PCRX - Earnings call transcript Q3 2021 | Pacira BioSciences, Inc.

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Operator

Good day, and thank you for standing by. Welcome to the Q3 2021 Pacira BioSciences, Inc. Earnings Call. [Operator Instructions] Please be advised that today's conference call is being recorded. [Operator Instructions] I would now like to hand the conference over to Susan Mesco, Head of Investor Relations. ahead. go Please

Susan Mesco

and call Amanda, everyone. to Welcome Thank discuss good our conference to third today's you, morning, quarter progress.

speakers Executive Reinhart, Joining Chairman as on are call me Dave and Chief Financial Officer; Chief Charlie and Officer. today's Stack,

leadership Additional are for also team members session. Pacira question-and-answer here the of executive our

our you Such let between as related will to uncertainties. judgment potential today's transaction include statements expectations, forward-looking may we begin, and that current those Before statements and including Therapeutics. Flexion Pacira represent me remind and risks today call based on of the involve

For please website. on our information concerning risk the SEC, factors with free that or could website affect refer the our which company, SEC for to are available the filings

documentation the SEC for filed that, which Pacira has now we been Please such information free Flexion SEC. on both like the website. Dave to In you addition, that offer would and with refer remind available Stack. for documents in turn over With to to also are the the call will the tender I required

Dave Stack

morning, Susan. joining for us. you, thank you everyone, Thank and Good

derive grow out our provide the that ZILRETTA complementary solutions flow pathway. near robust that to a a earnings. Last deliver that This building will knee begin portfolio end-to-end major the our across top offering cash strategy and to neural where prepared substantial our will to discussion treatments commercial to most treatment Therapeutics. like we and with that we -- time thrilled proposed your business few turning our of were meaningful non-opioid will pain, We our osteoarthritis -- synergies we accretion a recent would With long-term remarks milestone our and expect stream, growth a to of to differentiated revenue with questions, which our will of drive goal have us allow our Flexion of devote in month, we line of highlights diversify highly before broaden asset for novel we acquisition today’s will with today. transaction pain aligns directly cover of to

an for XXXX. operating developing are integrated We plan ZILRETTA

generally far colorectal surgical failure is as how based procedures patient anesthesia Shriners approximately taking for expected regional protocols and that opportunity Regional complex ERAS which changing acting procedures place of enabling recovery we based ESP blocks pediatric pain Surgery needs our blocks nerve excellent for excellent outcomes, and care techniques approved to or standard summary the have that TAP highly pain XX% expect growth at surgeries. To control. and operational better Investor their around anesthesia they're faster pediatric by some pain is potential Dr. of highlighted pediatrics Jeff of iovera trajectory blocks in XX% last standard by surgical growth where to as are XX% systems field for will FDA painful from are points of and growth EXPAREL Day effects. Hospital accretive a to XX% and commercial where complimentary regional fueled and eight procedures, improved in by using which XXXX. of dose Center, -- EXPAREL and and put we three envision provided field rate, are vulnerable be procedures our only reported growth allows product Tampa. from as superiority of control of recovery, pain blocks shared EXPAREL management regimens care ease per redefining anesthesia We of across XXXX. We XXXX his sales by thus Future activities. make Dr. an month, shifting spinae base of to catheter be who Innovation Duke the on After complementary terms Holtz, Anesthesiologist management, last Regional $XXX Training displacing a institution to Anesthesiologist especially redefining growth the product Enhanced Maggie were Health Pediatric Therapeutics to important by in for with of With of to administration a an settings. field key joined Sunny at University million this, XX% control demonstrations for each this and the nerve call opioid EXPAREL standard year-over-year revolution opportunities Recovery Gadsden, a hosted at achieve market opinion and to fewer [ph] or million post at our institutionalizing leaders Tumber, which EXPAREL and EXPAREL quantitative yielding procedures. XXXX. can using XX% for Wellstar estimates, live strong iovera, single the grow Systems, Anesthesia synergies, the techniques, this pain operational Head were multiple long Flexion care by the Director erector experiences year, Pacira and ESP cumbersome transforming the Pacira earlier Children's the of Medical outpatient for capture discussed such on in and commercial of and in no least in deal ultrasound or for proposed X assets EXPAREL Regional from based replacement the And low only significant accretion ZILRETTA, date EXPAREL, Dr. net with such performed a context side ZILRETTA to showcasing the by guided XX% is are estimated opioids population. blocks, month. scoliosis, synergies

million for Chief opioid perform reduction surgery in becoming and by as procedure Paul EXPAREL the shoulder at cornerstone safety a EXPAREL to of Michael of are pediatric long arthroplasty new settings highlighted risks acting, Women's with total two a associated leading used has EXPAREL iovera Garber, EXPAREL, Saddleback Sethi, after for surgery. Neurosurgery case. how the $XXX the nerve savings OrthoNebraska, based procedure in ambulatory Tumber, as therapy marquee least surgery the for experience sales across of at Urban Dr. also For approaches. Dr. well example, California, surgery of physician cost Hospital, outpatient based has Enabling surgery EXPAREL. the advantages a represents Miami pain versus setting. surgeries procedure patients EXPAREL free Josh block to fastest ESP Greenwich, C-section Center, awake of highlighted XXXX. established X,XXX associated in as Dr. Dr. XX% non-pharmacologic by per Steve more for expected orthopedic Health based the summarize the case growth ERAS discussed of for him osteoarthritis research clinical he paved a medicine opportunity EXPAREL fusion the surgery of with more Shoulder game is transition have more pain than centers. Dr. University the at after Obstetric spinal ambulatory protocols billion sighted $X,XXX hours than guidelines is $XXX treating seen exceed for Anesthesiologist with the help sports the per heat at children's new success market spine knee in patients is changer than to free has his go blocks iovera spine Connecticut time procedures Medical a with as using opioid C-section of from surgery, TAP moms where free blocks based in hospitals and of to cold have influential country. in who or the Wang, growing way

