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Centers for Medicare and Medicaid Propose New Reimbursement for EXPAREL in All Outpatient Surgical Environments Beginning January 1, 2025

Centers for Medicare and Medicaid Propose New Reimbursement for EXPAREL in All Outpatient Surgical Environments Beginning January 1, 2025

美国医疗保险与医疗补助中心(Centers for Medicare and Medicaid)提议,从2025年1月1日起,在所有门诊手术环境中为EXPAREL新定价报销。
Pacira BioSciences ·  07/10 00:00
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-- Proposed Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment System Rule extends separate payment from ambulatory surgical centers to include the hospital outpatient environment –

——提议的医院门诊和日间手术中心支付系统规则将单独支付从日间手术中心扩展到医院门诊环境——

-- Rule implements the NOPAIN Act, signed into law as part of the Consolidated Appropriations Act of 2023 --

——该规则执行NOPAIN法案,该法案是作为2023年综合拨款法案的一部分签署的——

TAMPA, Fla., July 10, 2024 (GLOBE NEWSWIRE) -- Pacira BioSciences, Inc. (NSDQ: PCRX), the industry leader in its commitment to non-opioid pain management and regenerative health solutions, today announced that the Centers for Medicare and Medicaid Services (CMS) has issued its proposed Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2025. In the proposed rule, EXPAREL (bupivacaine liposome injectable suspension) is one of six covered non-opioids—two of which are specific to ophthalmology— qualifying for separate Medicare reimbursement in both the ambulatory surgical center (ASC) and hospital outpatient (HOPD) settings. Pending finalization, this policy would go into effect beginning January 1, 2025.

2024年7月10日,美国康哲药业公司(股票代码:PCRX)行业板块的非阿片类疼痛管理和再生健康解决方案的领导者,今天宣布,CMS已发布其2025年拟议的医院门诊预期支付系统和日间手术中心支付系统规则。在拟议的法规中,bupivacaine liposome injectable suspension是6种被覆盖的非阿片类药物之一,其中有两个专门用于眼科医疗,符合在日间手术中心和医院门诊环境中单独获得医保报销的资格。在最终权定前,该政策将于2025年1月1日开始生效。

The proposed rule reflects impending implementation of the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, which mandates separate CMS payment for qualifying non-opioid drugs and devices across HOPD and ASC settings. The law was passed as part of the Consolidated Appropriations Act of 2023.

该拟议规则反映了预备实施的NOPAIN法案,该法案要求在医院门诊和日间手术中心环境中为符合资格的非阿片类药物和设备分别支付CMS。该法案是作为2023年综合拨款法案的一部分通过的。

"Following several years of advocacy for reimbursement policy reform to allow increased patient and provider access to non-opioids, we are pleased to see EXPAREL included as one of only six qualifying non-opioid drugs to treat postsurgical pain in the proposed rule," said Frank D. Lee, Chief Executive Officer of Pacira. "As the only covered single-dose product approved for both local and regional analgesia across surgical procedures, we believe this new reimbursement—pending finalization—will offer clinicians increased ability to utilize a best-in-class option for achieving long-lasting non-opioid pain control with an increased ability to transition to the outpatient environment."

“在推动报销策略改革以允许患者和供应商更加容易地获得非阿片类药物几年后,我们很高兴看到EXPAREL被包括在拟议规则中的仅有的六种符合资格的非阿片类药物之一,用于处理手术后疼痛”,Pacira的首席执行官Frank D. Lee表示。“作为唯一被批准用于外科手术中局部和区域麻醉的单剂量产品,我们相信这种新的报销——最终确定——将为临床医生提供更高的使用能力,以实现持久的非阿片类疼痛控制,并增加向门诊环境过渡的能力。”

Proposed Medicare payment rates for covered non-opioid drug products—as outlined in the proposed rule—equate to average sales price (ASP) + 6% in the HOPD and ASC environments.

