1. Pink Sheet
  2. >>Market Access

Pacira’s Exparel Will Get Separate Medicare Payment; CMS Still Wants Better Opioid-Sparing Data

 
• By Michael McCaughan

US Centers for Medicare and Medicaid Services proposes a change to its reimbursement policies for non-opioid pain therapies which will benefit a single product: Pacira’s Exparel. However, the broader message for that company is mixed.

Hospital exterior
CMS proposes to unbundle payment for Pacira's Exparel in ambulatory surgical centers but not in the much larger hospital outpatient department setting.

Pacira Pharmaceuticals Inc.’s campaign to secure better reimbursement for its liposomal bupivacaine formulation Exparel appears to have paid off – at least partially – with a proposal by the US Centers for Medicare & Medicaid Services (CMS) to unbundle payment for the drug when it is used in Ambulatory Surgical Centers (ASCs).

CMS announced the proposed change as part of the annual update to the Hospital Outpatient Prospective Payment System rule...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required
Start Free Trial

Already a subscriber?

More from Market Access

China Unveils Multiple Policies To Support Innovative Drugs Throughout Life Cycle

 
• By Xu Hu

China has announced a raft of new measures to encourage innovative drug development across the product life cycle, including using insurance data to differentiate new therapies and applying commercial insurance to selected novel products.

Medicaid Changes Could Have Major Impact on Recent Coverage Improvements

 
• By Tim Casey

Insurance trade groups warned that the Big Beautiful Bill destabilize Medicaid and result in the largest ever roll-back in health care coverage in the US.

England’s NHS Plan Eyes Cancer Vaccine Boost, Single Formulary & ‘Pay For Impact’ Drug Deal

 
• By Eliza Slawther

The creation of a single national formulary for medicines prescribing that could impact industry is among the action points in the UK government’s new 10-year health plan for the National Health Service in England.

Here At Last: Canada’s Long-Contested Guidelines For Curbing Excessive Drug Prices

 
• By Neena Brizmohun

Final guidelines explaining how staff at Canada’s Patented Medicine Prices Review Board should go about identifying drugs that could be considered for an excessive price hearing will come into force soon.

More from Pink Sheet

Opuni Appointed Acting CEO Of Ghana’s FDA As Darko Leaves To Lead African Medicines Agency

 
• By Anabel Costa-Ferreira

Kwabena Frimpong-Manso Opuni has been appointed as the new acting CEO of the Ghana Food and Drugs Authority, succeeding Delese Darko, who is now head of the Africa’s pan-continental medicines agency.

UK HRA Working On ‘Trusted’ Path Forward To Support Simplified Informed Consent

 
• By Vibha Sharma

The Health Research Authority is working on a streamlined model for informed consent that maintains people’s trust.

EU Ups Ante On Stockpiling For Crises

 
• By Francesca Bruce

The European Commission has published two new strategies on stockpiling that will improve the availability of critical medicines in times of crisis and reduce the EU’s dependance on suppliers outside the bloc.