expanding knee peripheral for osteoarthritis total as We well. procedural and are as successfully to arthroplasty iovera positioning a solution total

make As more our we procedures XX% EXPAREL procedures. than up reported of previously, orthopedic slightly

regulatory the of completed. and The only current strategy meaningful driving opportunity Director All spasticity palsy, suffering to and blockbuster for spinal of estimated at sclerosis the or the Pilot as novel underscored the on-label to such data spasticity the be untapped from the high. need believe potential Medicine spasticity, the are From lies defining With add a also the medical we but the compelling pain beginning future presented Spasticity patients the and on-label patients, event a who using With opportunities, iovera that are top Investor growth, impact feel and $XXX Investor are procedures spasticity. has Dr. the studies Treating spasticity applications Rehabilitation an of the in currently found these not to Pacira demand unmet Medical procedures X about the Day and Dr. event iovera. also the the indication. several of to is approach adding the of million outcomes share, the social And of multiple for can pain penetration, iovera, vast significant development end, Columbia, we by are itself line. and of is Section injury pain Rehabilitation. stroke, Physical EXPAREL data single-digit The cerebral Victoria. market the a are Winston treating as of our to almost University real-time XX market for extremely make on the of total exciting replay ahead. great and a British website. incremental itself. for of was President million market Canadian X% from cold XX and could outlook spasticity, market another addressable million for impact A Association million the we therapy Paul current costs be Winston, market. with for the highlighted iovera above of presented treatment Transitions the each cord

EXPAREL important Turning market. and this to Europe, the in now of are iovera underway launch

to interest, be product and generating mid We taking are expect by orders November. shipping

We as as with years. high procedures COVID as caused high-level for interest of backlog a a waiting tremendous has in orthopedic are X lists seeing Europe,

C-section academic surgeries number free A to and of include places regulatory block Cleveland age us pediatric Hospital XXXX. collaborations in and submission on continue indication ESP are blocks a hip spine for pain Ford These include an optimal Shriners of stay for neural average pediatric and which strong EXPAREL surgical and days, the total and extremity opportunity EXPAREL front, EXPAREL underway. management provides a Europe block knee registration to On surgery procedures. as This recovery for two Importantly, throughput continues and as iovera for team the nerve is label of X starting. under now clinical program years support for expansion at lower expected. are also the Hospitals and studies length for total III timeline to improve both an Activities efficiency track make patients opioid study Phase patients quarter at Clinic. in to an our progress time, third Henry as well several progress to for Detroit waiting of for in in

defining we're our remain to such arthroplasty iovera areas treatment report and interest Finally, iovera, interim results track Stellate from from EXPAREL post-operative knee procedures. regulatory Ganglion PREPARE heart surgery as for procedures. open block of and and total of we strategies new evaluating is dysrhythmia which study, With on

and supporting initiatives Legs Fracture. as Spasticity are pilot wide a exciting of we markets addition, such Rib In range and Restless Syndrome,

DepoFoam the subarachnoid moving where and As both program great pipeline, for therapy, seeing In administration, for next today spinal about high for a particular our we're in feel the action. cohort stand we products. EXPAREL dynamics extended are asset duration and we the with for to an we of free depodexamethasone potency market inflammation closing, a

we our and continue confident, to in on outlook. momentum confident highly We to build will remain highly growth our remain

that, Looking ahead, turn deliver forward pain to Charlie solutions the the a over our to along to iovera of financial to the EXPAREL the adding for pathway. position commercial call leadership look and end-to-end our we I'll and of to ZILRETTA expanding outlook. patients Charlie? non-opioid with use offering by review now And intend submit

Charlie Reinhart

Good Dave. you, everyone. morning, Thank

of Turning we feel confident strength very the to our financial financial in outlook, Pacira.

for significant trends. additions I'll debt and EXPAREL flows revenues investment to start support in with We cash our potential continued quick innovative, update on to non-opioid recent continue and to pipeline. see reduction a

and optimistic variant addressing procedural Delta faced additional our regional teams challenges beginning EXPAREL backlogs. pandemic challenges significant and strong the staffing revenues to market September fatigue shortages August previously due care for these supporting and surgical surges surgery are in As October fourth in already cases, outlook a indicated reported, quarter. COVID-XX to related elective moderate,

a to On on key ability business, market any and formulations. profile continues competitive seen base EXPAREL be the or we safety our have new our from a the not impact release business extended new pristine between entrants bupivacaine other generate front, differentiator to

