News Release

EXPAREL achieves record net product sales of $506.5 million for the full-year, $139.9 million for the fourth quarter, and $50.9 million for the month of December

TAMPA, Fla., Jan. 06, 2022 (GLOBE NEWSWIRE) -- Pacira BioSciences, Inc. (Nasdaq: PCRX), the industry leader in its commitment to non-opioid pain management and regenerative health solutions, today reported preliminary unaudited total revenue of $540.7 to $541.7 million for 2021, compared with $429.6 million for 2020, representing an increase of at least 25.8%. The company’s 2021 revenue includes net product sales of EXPAREL^® (bupivacaine liposome injectable suspension), ZILRETTA^® (triamcinolone acetonide extended-release injectable suspension), and the iovera°^® system.   Pacira began recognizing sales of ZILRETTA in November 2021 after completing its previously announced acquisition of Flexion Therapeutics, Inc.

“2021 was a very successful year for Pacira marked by record level sales for EXPAREL, the addition of ZILRETTA to our commercial offering, and significant growth in iovera° revenue and customers,” said Dave Stack, chairman and chief executive officer of Pacira BioSciences. “For the first three weeks of December, year-over-year EXPAREL sales growth was in the low teens, with the last week of the year impacted by a slowdown in elective procedures as regional surges in Omicron cases prompted government restrictions and escalated staffing challenges.”

“Expediting surgical recovery is more critical than ever and long-acting field and nerve blocks with EXPAREL are transforming the field of regional anesthesia, enabling earlier discharge, and migrating elective procedures to 23-hour sites of care. We continue to support the market’s ongoing shift to anesthesia-driven postsurgical pain management through robust educational and training initiatives that are driving demand within our orthopedic, general surgery, cardiothoracic, women’s health and pediatric franchises. Looking ahead, we believe we are well positioned to continue to deliver strong top- and bottom-line growth as we advance innovative non-opioid options to redefine patient care along the neural pain pathway,” continued Mr. Stack.

Fourth Quarter and December 2021 Preliminary Revenue Highlights

• EXPAREL net product sales were $139.9 million and $125.3 million for the fourth quarters of 2021 and 2020 and $50.9 million and $46.5 million for the months of December 2021 and 2020, respectively. EXPAREL average daily sales were 110 percent of the prior year for the fourth quarter and 100 percent for the month of December, respectively. The company reports average daily growth rates for EXPAREL to account for differences in the number of selling days per reporting period. For the fourth quarter, EXPAREL selling days were 64 in 2021 and 63 in 2020. For the month of December, EXPAREL selling days were 23 in 2021 and 21 in 2020. Sales of bupivacaine liposome injectable suspension to a third-party licensee for use in veterinary practice were $1.0 million and $2.0 million in the fourth quarters of 2021 and 2020, respectively.
• ZILRETTA net product sales are expected to be between $27.0 million and $29.0 million for the fourth quarter of 2021, compared with $26.3 million for the fourth quarter of 2020. A portion of 2021 and all of 2020 ZILRETTA sales occurred prior to the completion of the company’s acquisition of Flexion in November 2021. Pacira expects to recognize post-acquisition ZILRETTA net product sales of between $12.0 million and $13.0 million for the fourth quarter of 2021. Pacira currently reports a range for preliminary quarterly ZILRETTA net product sales as the required adjustments for certain product rebate programs are calculated after the end of the quarter. Pacira is currently not reporting preliminary monthly ZILRETTA net product sales.
• ioveraº net product sales were $4.9 million and $2.4 million for the fourth quarters of 2021 and 2020 and $2.2 million and $0.6 million for the months of December 2021 and 2020, respectively.
• Fourth quarter 2021 royalty revenue was $0.6 million, compared with $1.2 million in 2020.

