In its third quarter financial report, Pacira noted a 23 percent increase in Exparel net product sales, which hit $82.2 million for the quarter,. Due to recent positive coverage announcements from CMS and private payers, the company updated its full year net product sale guidance from $325 million to $330 million.
The financial report was released Nov. 1, two days after Aetna launched a pilot program for expanded coverage to select ASCs in Florida and New Jersey that used non-opioid therapy for postsurgical pain management. Two days after the release and conference call, CMS announced it would make separate payments for non-opioid pain management drugs for ASCs, with the only HCPCS code falling into that category being Exparel. Mr. Stack alluded to this expected decision during the call and discussed the potential growth for Exparel as a result.
To learn more about the new CMS rule as well as hear from ASC owners, administrators and leaders in ASC billing and coding on their experiences with Exparel, register for this webinar titled "CMS Reimburses Non-Opioid Postsurgical Pain Management in the ASC: Review of the New CMS Rules and Opportunity for ASCs" on Dec. 4, from 12:00 p.m. to 1:00 p.m.
"Our mission at Pacira is focused on providing an opioid alternative to as many patients as possible," said Pacira Chairman and CEO David Stack on the quarterly conference call. "To accomplish this, we are advancing three strategic pillars: First, providing clinical data and Enhanced Recovery After Surgery protocols to expand the use of Exparel in key surgical settings; second, driving education and awareness around the need for improving access to opioid-sparing solutions within and outside of the operating room; and third, partnering with those who share our commitment to reducing or eliminating opioids in the postsurgical setting."
Here are eight key quotes from the conference call, as transcribed by Seeking Alpha:
On brachial plexus nerve block growth: "We are seeing continued interest on the use of Exparel as a brachial plexus nerve block for upper extremity procedures. Specifically, many anesthesiologists are viewing Exparel as a game-changer, and the positive results that they are achieving with bronchial plexus blocks are driving use in newer regional anesthesia techniques, such as transverse abdominis pectoralis and fascial iliaca plane blocks."
On Pacira's partnership with Johnson & Johnson: "Much of the nerve blocks' success is attributable to our highly successful collaboration with [Johnson & Johnson]. Their commitment, passion and critical mass are delivering significant results. Together, we are integrating Exparel across multiple joint marketing programs, including a new initiative that will promote Exparel and Tylenol as a platform for opioid-free post-surgical pain relief."
"J&J continues to invest in making Exparel a success through their talent and financial resources as well as their organizational expertise. Now that Exparel is being integrated into each of J&J's orthopedic sales verticals and educational materials, the team is focusing on total non-opioid solution strategies for key procedures, such as rotator cuff, spine and hip fractures."
On CMS unbundling the code for non-opioid postsurgical drugs: "We believe that separate [unbundled] code will significantly enhance patient access. Commercial payers and employer coalitions are also recognizing the need to increase access to non-opioid options. Here, our partner Aetna is paving the way by expanding coverage in certain ambulatory and dental settings. The American Dental Association has issued a new D code that will also take effect January 1."
"CMS's decision to unbundle Exparel and reimburse ambulatory centers at average selling price plus 6 percent is a significant victory for patients and providers. We believe the removal of this reimbursement hurdle will accelerate the transition of certain procedures to the ambulatory setting. This will not only drive patient and provider satisfaction, but also reduce the overall cost to the healthcare system."
"We also now have a focused team of field outpatient account managers who are working with the ambulatory centers and commercial payers to facilitate Exparel reimbursement."
On expanded use for oral surgery: "We see an expanding role for Exparel in [the] oral surgery field, where an overwhelming majority of patients would prefer a non-opioid option for managing pain. Many of these younger patients are exposed to opioids for the first time following common procedures like wisdom tooth extractions. Improving access to opioid-free solutions like Exparel is critical in this vulnerable population."
On the future of orthopedics and total joints in ASCs: "We have some pretty good intelligence that it is highly likely that the joints will be paid for by CMS next year in an outpatient environment, but also remember that many of the initiatives we have with the commercial payers are encouraging total joint procedures to be done in the ambulatory surgery center."