerve block in the popliteal fossa in
adults, and an adductor canal block in adults. The safety and
effectiveness of EXPAREL have not been established to produce
postsurgical regional analgesia via other nerve blocks besides an
interscalene brachial plexus nerve block, a sciatic nerve block in
the popliteal fossa, or an adductor canal block. The product
combines bupivacaine with multivesicular liposomes, a proven
product delivery technology that delivers medication over a desired
time period. EXPAREL represents the first and only multivesicular
liposome local anesthetic that can be utilized in the peri- or
postsurgical setting. By utilizing the multivesicular liposome
platform, a single dose of EXPAREL delivers bupivacaine over time,
providing significant reductions in cumulative pain scores with up
to a 78 percent decrease in opioid consumption; the clinical
benefit of the opioid reduction was not demonstrated. Additional
information is available at www.EXPAREL.com.
Important Safety Information about EXPAREL for
PatientsEXPAREL should not be used in obstetrical
paracervical block anesthesia. In studies in adults where EXPAREL
was injected into a wound, the most common side effects were
nausea, constipation, and vomiting. In studies in adults where
EXPAREL was injected near a nerve, the most common side effects
were nausea, fever, and constipation. In the study where EXPAREL
was given to children, the most common side effects were nausea,
vomiting, constipation, low blood pressure, low number of red blood
cells, muscle twitching, blurred vision, itching, and rapid
heartbeat. EXPAREL can cause a temporary loss of feeling and/or
loss of muscle movement. How much and how long the loss of feeling
and/or muscle movement depends on where and how much of EXPAREL was
injected and may last for up to 5 days. EXPAREL is not recommended
to be used in patients younger than 6 years old for injection into
the wound, for patients younger than 18 years old for injection
near a nerve, and/or in pregnant women. Tell your health care
provider if you or your child has liver disease, since this may
affect how the active ingredient (bupivacaine) in EXPAREL is
eliminated from the body. EXPAREL should not be injected into the
spine, joints, or veins. The active ingredient in EXPAREL can
affect the nervous system and the cardiovascular system; may cause
an allergic reaction; may cause damage if injected into the joints;
and can cause a rare blood disorder.
Forward-Looking StatementsAny statements in
this press release about Pacira’s future expectations, plans,
trends, outlook, projections and prospects, and other statements
containing the words “anticipate,” “believe,” “can,” “could,”
“estimate,” “expect,” “intend,” “may,” “plan,” “project,” “should,”
“will,” “would,” and similar expressions, constitute
forward-looking statements within the meaning of Section 21E of the
Securities Exchange Act of 1934, as amended (the “Exchange Act”),
and the Private Securities Litigation Reform Act of 1995,
including, without limitation, statements related to our growth and
future operating results and trends, our strategy, plans,
objectives, expectations (financial or otherwise) and intentions,
future financial results and growth potential, including our plans
with respect to the repayment of our indebtedness, anticipated
product portfolio, development programs, patent terms, development
of products, strategic alliances and intellectual property and
other statements that are not historical facts. For this purpose,
any statement that is not a statement of historical fact should be
considered a forward-looking statement. We cannot assure you that
our estimates, assumptions and expectations will prove to have been
correct. Actual results may differ materially from those indicated
by such forward-looking statements as a result of various important
factors, including risks relating to, among others: the integration
of our new chief executive officer; risks associated with
acquisitions, such as the risk that the acquired businesses will
not be integrated successfully, that such integration may be more
difficult, time-consuming or costly than expected or that the
expected benefits of the transaction will not occur; our
manufacturing and supply chain, global and U.S. economic conditions
(including inflation and rising interest rates), and our business,
including our revenues, financial condition, cash flow and results
of operations; the success of our sales and manufacturing efforts
in support of the commercialization of EXPAREL, ZILRETTA and
iovera°; the rate and degree of market acceptance of EXPAREL,
ZILRETTA and iovera°; the size and growth of the potential markets
for EXPAREL, ZILRETTA and iovera° and our ability to serve those
markets; our plans to expand the use of EXPAREL, ZILRETTA and
iovera° to additional indications and opportunities, and the timing
and success of any related clinical trials for EXPAREL, ZILRETTA
and iovera°; the commercial success of EXPAREL, ZILRETTA and
iovera°; the related timing and success of U.S. Food and Drug
Administration supplemental New Drug Applications and premarket
notification 510(k)s; the related timing and success of European
Medicines Agency Marketing Authorization Applications; our plans to
evaluate, develop and pursue additional product candidates
utilizing our proprietary multivesicular liposome (“pMVL”) drug
delivery technology; the approval of the commercialization of our
products in other jurisdictions; clinical trials in support of an
existing or potential pMVL-based product; our commercialization and
marketing capabilities; our ability to successfully complete
capital projects; the outcome of any litigation; the ability to
successfully integrate any future acquisitions into our existing
business; the recoverability of our deferred tax assets;
assumptions associated with contingent consideration payments; the
anticipated funding or benefits of our share repurchase program;
and factors discussed in the “Risk Factors” of our most recent
Annual Report on Form 10-K and in other filings that we
periodically make with the Securities and Exchange Commission (the
“SEC”). In addition, the forward-looking statements included in
this press release represent our views as of the date of this press
release. Important factors could cause actual results to differ
materially from those indicated or implied by forward-looking
statements, and as such we anticipate that subsequent events and
developments will cause our views to change. Except as required by
applicable law, we undertake no intention or obligation to update
or revise any forward-looking statements, whether as a result of
new information, future events or otherwise, and readers should not
rely on these forward-looking statements as representing our views
as of any date subsequent to the date of this press release.
Investor Contact:
Susan Mesco, (973) 451-4030
susan.mesco@pacira.com
Media Contact:
Sara Marino, (973) 248-7005
Sara.marino@pacira.com
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