2021 Full-Year Preliminary Revenue Highlights

• Full-year EXPAREL net product sales were $506.5 million in 2021, compared with $413.3 million in 2020. Sales of bupivacaine liposome injectable suspension to a third-party licensee for use in veterinary practice were $3.5 million in 2021, compared with $4.5 million in 2020.
• Full-year ZILRETTA net product sales are expected to be between $101.1 million and $103.1 million for 2021, compared with $85.6 million in 2020. A portion of 2021 and all 2020 ZILRETTA sales occurred prior to the completion of the company’s acquisition of Flexion in November 2021. Pacira expects to recognize post-acquisition ZILRETTA net product sales of between $12.0 million and $13.0 million for 2021.
• Full-year iovera° net product sales were $16.2 million in 2021, compared with $8.8 million in 2020.
• Full-year royalty revenue was $2.4 million in 2021, compared with $3.0 million in 2020.

The company’s net product sales were negatively impacted by the COVID-19 pandemic in 2020 due to the significant postponement or suspension in the scheduling of elective surgical procedures resulting from public health guidance and government directives. Elective surgery restrictions began to lift on a state-by-state basis in April 2020, allowing EXPAREL sales to return to year-over-year growth in June 2020. However, while many restrictions have since eased and COVID-19 vaccines become more widely available and administered to the general public, it is still unclear how long it will take the elective surgery market to normalize, or if restrictions on elective procedures will recur due to COVID-19 variant strains or otherwise. In order to provide greater transparency, the company is reporting monthly intra-quarter unaudited net product sales until it has gained enough visibility around the impacts of COVID-19. The company reports the number of selling days for EXPAREL to normalize for differences in reporting period growth rates. The company also provides weekly EXPAREL utilization and elective surgery data within its investor presentation, which is accessible at investor.pacira.com.

The financial information included in this press release is preliminary, unaudited and subject to adjustment. It does not present all information necessary for an understanding of the company’s fourth quarter and full-year 2021 financial results. Pacira expects to report its complete financial results for the fourth quarter and full-year 2021 in the first quarter of 2022.

About Pacira

Pacira BioSciences, Inc. (Nasdaq: PCRX) is committed to providing a non-opioid option to as many patients as possible to redefine the role of opioids as rescue therapy only. The company is also developing innovative interventions to address debilitating conditions involving the sympathetic nervous system, such as cardiac electrical storm, chronic pain, and spasticity. Pacira has three commercial-stage non-opioid treatments: EXPAREL^® (bupivacaine liposome injectable suspension), a long-acting, local analgesia currently approved 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. To learn more about Pacira, including the corporate mission to reduce overreliance on opioids, visit www.pacira.com.

About EXPAREL^®

EXPAREL (bupivacaine liposome injectable suspension) is indicated in patients 6 years of age and older for single-dose infiltration to produce postsurgical local analgesia, and in adults as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia. Safety and efficacy have not been established in other nerve blocks. 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 for Patients

EXPAREL 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.

About ZILRETTA^® 

On October 6, 2017, ZILRETTA (triamcinolone acetonide extended-release injectable suspension) was approved by the U.S. Food and Drug Administration as the first and only extended-release intra-articular therapy for patients confronting osteoarthritis (OA)- related knee pain. ZILRETTA employs proprietary microsphere technology combining triamcinolone acetonide—a commonly administered, short-acting corticosteroid—with a poly lactic-co-glycolic acid (PLGA) matrix to provide extended pain relief. The pivotal Phase 3 trial on which the approval of ZILRETTA was based showed that ZILRETTA significantly reduced OA knee pain for 12 weeks, with some people experiencing pain relief through Week 16. Learn more at www.zilretta.com.

Indication and Select Important Safety Information for ZILRETTA

Indication: ZILRETTA is indicated as an intra-articular injection for the management of OA pain of the knee. Limitation of Use: The efficacy and safety of repeat administration of ZILRETTA have not been demonstrated.

Contraindication: ZILRETTA is contraindicated in patients who are hypersensitive to triamcinolone acetonide, corticosteroids or any components of the product.

Warnings and Precautions:

• Intra-articular Use Only: ZILRETTA has not been evaluated and should not be administered by epidural, intrathecal, intravenous, intraocular, intramuscular, intradermal, or subcutaneous routes. ZILRETTA should not be considered safe for epidural or intrathecal administration.
• Serious Neurologic Adverse Reactions with Epidural and Intrathecal Administration: Serious neurologic events have been reported following epidural or intrathecal corticosteroid administration. Corticosteroids are not approved for this use.
• Hypersensitivity reactions: Serious reactions have been reported with triamcinolone acetonide injection. Institute appropriate care if an anaphylactic reaction occurs.
• Joint infection and damage: A marked increase in joint pain, joint swelling, restricted motion, fever and malaise may suggest septic arthritis. If this occurs, conduct appropriate evaluation and if confirmed, institute appropriate antimicrobial treatment.