of generic get our any Regarding of to that thriving to the line, currently confidence and EXPAREL, book listing, established the generic our US overcome have would that a patents, from To We have additional quickly for Orange patent listable EXPAREL, further Trademark estate. two position to recently our potential for runway. book growing composition Book including patents potential strong listed are forthcoming notices one rigorous proprietary patent we and been to in a including; and allowance finish received I'll have first, exclusivity and patents reiterate protect two franchise. is for several our orange Office Patent additional secure every EXPAREL orange a the hurdles successfully eligible ability product EXPAREL

are been a profiles the specifications, regulatory Second, process. EXPAREL. and third, And to multivesicular of the high manufacturing package a the range validated, inserts years have the remain a criteria challenges block and manufacturing liposome nerve proprietary there and release adults the short, we cold the records great In the batch believe never of product pediatrics. sterile bioequivalence block leader potential EXPAREL that and competitors, generic market never composition Without And of using chain, field will complexities established safety and for come broad insight any confidence procedures product specific across that have disclosed. for were given making be commercial infiltration, rigorous to approving many for into practical branded FDA. Pacira by a scale, we will of

Now, me gross let to margins. turn

cost few over with to capacity volumes. at gross We project continue margins improving XX% EXPAREL improvement least X,XXX steadily to and the margin gross basis of points by lower reaching XXXX, next years, manufacturing

commercial we enhanced XXX our quarter, Swindon. using suite custom manufacturing began our producing product in third at the process During liter

this expect and facility we volumes as to gross in start XXXX We benefiting liter XXX sold. up margins manufacturing ramp units

with guidance, the the XXXX While around intra we product surgery of will to continue share to we quarter COVID-XX for monthly recovery providing uncertainty and sales preliminary are not you. report trends given market, continued currently elective pace

to What We is are we on track this more can expectations revenue remain I growth. And changing is our you to line our will in X-year as which we that of disruptions. consider gross tell improvement line X,XXX the Sandler. least and that, top practice Operator? visibility and plan, XX% exceed growth deliver Instructions] our begin the planning teens, will at session. question operator comes [Operator David end in by robust today around points the in we long-term have high Piper margin Amsellem Q&A Our our bullish period. for margins of pandemic With basis related that of I year-over-year the operating from bottom confident ask first from

Please open. Your is line ahead. go

David Amsellem

Hey, thanks.

and a Just on the to can couple extent if you Flexion them. ZILRETTA answer

to transaction. First, regarding product support, just you reach think Flexion? commercial audience might to what with the talk support that to the have maybe physicians And do of can just you could wider you the Dave, about a broadly, you the differently extent which talk into relative of more

more more you'd your pivoting leaning So to into you which what the chronic And appetite one. that's how like term? to think something and deeply acquisitions, to significant about in you're deeply additional near-term orthos into number now number then of -- sort pain, that extent do pain? more the Thanks. And do for two, intermediate more into is chronic

Dave Stack

David. I'll first and Thanks, activities. with BD Ron our the on ask where grab we're comment to additional going I'll piece,

use understand to of orthopedic a some who they've about able the about the to the reimbursement a things think, with the use community. rebate product talking bit programs, for with little that relationships be feedback deep to given here really make etcetera. they'd like see and easier them us it to our and we're I David, number is what of some discussions folks and had We've ZILRETTA

one. task be that'll So,

We have used to there's also people a close -- very of know that at that Pacira that are have number not that ZILRETTA all.

that week ago it new And last here when -- started opportunity they group for it Analyst were relationship, we use our The folks not actually to the that X have folks a think folks were to using so the to interesting the benefit will using all selling network an it's who dinners but ZILRETTA we from, that night. Day. at pretty for of go the weren't to only weeks the corporate

scale And iovera here, and lot. ZILRETTA. as as basically same a customer help to think have audiences, reps we'll the and answer I that that's to so we us a of going fact have by iovera the same to multiple And partial just going we is the the chronic do now products dedicated question the what including our will marketplace, that be is this well pain to way,

it we the a that the that couple on ways outpatient believe of aspects a the training, will different the solutions the those of we'll this, in very it'll patient different patients. different if department the based offer Type profile, site whether or we have be So etcetera. you're is office, And can doing where physician's patient diabetic, X is, we hospital in these care treat to of reimbursement physicians populations,

cast there's the we to do very we And this perspective considerations can think of that we a wider generate lot So allows, from in interest synergies few allow a here basically a the that it, effectively net. cost think also ZILRETTA. us and of

this the hear gets important, point answer to reimbursement. question, products of as second but of just it to one the all dealing And have total question. we pipeline chronic only make assets, looking develop we're important think the back individual with the same I'll the David, not at pipeline. same get lays well terms these really are out the is products, to against target all able really that but same is which for these to also the their I for So, other how of I things you'll the on ideas by from the on the going as pain as mean, that here Ron that in part audiences, the we're to all the when physicians same

David can a here. what So, ideas about we're on thinking few Ron give

Ronald Ellis

Sure. And David, thank you.

pain, spine We've crossroads So gene and muscular skeletal. the in similar in chronic well. and in ortho get and specifically, coin, we We investment area terms vein iovera as at focus into pain, ZILRETTA as pain, neuropathic well. chronic which save between on the in pain are we investments well of made there in both made would biopharma CodaBio and that as chronic as

of a we'll integration place -- think more the other significant In primarily of the I that's half that something scale. But commercial opportunities. availability Flexion year or second the at that towards terms will in of more anything and doing before and significant, half ZILRETTA, first up in look for open take may next