拟议规则中覆盖的非阿片类药物产品的预计医保支付率——在医院门诊环境和日间手术中心环境中——等同于平均销售价格(ASP)+ 6%。

The six products and associated reimbursement rates included in the rule are as follows:

该规则包括以下六个产品及其相关的报销率:

Non-Opioid Drug Proposed Separate CMS
Payment Rate (Per Billing Unit)*
EXPAREL $1.41
Zynrelef $0.73
Xaracoll $0.85
Ketorolac tromethamine injection $0.702
Dextenza $117.01
Omidria $97.12
非阿片类药品 拟议的单独CMS支付
付款费率(每个计费单位)*
EXPAREL $1.41
Zynrelef 0.73美元
Xaracoll $0.85
Ketorolac tromethamine injection $0.702
Dextenza $117.01
Omidria $97.12

*Payment rates given in the proposed rule are subject to change and may not be the same payment rate listed in the final rule later this year.

*拟议规则中给出的支付价格可能会有所改变,可能与本年度后期发布的最终规则中列出的支付价格不同。

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 14 million patients across the United States to date.

EXPAREL适用于6岁及以上年龄组的患者通过浸润产生术后局部镇痛以及成人通过颈间隙臂丛神经阻滞、腘窝坐骨神经阻滞以及股四头肌腔加药导管的区域局部麻醉。其他神经阻滞的安全性和有效性尚未得到确立。迄今已经有超过1400万名患者在美国接受了使用。

To view the preliminary rule in its entirety, visit the Federal Register.

要查看全面的初步规则,请访问联邦公报。

About Pacira BioSciences
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 .

关于pacira biosciences。
Pacira Biosciences, Inc.(Nasdaq:PCRX)致力于为尽可能多的患者提供无阿片类选择,将阿片类药物重新定义为仅供抢救治疗。该公司还正在开发创新的干预措施,以解决涉及交感神经系统的令人沮丧的病症,例如心脏电风暴、慢性疼痛和痉挛性。Pacira拥有三个商业化阶段的非阿片类治疗方法:EXPAREL (bupivacaine liposome injectable suspension),一种长效局部麻醉,目前获得了术后疼痛管理的批准;ZILRETTA (triamcinolone acetonide extended-release injectable suspension),一种延长释放的关节内注射,适用于治疗骨关节炎膝关节疼痛;iovera,一种新型手持装置,可使用精确控制剂量的低温在定向神经上提供即时、长效且无药物控制疼痛。要了解有关Pacira的更多信息,包括降低过度依赖阿片类药物的公司使命,请访问。

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 .

关于EXPAREL。
EXPAREL (bupivacaine liposome injectable suspension)适用于6岁及以上年龄组的患者通过浸润产生术后局部镇痛,成人通过颈间隙臂丛神经阻滞、腘窝坐骨神经阻滞以及股四头肌腔加药导管的术后区域麻醉。其他神经阻滞的安全性和有效性尚未得到确认。该产品将布比卡因与多泡脂体结合使用,多泡脂体是一种已经证明的药物输送技术,可以在所需时间内输送药物。EXPAREL代表了首个并且唯一一个可以在围术期或术后使用的多泡脂体局部麻醉剂。通过使用多泡脂体平台,EXPAREL的单次剂量可以逐步释放布比卡因,使累积疼痛评分显著降低,镇痛时长可缩短至78%,缩减阿片类药物的用量;未展示减少阿片类药物的临床获益。更多信息详见。

Important Safety Information about EXPAREL 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.

EXPAREL患者的重要安全信息。
EXPAREL不应用于产科阴道旁麻醉。成人研究中,EXPAREL注入切口时最常见的副作用是恶心、便秘和呕吐。当EXPAREL注射在靠近神经处时,最常见的副作用是恶心、发烧和便秘。在给儿童使用的研究中,最常见的副作用是恶心、呕吐、便秘、低血压、红细胞计数减少、肌肉抽搐、视力模糊、瘙痒和心跳加速。EXPAREL可能会导致暂时性的感觉丧失和/或肌肉运动丧失。感觉丧失和/或肌肉运动丧失的程度和时间取决于注射点和药物用量及可能持续大约5天。不建议将EXPAREL用于6岁以下儿童的切口注射,18岁以下患者的神经注射和/或孕妇。如果您或您的孩子患有肝病,请告诉您的医疗保健提供者,因为它可能会影响体内活性成分(布比卡因)的消除。不应将EXPAREL注射到脊柱、关节或静脉内。EXPAREL中的活性成分可能会影响神经系统和心血管系统;可能会引起过敏反应;可能会注射到关节中引起损伤;并可能引起罕见的血液疾病。

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 "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 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 and intellectual property 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.