Adverse Reactions: The most commonly reported adverse reactions (incidence ≥1%) in clinical studies included sinusitis, cough, and contusions.

Please see ZILRETTALabel.com for full Prescribing Information.

About iovera°^®

The iovera° system uses the body’s natural response to cold to treat peripheral nerves and immediately reduce pain without the use of medication. Treatment is achieved through the formation of a precise cold zone delivered under the skin that is cold enough to immediately prevent the nerve from sending pain signals without causing damage to surrounding structures. The effect on the nerve is temporary, providing pain relief until the nerve regenerates. Treatment with iovera° does not include injection of any substance, opioid, or any other drug. The effect on pain control is immediate and can last up to 90 days.   The iovera° system is not indicated for treatment of central nervous system tissue. Additional information is available at www.iovera.com.

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 line. Potential complications: As with any surgical treatment that uses needle-based therapy, 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. Patients may help the healing process by applying ice packs to the affected sites, and by taking over-the-counter analgesics.

Forward-Looking Statements

Any statements in this press release about Pacira’s future expectations, plans, trends, outlook, projections and prospects, and other statements containing the words “believes,” “anticipates,” “plans,” “estimates,” “expects,” “intends,” “may,” “will,” “would,” “could,” “can” and similar expressions, constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements include, without limitation, statements related to the acquisition of Flexion and the costs and benefits thereof, Pacira’s growth and future operating results and trends, Pacira’s strategy, plans, objectives, expectations (financial or otherwise) and intentions, future financial results and growth potential, anticipated product portfolio, development programs, patent terms 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. Pacira cannot assure you that its 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: risks associated with acquisitions, such as the risk that the 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; the commercial success of ZILRETTA; risks related to future opportunities and plans for Flexion and its products, including uncertainty of the expected financial performance of Flexion and its products; the possibility that if Pacira does not achieve the perceived benefits of the Flexion acquisition as rapidly or to the extent anticipated by financial analysts or investors, the market price of Pacira’s shares could decline; the impact of the COVID-19 pandemic on elective surgeries, our manufacturing and supply chain, global and U.S. economic conditions, and Pacira’s business, including its revenues, financial condition and results of operations; the success of Pacira’s sales and manufacturing efforts in support of the commercialization of EXPAREL, iovera° and ZILRETTA; the rate and degree of market acceptance of EXPAREL, iovera° and ZILRETTA; the size and growth of the potential markets for EXPAREL, iovera° and ZILRETTA and Pacira’s ability to serve those markets; Pacira’s plans to expand the use of EXPAREL, iovera° and ZILRETTA to additional indications and opportunities, and the timing and success of any related clinical trials for EXPAREL, iovera° and ZILRETTA; the related timing and success of United States Food and Drug Administration supplemental New Drug Applications; our plans to evaluate, develop and pursue additional multivesicular liposome-based product candidates; the approval of the commercialization of our products in other jurisdictions; clinical trials in support of an existing or potential multivesicular liposome-based product; our commercialization and marketing capabilities and our ability to successfully construct an additional EXPAREL manufacturing suite in San Diego, California; the outcome of any litigation; the ability to successfully integrate any future acquisitions into Pacira’s existing business, including Flexion; the recoverability of Pacira’s deferred tax assets and assumptions associated with contingent consideration payments; and factors discussed in the “Risk Factors” of Pacira’s most recent Annual Report on Form 10-K and in other filings that Pacira periodically makes with the Securities and Exchange Commission. In addition, the forward-looking statements included in this press release represent Pacira’s 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 Pacira anticipates that subsequent events and developments will cause its views to change. However, while Pacira may elect to update these forward-looking statements at some point in the future, Pacira specifically disclaims any obligation to do so, except as required by law. These forward-looking statements should not be relied upon as representing Pacira’s 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: Coyne Public Relations Kristin Capone, (973) 588-2108 kcapone@coynepr.com