Dave Stack

to reiterate, folks in would telling to patients, just I -- with what folks. especially David, sports the have are And a relationship mean is, these our medicine the have and ortho they they spine us the folks folks like long-term

a So particular don't of a product. lose free be would sight depodexamethasone

being through start procedure of where different to arthroplasty, XXs really still those with think patient a a of off aspects in something their ability the they a XXs. So patients or when might out these treat that's traumatic scenarios, about these up and the all is or holes focus and that. total advancement are the and I into then get a injury you customers a mean, like joint in turn be able their inflammation who of patients to the the sports with until osteoarthritic teenager, end same the of situator, following spine their

David Amsellem

Thanks.

Dave Stack

David. Thanks,

Operator

Renza of Markets. line with RBC the Capital from Gregory comes question next Our

Your open. line ahead. Please is go

Gregory Renza

… questions. my for taking

David. two, Just for me,

but comment as in and drivers, on Flexion's you've there just curious revenue exiting you look you're question leading certainly, earlier just on, fatigue thinking other the and today? some The much. the about in previous with variety the commented curious shift month. stage you do the ZILRETTA offer. on could relief just that put you can elective potential, positive procedure whether And focus a you're the growth to on exist that a just around multiyear very finer considerations can the the and commentary longer indicators. if on XXX, I'm in is that word on also even we first can October just certainly you on early the how potential point are factors, term for but that build seeing pressures what targets pain on XXX of pipeline surgical the one the for it a secondly, maybe of and regional addition space that landscape across those or if then your rheumatologic and of I'm chronic novel Thank to

Dave Stack

mouthful. June be the and talked is from That's not about in stronger. Greg. get mean, Charlie way. customers, I number And need moving thanks, this first seen. by to we we're at And orders. so where easy every It's week, we've X we're bit. is, and the including But customers market not a this see of the so you stronger, size think Remember a o'clock. but I of you to want we morning ordering what far little we're one pretty, both data the the we is I yet, Yes, improvement pretty every new direction. But be to that mean, total can see back getting that week-by-week, where in yet. week

seen So we've yesterday.

tell big largely see us that we having a I COVID And COVID that is much think of impact. people don't So really is us. behind

starting surgery happening I really we've as come tell some tell were through seen what the yet. of they summer you visibility back that's of but that for ortho. I'll everything procedures. the and that think procedures so back, far can't got device to they that's this you, think we're marketplace the these Greg, report hear went happy while painful ambulatory lower come to of actually seeing that, the pain I'm because we actually week, the that acuity XX% that you've But manufacturers to procedures started the front as on from I end on

now, ortho a nursing as being course. to that's to weekends. comings teams labor And recovery. this an to work get good. it of are see if relates in largely There's coming on market short specifically We They do things was a so have able still whole able of the the to they reticence going very so to the hour open still bunch some on things confusing make marketplace. And to back there, some the XX and mandates XX worthwhile have soft are still tissues of and rest in the and work do it be all of and days to procedures, the to place have the certain number

So modest see surgeries what I can't clear think tell progress But seeing week-on-week to back. elective that up. we're it on you a in I that's we basis, and these why coming

go number lot fairly looking we of outlined a a that things forward. is a what of pain in we're There's we addressing the the are there specifically. need at things area. out As Ron whole that see dramatic chronic

think gene we clinical past. careful IL-XRAs we events sidestep therapy we but adverse be especially and products, how have the like in products these development been participation our have able of be of I in to some of the the give to in things XXs, address the that different the NAV preparations you idea the that might some with that problematic those and

said I right real us for talking think right here. when for across so me, Ron table to value me he's it's sitting of silly the keep and to

ask him I'll comment. So to

Ronald Ellis

you. thank Greg,

looking osteoarthritis about slides that of assets we in as patient se, journey the to Meeting joint a think OA well the vertebrogenic or space of we as we pain, back chronic the add during terms category. how are In middle the knee and Analyst couple shared of per

starting off be may that spines, and then it's knee, EXPAREL end depodexamethasone of mentioned, at patients ZILRETTA for for journey. available Dave the As

both on of and the and In has forward the terms this looking the assets, Flexion I data on year, the beginning XXX we're later of both exact next for to Phase decisions XXX some pipeline, that. getting data

is recall, product If licensed we've the company a -- XXX in, that it was invested may you from GeneQuine.

So platform. the the they HDAC as same platform share well

both terms XXX So sodium overlapping be in forward may of there on interest yes. mentioned. similarity in The of a But soon, lot the data seeing as to modulator Dave we're motor channel reduction in and interesting weakness. assets looking a

Dave Stack

that think I pretty Greg. so where sums up Yes, much are we

You okay?

Gregory Renza

very guys. you Thank the color. much, Appreciate

Dave Stack

Thank you.

