Background
- Liposomal Bupivacaine (Exparel) has been a common post-operative analgesic option since 2012
- Commonly used for bunionectomy, hemorrhoidectomy, and interscalene brachial plexus nerve block
- Current AWP = $515 per 20 mL vial
- Literature published in Anesthesiology in February 2021 by Ilfeld et al provided opposing evidence for the use of
liposomal bupivacaine
- Many hospital formulary committees have begun to limit the availability of liposomal bupivacaine or remove it from formulary
- In Fall 2021, FMC P&T Committee discussed possibility of limiting Exparel use
- FMC Surgeons want to see internal data before formulary alterations are made
- Most surgeons at FMC had previously used liposomal bupivacaine in combination with unencapsulated bupivacaine for post-operation analgesia
- Study assessed the post-operative pain and medication usage who receive:
- Liposomal bupivacaine + unencapsulated bupivacaine
OR
- Unencapsulated bupivacaine alone
- Results could drive formulary changes and ultimately cost savings
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