Announcement • May 29

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Pacira Biosciences Reports Real-World Study Showing Exparel Use Is Associated with Reduced Opioid Use and Healthcare Costs in Patients Undergoing Total Shoulder Arthroplasty

Pacira BioSciences, Inc. announced findings from a real-world study evaluating outcomes associated with the use of EXPAREL (bupivacaine liposome injectable suspension) following outpatient total shoulder arthroplasty (TSA) in Medicare Advantage patients. The study was presented at ISPOR—The Professional Society for Health Economics and Outcomes Research 2026 Annual Meeting that was held May 17–20, 2026 in Philadelphia, PA. The retrospective analysis assessed more than 6,400 opioid-naïve Medicare Advantage patients undergoing outpatient TSA and compared outcomes between those receiving EXPAREL and those receiving standard-of-care analgesia. Data was analyzed from Optum Clinformatics from July 2019 to December 2024. As a retrospective observational analysis, the study identifies associations and may be subject to the limitations inherent in claims-based research. The study evaluated healthcare costs, opioid intake, and opioid-related adverse events over 90 days following surgery. EXPAREL use was associated with lower opioid use, fewer opioid-related adverse events, and lower healthcare costs compared with standard analgesia. These findings come at a time of increasing national focus on expanding access to non-opioid pain management options, including through policies such as the NOPAIN Act, which aims to improve reimbursement among the Medicare population for non-opioid therapies in outpatient settings. EXPAREL 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% decrease in opioid consumption; the clinical benefit of the opioid reduction was not demonstrated. EXPAREL 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.

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