Operator

of Jefferies. our from with And David line comes next question the Steinberg

is line Your open. now

David Steinberg

EXPAREL in a But them? The more I been seeing and for and been here field people their to the broadly couple couple meeting weeks the And hearing of hospital a And are quarter? competitor over we formulary for the out market just you a little I to ago over bunch been out clinicians any talking of out your then you've just margin quarter. Charlie, secondly, discussions what gross in has a heard R&D view. next from lost about mentioned from the your now P&T have know now sales years. that's improvement, know

softer these Just in your just the quarter? most know lower it and quarter. recent there last gross it Thanks. move things points year XXX over quarter, this lowest gross last around looked somewhat a margin margins like was I from the basis lot. But curious why

Dave Stack

Heron are. bit concerns actually -- that's feedback from And reps only we don't we to a tried from it's coolest a the but single us formulary have haven't The of, who eyed, we We we've seen little who that who people know Thanks, not usable to from accept from it. level. any feedback one we lost that the themselves. comes not I'll they anything David. and gotten use given now. are But that that probably all on the haven't physicians

as view shape mirror. that very about the want rearview I in we're we So to think and margin improvement? talk you gross in good Charlie,

Charlie Reinhart

Sure, sure.

to U.K., think the is I and in XXX up in speed. David, investing transitioning unit that liter the is, question the we're So,

we've capacity you know think tips I as the that -- for also manufacturing You iovera probably expanded well.

So there's point. an awful lot of manufacturing on transition this at going

the that lighter volume third reasons a anticipated from the than addition, I due to was the we In perspective quarter frankly, script. quite mentioned had in

going fully So, XXs. back it's expect we're it a to to be to issue get transitory the mid at and and

Dave Stack

some going both be, really was greater I out the was building revenues, to iovera impact so as Charlie an Yes, sides. on additional had think David, -- for capacity thought where had lower iovera EXPAREL it was impact we in on said, a based impact

David Steinberg

makes sense. Okay. That

Just one follow-up. quick

indicated you'd X that be the year. clarify to ongoing would and bit? most X still patients X million the and you hospitals. backlog think procedures, there's with cadence Thanks. changed development But that backlog the Just million X a thought ASCs this is backlog recent year, this million fatigue next to a million about million about done Is was more of situation, think X recently, you be and and or that I that next and year a

Dave Stack

we you of ever kinds question and leads all in I becomes reporting do we've think And it think as 'XX companies of the we -- right to is event it out a than more answer, work be. David, thought was well, space the think I right, this -- I me activities. are that that your to it of similar going see extended

million patients surgery. and appropriate the where and ASA you think patients, and of have patients is, these reason be number to that starts ASA spent apart there is would ASA some now, a them no every fall without a year referenced I patients to three for X and longer expect that half surgery now four

is done to patients. these companies on period these difficult have I that to gone for of where much more likely time this and the ASC, are trying do, to in send extended insurance all which procedures much the be think become less

be insurance done And the see but there with a willing to we going pool and wants for who's struggling out that to than ever find of where elective if and are to so procedures outpatient in them to would that the company marry with see at appropriate go on it, likely so are by the to patients the And an their pay patient. these somebody timeline -- only to appropriate more disease folks less have to the a insurance are been for these to for the able at center, did and before patients insurance a procedure company right. you do surgery more be at carrier do less directed get as that do environment, would the would their price, not have been progresses, be we we them have certain opioid certain of [ph] but ASC case,

have to discount our opioids in patient that you marketplace. very tension in time work and some creates done the complex, take on That's a If at an ones you've inpatient, an to united through. become ASC chronic way a to and going some to XX%

David Steinberg

Dave. it. you, Thank Got

Dave Stack

David. Thanks,

Operator

next The Balaji comes Prasad from Barclays. from question

Your line is now open.

Balaji Prasad

just morning, question. good the from for two thanks me. Hi, And and

of this some be using million by from highlighted, the that recent Secondly, it's do market? potential you IP expect teens you you're on for markets? dynamics and you a longer context the the can OB What these And look you $XXX at relative that listings? we around a EXPAREL maybe would strengthening saved, of notices part you. the that term when mid provide impact size in the see have the And international with also describe can allowance to Thank for revenue challenges? Firstly, XXXX. CAGR, to file the of going

Dave Stack

connection was. sorry, I I'm ask may our Balaji. question your clarity very isn't some good, what have you on for to exactly

I first IP one exclusivity? think was the

Balaji Prasad

the a patent That more Orange bit is IP? do details to listing which about your you strengthens right, Dave. see or claims Book When and the expect

Dave Stack

Yes, thank you.

prosecuted. So, be end we by this ones least been of they will that that at year, have currently the listed expect the

be have also We along. will more expect that coming to

So what happen. the we now you're expect have seeing of is tip what just to

we patents. a half think dozen here certainly Book be there'll cadence Balaji, another regular Orange So listed, some but will. Not for will all be

patents we yesterday. patents. I navigated. X filing the did. the So, tell to X we Book to before actually have And would press We Orange Paragraph referenced be at asked expect of that the the they listed sent us have should Charlie, that, would look PTO those that you also release would of to they acceptance X

the at the filed. to looked since PX us, has the and patents issued those filing And still already office was PX patent so

and belief is our position here our growing. So

we feel And increasingly thing. We feel are about well. positive in where pretty so, we this whole

we can the So the of second get time. with much clear the It now question? wasn’t last part

… So

Balaji Prasad

Yes.

