Pacira CEO David Stack says 70% of surgeries will be outpatient in 10 years — Here are the key drivers

Pacira Pharmaceuticals CEO David Stack spoke at the Jeffries London Healthcare Conference Nov. 14 and discussed the company's growth, as well as where Pacira, and it's Exparel product, are headed in the future.

Looking ahead to 2019, CMS recently released the 2019 payment guidelines which included separate payments for non-opioid postsurgical pain management, including Exparel, in the outpatient setting. 

Mr. Stack said he sees the move to outpatient surgery as an important driver for the company's success in the future. The company estimates around 70 percent of surgeries are done in hospitals and 30 percent are done in ASCs; however, over the next 10 years Mr. Stack projects that will flip to 70 percent of surgeries performed in an outpatient or ambulatory setting and 30 percent in the inpatient hospital.

"The payers have seen the value of providing improved care at a 40 percent reduced cost [in the ASC]," said Mr. Stack. "With the advent of [enhanced recovery after surgery protocols] and physician-owned surgery centers, physicians want to work there and payers want surgeries performed there."

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.

Evidence in the literature shows the opioid-reduction effect Exparel can have on surgical patients. Studies show Exparel can help arthroscopic rotator cuff repair patients lower opioid consumption and reduce pain, and similar results were found for total knee replacement patients. Spine surgeons can also use Exparel in procedures.

"If you are treating spine patients, you want to get them out of the PACU and mobile as quickly as possible," said Mr. Stack. "If we can [achieve this] without opioids, you can make spine an outpatient procedure."

Mr. Stack emphasized that Exparel can be used in a multimodal pain management approach as part of enhanced recovery after surgery protocols. 

Partnerships will also be a focus for Pacira in the future. The company is currently partnered with Aetna to examine separate payments for Exparel in select Florida- and New Jersey-based ASCs as a pilot program that could spread to other geographies and payers.

"We have other pilots not disclosed with several other payers," said Mr. Stack. "I'll go back to patient satisfaction and physician satisfaction; they would like to be outside of the hospital environment if possible. The payers would like to reimburse outside of the hospital, so this [transition] is taking place in real time."

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