Pacira BioSciences, Inc. (NSDQ: PCRX), the industry leader in the
delivery of innovative, non-opioid pain therapies to transform the
lives of patients, today announced that the Centers for Medicare
and Medicaid Services (CMS) issued its final Medicare Hospital
Outpatient Prospective Payment System (OPPS) and Medicare
Ambulatory Surgical Center (ASC) Payment System rule for 2025,
which implements the Non-Opioids Prevent Addiction in the Nation
(NOPAIN) Act that mandated separate Medicare payment for qualifying
non-opioid drugs and devices. In the final rule, CMS confirmed that
both EXPAREL® (bupivacaine liposome injectable suspension) and
iovera° qualify as eligible non-opioid pain management products
under the NOPAIN Act. Hospital outpatient departments (HOPDs) and
ASCs that use these products will receive additional Medicare
reimbursement beginning January 1, 2025.
Congress passed the NOPAIN Act as part of the Consolidated
Appropriation Act of 2023 to provide better patient access to
non-opioid drugs and devices used to manage pain in the HOPD and
ASC settings, by providing additional Medicare reimbursement for
qualifying non-opioid items.
“We are pleased to have both EXPAREL and iovera° counted among
the eleven qualifying drugs and devices under this important
reimbursement policy change to increase patient and provider access
to non-opioid options,” said Frank D. Lee, Chief Executive Officer
of Pacira. “Having invested significant time and effort toward
reimbursement reform that ultimately affords more patients the
benefit of receiving non-opioid pain management interventions, we
are proud to receive separate payment for not one—but two—of our
best-in-class products across ASC and HOPD settings.”
The reimbursement rate for EXPAREL equates to 106% of the
average sales price (ASP +6%) in the HOPD and ASC environments
using the new product-specific J-code (J0666) beginning January 1,
2025.
The separate reimbursement for iovera° will pay up to an
additional $255.85 when providers administer iovera° in ASC and
HOPD settings, using a new C-code created for the iovera° system
(C9809). This new Medicare payment is provided in addition to the
current reimbursement available to HOPDs and ASCs when they perform
a procedure with the iovera° system.
To view the final rule in its entirety, visit the Federal
Register.
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, interscalene brachial plexus nerve block in
adults, sciatic nerve block in the popliteal fossa in adults, and
adductor canal block in adults 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 iovera°®The iovera°
system is used to destroy tissue during surgical procedures by
applying freezing cold. It can also be used to produce lesions in
peripheral nervous tissue by the application of cold to the
selected site for the blocking of pain. It is also indicated for
the relief of pain and symptoms associated with osteoarthritis of
the knee for up to 90 days. In one study, the majority of the
patients suffering from osteoarthritis of the knee experienced pain
and system relief beyond 150 days. When stimulation compatible
components are used, the iovera° system can also facilitate
targeting nerve location by conducting electrical nerve stimulation
from a compatible 3rd party nerve stimulator. The iovera° system is
not indicated for treatment of central nervous system tissue.
Important Safety Information for iovera°The
iovera° system is contraindicated for use in patients with the
following: Cryoglobulinemia; Paroxysmal cold hemoglobinuria; cold
urticaria; Raynaud’s disease; open and/or infected wounds at or
near the treatment site. Potential complications: As with any
surgical treatment that uses needle-based therapy and local
analgesia, there is potential for temporary site-specific
reactions, including but not limited to: bruising (ecchymosis);
swelling (edema); inflammation and/or redness (erythema); pain
and/or tenderness; altered sensation (localized dysesthesia).
Typically, these reactions resolve with no physician intervention.
Do not receive treatment with iovera° if you experience
hypersensitivity to cold or have open and/or infected wounds near
the treatment site. Patients may experience bruising, swelling,
inflammation and/or redness, local pain and/or tenderness, and
altered feeling at the site of application. In treatment area(s),
you may experience damage to the skin, skin darkening or
lightening, and dimples in the skin. Very rarely, patients can
experience a temporary loss of your ability to use your muscles
normally outside of the treatment area.
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 future
outlook, our intellectual property and patent terms, 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, 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;
assumptions used for estimated future cash flows associated with
determining the fair value of the Company; 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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