前瞻性声明
本新闻稿中关于Pacira未来的期望、计划、趋势、前景、预测和前景以及其他包含"预计"、"相信"、"可以"、"可能"、"估计"、"期望"、"意图"、"所有"、"计划"、"项目"、"应该"、"将"、"会"和类似表述的其他文字的所有声明均构成根据1934年修正版证券交易法("交易法")第21E款和1995年证券诉讼改革法的前瞻性声明。本新闻稿中的前瞻性声明还包括我们的增长、未来的营运业绩和趋势、我们的策略、计划、目标、期望(财务或其他方面)和意图、未来的财务业绩和增长潜力、包括有关我们计划偿还债务的计划、预计产品组合、开发计划、专利期限、产品开发、战略联盟和知识产权;以及不是历史事实的其他声明。为此,应将任何非历史性陈述视为前瞻性陈述。我们不能保证我们的估计、假设和期望将会被证明是正确的。由于各种重要因素的影响,实际结果可能会与相应的前瞻性陈述所示不同,其中包括与众多风险有关:我们的新任首席执行官的整合;收购相关的风险,如收购业务将无法成功整合,这种整合可能比预期的更加困难、耗时或成本更高,或该交易预计的收益将不会发生;我们的生产和供应链、全球和美国的经济状况(包括通胀和不断上升的利率)以及我们的业务,包括我们的收入、财务状况、现金流和运营结果;我们支持EXPAREL、ZILRETTA和iovera°商业化的销售和制造力量的成功;EXPAREL、ZILRETTA和iovera°市场接受程度的速度和程度;EXPAREL、ZILRETTA和iovera°的潜在市场的规模和增长,以及我们服务这些市场的能力;我们计划将EXPAREL、ZILRETTA和iovera°扩展到其他指示和机会的方法和时间,并且EXPAREL、ZILRETTA和iovera°的任何相关临床试验的时间和成功;EXPAREL、ZILRETTA和iovera°的商业成功;相关的U.S.食品和药物管理局补充新药申请和预市通知510(k)的时间和成功;欧洲药物管理局营销授权申请的时间和成功;我们计划评估、开发和追求额外的产品候选人,利用我们专有的多泡脂体("pMVL")药物传递技术;在现有或潜在的pMVL基础产品的临床试验支持下的商业化;我们的商业化和营销能力;我们能否成功完成资本项目;任何诉讼的结果;成功将任何未来收购整合到我们现有的业务中;我们的递延税款资产的可收回性;与待支付的条件交易额相关的假设;我们的股份回购计划的预期融资或利益;以及我们定期向证券交易委员会("SEC")提交的最新的年度报告的"风险因素",以及我们其他时而提交的文件。此外,包含在本新闻稿中的前瞻性陈述代表了我们截至本新闻稿日期的意见。重要因素可能会引起实际结果与前瞻性陈述所示或暗示的结果不同,因此我们预计随后的事件和发展将引起我们的看法发生变化。除非法律法规有所规定,我们无意义务更新或修订任何前瞻性陈述,无论是基于新信息、未来事件或其他原因,而读者不应将这些前瞻性陈述视为表达我们的看法的日期的任何随后日期。


Investor Contact:Susan Mesco, (973) 451-4030susan.mesco@pacira.comMedia Contact:Sara Marino, (973) 248-7005Sara.marino@pacira.com

投资人联系人:Susan Mesco,(973) 451-4030,susan.mesco@pacira.com 媒体联系人:Sara Marino,(973) 248-7005,Sara.marino@pacira.com

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