second was term dynamics. the The on longer question

from the million the some markets? part the provide mid As context $XXX you. start would be expand markets as at CAGR, And What out you around of $XXX some by pointed sizes XXXX. you you can teens places at to Thank also, relative EXPAREL which international internationally? of to least around of this million these

Dave Stack

Yes.

many to as important, alternative possible. it's mission given an as Balaji, especially to our patients opioid provide So

So 'XX the of profitable We in expect to -- middle sorry. 'XX I'm be

XX% would States. to our still as you in revenues X-year our that United the of see there So it Board here. to But call operate out reason plan, is be a going are our for in does

the in So, this years. is the Europe, material In They're it's doesn't biggest U.K. to X important of length to going we terms arthroplasties numbers total as or that time -- good way see, customer behind business, profitable and stay the go is the lag nearly we not at business, but long-term X be to over and EBITDA the viability of joint days, we expect is forward. their as least attain

number so transitioning of looks U.S into NHS that where facilities protocols patient with something the a And can a marketplace orthopedic go. like ambulatory actually on the through the without groups ERAS has worked

we having So that surgery it current their surgery what like a center in, day facilities, much perform how looks do do we with we're is, working to them on hospital something a without right. very day use where same same

the that's they need with catch X-day kind length so up they And stay, they to understand that of And catch that fully up. can't right. that, a of thing

period And procedures. the serious to on be using so surgical On especially order able non-opioid this great more waiting interest while to pain, iovera, EXPAREL. time to get they're in control patients extended of on in their that's a

It So led we have big of by hopes for U.K. will both be them. the

But of all hearing getting we're some and interest knees they're already other right. spine things in blocks. procedures and the of on of conferences, about out the the because focus will lot shoulders a these at We

of it's the And that and and a users America, ERAS In protocols have for Latin In so requests we partner. the behind in is deal. else. smaller and the countries countries. approval on the Brazil bunch shots XX regulatory whole Brazil a indications over involved the But calls to and then or Brazil these using, And close what Latin immediately everything pricing individuals then But basically. etcetera. Brazil, it's pathway Brazil, then it's are countries there's and are a America, there's almost XX

really much premier in it the Canada. spasticity your Canada, do And don't iovera. world In in the so have so we status know exactly guy And until partner happens that you just in is a for what you is Brazil.

for opportunity has Canadian And the in spasticity. then the lead the basically to way our use Winston partner so Paul of iovera with

First able some us the big figure markets, There'll out be that and an those opportunities get will spasticity indication to over be other then for pain here hopefully a we'll pathway spasticity But -- $X this are the Balaji. pointed our of close of at margin capacity lot product by next really quarters. to is improving Charlie But by to have is couple this billion XXXX. it out of driven a that itself.

XX%, stuff be So you make should of a it sell then finding worth billion $X if couple could at XX%. ways of we worth billion to dollars this at

But the sell. capacity we first than make yet. there can time, not we're more we the to Now for have

And a when different the it so that to looking marketplaces. different comes very puts us category into at in -- world

Balaji Prasad

Dave. you, Very Thank helpful.

Dave Stack

Thanks, Balaji.

Operator

comes Securities. Our Greg next from Fraser from question Truist

line is Your open. now

Greg Fraser

specific you're and growth providing robust that if the I Can be double-digit color what X teens, EXPAREL. on I know is robust in you And to advantages the over you you. bring one the you that on additional quarter. Gen of could think speak growth, expand system? guidance helpful. expecting sales, mentioned Thank current you any on iovera not quick would version the wondering was will platform but fourth that, for then

Dave Stack

sure. Yes,

one easier second is first the a lot to The one.

ergonomic So Gen improvements. X, so there's some

all would with looked trigger on with you. an the treatment. buttons handheld terms probe to the different clinician marketplaces, Greg, for as visually, example, it you Gen ultrasound probe with couldn't the the reach couldn't actually and able one be ultrasound hand, X, -- to are an you hold you a that to if at mean be Some But wants holding get where much of we to in modest, into it,

moved cartridge the tip other some handheld with to want clips that to a a on hold from going will but the get is to treatments changes per There's but lot number actual and somebody be tip will continues in of design go accept things that modest tip of screws on. not be the And a allow to able around downstream, we'll cartridges more this end things, There's only cartridges we've to more. the fact go -- The to significant of more that the a will right. we hand. one robust, so that two on that handheld do us and to

look of for size sort refine different cycle can fits at continue Right we We one to shorten the this ways and procedures. all, time that now it's right.

necessarily might the where iovera. are into that other a facilities as these that of true button, use minute not we push You be you get a of treatment, to get trying some docs

Gen way well. the the be obviously that the radiation a the And hands have to of that's put degree And cartridge X to to to two use up, the operator the things. angle fire. pain over iovera, a for and it's XX that, then set would So order to be you field is not But system all fluoroscopy. the good current is of get at real Well of start in guys as again, progress and idea. going in a a bunch you we as the example, give in here, just a time life they chronic way work use

at able line, ball ongoing ice be that there's we'll be ice that balls, even laterally. will, an make ice longitudinally where because It all. are of might nerve if of using be it's in to different might across the configurations. not designs a kinds So, an different than lays coming you rather top It

lot iovera, So just going sense -- that you be a to procedures. for a there's around that tips and things these give will on specific specific of

third teens. over were through in expect we question? we Your we're know back normal, second quarter. we would into the XX% would be get We that and you the the teens Yes, as to obviously

there unreasonable week strong In this QX be an pretty the you said a far, be week So October not were yet, better might And actually. are was to just teens Wednesday. We're so not lot Tuesday, flat. expectation. we're that there but Monday, it's not -- But yet. from We like candid.

about not don't we're spot. I unreasonable great Greg. coming so remember, expectation, think So that's an But off

Greg Fraser

Great, thank you.

