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reduced opioid consumption for up to 72 hours, represents a significant, much-
needed addition to the currently available postsurgical pain management
options."
Pacira's ad campaign featured a happy young patient perched in a wicker
chair. "Patient-Focused Pain Control That Lasts for Up to 72 Hours," the head-
line read. It continued: "The only single-dose local analgesic to … reduce or
eliminate opioids with pain control for up to 3 days."
The company recruited a team of anesthesiologists, orthopods, pharmacists and
other professionals to perform studies and talk up the drug on the lecture circuit
— a not-at-all unusual step for a pharmaceutical company. In 2013, the only year
data are available to date, Pacira spent close to $800,000 on consulting fees, grants,
travel and other items for physicians.
Perhaps coincidentally, articles began to be published that were laudatory of
Exparel.
In 2015, a 7-doctor "consensus" group published recommendations on inject-
ing Exparel for total hips and total knees. In 2013, Pacira paid 6 of the authors a
total of more than $46,000.
In 2015, anesthesiologist Jacob Hutchins, MD, and colleagues published an
article lauding Exparel for transversus abdominal plane (TAP) blocks in hys-
terectomies. Pacira paid and provided benefits for Dr. Hutchins totaling more
than $48,000 in 2013.
At least 2 retrospective (as opposed to prospective) studies found that
Exparel works as well or even slightly better than femoral blocks for pain con-
trol, and ambulation is quicker.
Currently underway is a "case control" study pitting bupivacaine against
Exparel in total knee cases, by Texas surgeon John Barrington, MD. His study so
far has shown a slight edge for Exparel in pain scores (2.48 for bupivacaine vs.
1.98 for Exparel), a slight decrease in length of stay for Exparel patients (0.29
days) and a better Press-Ganey score (98.3% vs. 96.7%). Dr. Barrington presented
the results at the American Academy of Orthopedic Surgeons, but his study has
