UnitedHealthcare to reimburse EXPAREL separately for 40M members, expands access
PCRX•UnitedHealthcare, covering approximately 40 million lives, now provides separate reimbursement for EXPAREL across hospital outpatient departments and ambulatory surgery centers. This raises the total covered lives with separate reimbursement for EXPAREL to roughly 150 million across national and regional payers, including Aetna, Cigna, TRICARE and Humana.
1. UnitedHealthcare Implements Separate Reimbursement
UnitedHealthcare now reimburses EXPAREL outside of surgical bundles in hospital outpatient departments and ambulatory surgery centers for eligible members, representing a key reimbursement policy change for non-opioid postsurgical pain management.
2. Coverage Expands to 150 Million Lives
With this addition, EXPAREL is reimbursed separately for roughly 150 million covered lives nationwide, joining national payers such as Aetna, Cigna, TRICARE and Humana, as well as multiple regional plans.
3. Impact on Patient Access and Adoption
Separate reimbursement removes financial barriers for providers and patients, enabling broader adoption of EXPAREL based on clinical need rather than bundled payment constraints, and supports Pacira’s goal of expanding non-opioid pain therapy access.
4. Strategic Implications for Pacira BioSciences
This milestone with the largest U.S. health insurer enhances Pacira’s market position, potentially driving incremental revenue growth and reinforcing its leadership in non-opioid analgesic therapies as reimbursement landscapes evolve.