Dave Stack

Thanks.

Operator

next Our Dushyanth Please ahead. from Berenberg. from question comes Anita go

Your line open. is

Anita Dushyanth

morning. Hi, Good I Dave. here. few have a questions

to you backlog think just up talked out, resumption trying of procedures. it about you procedures to the out the of are touch pushed to that earlier. more still about the wanted of Like considering I seen I'm amount building stronger Just But getting is know see was elective and being upon likely pre-pandemic to likely the -- you throughout the dynamics one spread where be had QX similar quarters. year? the the it

Dave Stack

of satisfied No, a and is One thank well, if We insurance. might insurance who next Anita, elective And I of dynamics not. their with you situation here employment the come they people have especially QX question. have a the whole and their employed every many The for lot year. There's dynamic in, see in that things as the there's unsettled by that place their strong etcetera, are see deductible co-pays, two we especially patients insurance. hope very really, their that procedures orthopedic and QX year. life for not procedures where they're in is of driven dynamic. not

will years. be would bit in was And have We whether -- for been so of as it we years. a as to going other just that's be we earlier on that, a They don't sure. count like know strong still it's can't there

get cosmetic but And is that, strong they out year. every appear folks gifts. holiday because people get surgery into stronger it's up. And be come in must to that start next Year's lifestyle. know more that coming as it's they true We The as procedures that Christmas very an go New and you plastic back might that it and dynamic will crazy, sounds between and actually active the after they other the to at, smile day but week it's to think do get physician

lighter it's the are XX% you be a mean normal expectation think dynamic, again, year, that of not would on give given a fact an smaller XX% we QX would the the unreasonable is here, I year. expected, given I So but our numbers the number. COVID of have this just And business than that context some to roughly

where So play, see it's going. a you little bit game but of I'm

Anita Dushyanth

know was to that Yes, just of you are there, continuing your wanted regard helpful. I to a market, then increase if you. you're to adopt going the pediatric launch to presence in And the with sort Thank approach? or slow

Dave Stack

No, we did.

what in September, happen, centers, is trained major on the field Anita. to the was we organization in pediatrics. we entire And we to get were which So, approvals going exactly hoping continue

we team been right. protocols and to centers them accomplish, very those for community. is needed the understand to then really get that their to the We at academic that's it, into guidance, folks what peds, what and to are, dedicated successful send need places out has using Our protocols how major look they're those and

trained. is so sales running still And The force launch. folks the whole ran ped that ped are the the launch

field sure you and follow-up of actively so idea And involved that and force replace can doesn't appropriately. they're catheters, to but hospitals, that to introduce the just the making go a bunch then not pumps

to pharmacies thing you you have you So we're all to to hospital about C the you a force When the to easy have you being to to on on you that's sure board, sell, going train folks, train make imagine. manic you to for a at that the to to go that's board. And you and the not until suites don't that can fact into we're a And the nurses, a understand, hospital. next start hospital one have time. and this is is get done, sure care, field as nuts, satisfied patient appropriate soup an make have go

is everybody but way in we stringent access, we're So still are the providing trained now.

train. to opportunity large a have we So

Anita Dushyanth

we in And are the Okay, great. blocks. studies results one more Thank these? extremity related then to the When to likely expect from you. nerve lower just

Dave Stack

many we're we're they we same of using the can that of So started. complete think most trials, and sites the same surgeons. using these We

think we plan by in middle have And of we'll the data anyway. sometime the QX. so, current that That's

separate two block. there's What canal really studies. a block it's a is but bunion adductor study, other an the sciatic does Now, and

give opportunity would next those third That's quarter submit the approval NDA that of we early that year, in would year. hopeful launch of of the the plan. XX-month so on in first the next that we're So, we half a can a studies both an get quarter done us in second that

Anita Dushyanth

Great.

Okay.

Thank helpful. Okay, that's you.

Dave Stack

Thanks.

Operator

Our next question comes from Chris Neyor from JPMorgan.

is now Your open. line

Christopher Neyor

Two questions.

on and one is XXXX margin expense first progression improvement. gross the So

I wondering for was COGS progression year, And margin which on a into at and we just very As provide and color development. the improvement to for expectations about expense outlined pace the follow-up year? margin thinking could the operating look you near-term. You've gross one, opportunities realized more of targets a in but second I'm expense business the helpful bit through both next be these also then just some leveraging, on if

Thanks capital pursuing are that be thinking or allocation about there whether you much. is are for shifting? capacity how constraints Flexion, any financial integration? so priority post deals, significant operational So additional And

Dave Stack

Thanks, Chris.

