Pacira BioSciences, Inc. (NASDAQ: PCRX), the industry leader in the
delivery of innovative, non-opioid pain therapies, today announced
that the Centers for Medicare and Medicaid Services (CMS)
has established a permanent product-specific Healthcare Common
Procedure Coding System (HCPCS) J-code for EXPAREL® (bupivacaine
liposome injectable suspension). The new J-code for EXPAREL, J0666,
becomes effective January 1, 2025, and will supersede the current
C-code (C9290), which has been in place since 2019.
In addition to the separate CMS reimbursement EXPAREL will
receive in outpatient settings with the implementation of NOPAIN in
January 2025, this new J-code will also provide reimbursement when
EXPAREL is used in the office setting and for office-based
surgeries.
J-codes are reimbursement codes used by commercial insurance
plans, Medicare, Medicare Advantage, and other government payers
for Medicare Part B drugs like EXPAREL. Claims submission and
payment are standardized with a J-code, facilitating and
streamlining billing and reimbursement. In addition, some
commercial insurers require a J-code for payment.
“We are pleased that EXPAREL will have its own product-specific
J-code beginning on January 1, 2025,” said Frank D. Lee, chief
executive officer of Pacira. “In addition to streamlining the
reimbursement billing and coding process at large, a J-code is also
more likely to be recognized and covered by commercial payers—a
growing portion of the EXPAREL patient population. This, combined
with the impending reimbursement from NOPAIN, is particularly
important toward increasing clinician access to EXPAREL across
sites of care and payer types, offering them the enhanced ability
to offer a best-in-class option for achieving long-lasting
non-opioid pain control with an increased ability to transition
procedures to outpatient settings.”
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 15 million patients across
the United States to date.
About Pacira BioSciencesPacira BioSciences
delivers innovative, non-opioid pain therapies to transform the
lives of patients. Pacira has three commercial-stage non-opioid
treatments: EXPAREL® (bupivacaine liposome injectable suspension),
a long-acting local analgesic currently approved for infiltration,
fascial plane block, and as an interscalene brachial plexus nerve
block 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. The company is also advancing the development of
PCRX-201, a novel locally administered gene therapy with the
potential to treat large prevalent diseases like osteoarthritis. To
learn more about Pacira, 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.
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
intellectual property, 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, plans
with respect to the Non-Opioids Prevent Addiction in the Nation
(“NOPAIN”) Act 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
Pacira BioSciences (NASDAQ:PCRX)
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