News ReleaseView printer-friendly version << Back
Aetna Offers Expanded Coverage for EXPAREL® in Select Ambulatory Surgical Centers
This expanded coverage of EXPAREL advances Aetna’s clinical strategy of supporting increased member access to non-opioid pain treatment options and encouraging reductions in inappropriate opioid prescribing. In 2017, the company began reimbursing for EXPAREL for select impacted third molar (wisdom tooth) extractions. EXPAREL provides patients prolonged pain control that can help reduce or eliminate reliance on opioids, their associated side effects and the long-term risks of addiction or dependence.
“Aetna is demonstrating its commitment to addressing the opioid epidemic by leading the way in expanding coverage of EXPAREL in the ASC setting,” said
Studies continue to show that surgery is an inadvertent gateway to persistent opioid use. According to new research examining seven orthopedic and soft tissue surgical procedures, patients were prescribed an average of 82 opioid pills to manage postsurgical pain. Approximately 9 percent of surgical patients became newly persistent users in 2017, continuing to take these opioids at least three to six months after their operation1. Unused opioids after surgery also pose the risk of diversion, another avenue to opioid misuse or dependence.
The reimbursement for EXPAREL in the ASC setting is demonstrative of Aetna’s ongoing collaborations with Pacira to combat the opioid epidemic. Recent initiatives include Aetna’s update to its online provider directory to help members easily identify surgeons who are trained to administer EXPAREL, as well as the creation of a national program launched by Pacira,
Important Safety Information
EXPAREL is contraindicated in obstetrical paracervical block anesthesia. In clinical trials, the most common adverse reactions (incidence ≥10%) following EXPAREL administration were nausea, constipation, and vomiting. EXPAREL is not recommended to be used in the following patient population: patients <18 years old and/or pregnant patients. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks, or intravascular or intra-articular use. Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Formulations of bupivacaine other than EXPAREL should not be administered within 96 hours following administration of EXPAREL. Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesias. CNS reactions are characterized by excitation and/or depression. Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability which may lead to dysrhythmias sometimes leading to death. Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients. Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use.
Coyne Public Relations
1 Pacira. Exposing a Silent Gateway to Persistent Opioid Use – A Choices Matter Status Report.