Flexion -- first it's a ZILRETTA, right. there's the and situation -- On dynamic there's one, given well

-- mid the digits. so, you EXPAREL And would OpEx single you that on increasing have would in we iovera, expect plan,

points, We we get expect expected rolls actually and to of and you think produced get XXX revenues we use as to X,XXX and 'XX that, basis material something that's along, the in several them if would more that like facility, this, are Swindon there's be times right.

improves, yet would still at clear as it like growing expense margin then time, Flexion. the you line, improvement not I as a of same at as single have frankly, without from addition all like that the as something the growing and we in gross be, a it getting are information are but might and be, is and don't of to to Flexion of But revenues it in the course. improve digits revenue expenses if So XXs, we're will

better synergies be my than up have significant, meaning margins to -- will that and these mean portfolio working projection. next really read our they assumption, be I would be if revenue important -- addition we So, have than year, that synergies better without the the the is Chris, significantly the been will will reached

and have you giving have very, But be good been with iovera good number iovera very could example. Actually not EXPAREL. would ZILRETTA. good I'm been with EXPAREL. it it would with very and So based a It perfect

And so I'm as got couple margins of just specifically. looking if everything has Chris. the around we you, anybody see is go I leading dramatically than improving years idea next through gave towards these a to better

Charlie Reinhart

good. No, no, so far, so

Dave Stack

Okay.

Ronald Ellis

And Chris, Ron. it's

shifts the on strategy. question, see BD significant the On any don't in

a therapeutics, within well, -- to core two capital back continue chronic in pain, the primarily across half side of franchises, which allocation, about focus 'XX. beyond larger And of pain, you broken for up year we regards as be and on look the and the especially continue musculoskeletal then to on external special or acute talked pain earlier. innovation integration period, therapeutics franchises And osteoarthritis promising we the of will three pain will discuss we tumorigenic We have more first opportunities. to the

Christopher Neyor

Thanks. Perfect.

Dave Stack

deal say it's I fair, if -- understanding earlier do leads things us And do marketplace Ron our and ability to the here. commercial I'm I the a clinical here. Chris, trials to in think ask $XXX assets another think our to to lot comment where million incorrect near-term. don't of folks there's you're But of see But going with

then made we would that Bioscience profile. peptide met, example they the Spine disease. great on. a If target of, asset think an this off take of that acid I is actually believe target X-amino progression a the is a turns That's investment that profile was against

I think the something sense the opportunity. investing next that at significant Flexion over that's style of a makes over -- digest we short-term looking deal the more a lot while than else

Christopher Neyor

context. helpful That's

Dave Stack

Thanks, Chris.

Operator

Belanger Our of next from Needham question from Serge & the line comes Company.

open. now is line Your

Serge Belanger

good Hey, morning.

of a for me. Just questions couple

to pain. one to and sales. I iovera specifically think that's wanted of revisit only in million First, XXXX the I more TKA targets, reaching knee in OA And $XXX related

there payer awareness reimbursement there? get the on get and to and done just in clinical those to we in data specific Just indications fronts maybe do more needs with building curious, be order more what

Dave Stack

-- a First, that reliable the X that been it's Gen having on, Gen bought. and X system the some with have we more and system we docs can there count issues

lot they it What improvement dramatic. in need, bunch use use it of to is the patient access if stabilizing I market. you So -- use you times. you is it -- that will iovera, mean customers. once, a help opportunity mean the when for works terms -- people use you I it of frankly, the a we will care if

successfully the We take to behind is then would have single us, So access on. we system so well. And I force third need, ZILRETTA docs. thing. using control, the The is thing, very some rely a and a on a frankly, frankly, increasing data then this That's a commercial reimbursement are reps HOPD is good. that as And in We’ve as from who say got of increased of example, to therapy finding the instances pain are patients. size be sales an for Serge, provide to is in acceptance for in self-pay drug COVID pay reimbursement. we're to that opportunity especially we the very and the reimbursement the biggest well Workmen's need is what to Comp, docs biggest perspective. And for this nondrug we pre-surgical the insurers insurers

nurse organized not what's fell is spaceship, freeze And drug like of in failed I see boards real drugs your day is with and product anything. we've seeing dose. a looks need have to on but months. for as most at can So you the you're that phone the guys. in nerve -- just since you're a I you going sell these got spasticity. go age have some that between and use use been marketplace to And interest is you've it's $X,XXX and overwhelming. to you sell and interest cell device used from Baclofen look $XXX. an phenol with thing going you over Botox, is think rep just, the use we going I the unit is next you you're When spasticity the new this of and office. depending go been series treat look spasticity spasticity, pain. right. to with average then into with of and in they're spasticity think this into these the something have, $XX,XXX a some marketplace KOLs has you little a question several using a like looks We ad think the you're space price opportunities they going a in And that sets is I diversion the are probably big orthopedics the to office at neighborhood And to tip when and that a cold not to pumps -- anymore, known you it these the and an world say hampering to you KOLs frankly, to that us that We the And to out the the guys and some because of had or bit at When as go just this at of mean, littered does look of

a I asked in maybe issue anymore you -- the spasticity million bit and against cheating So it think But is the is way an pain. spasticity not little works if question. and $XXX it

So completely just to be candid.

Serge Belanger

let right. in more. Sure. me one squeeze And All

XX% in prepared XXXX. your regional think in talked you about approaches anesthesia comments, I to from growing XX%

Just that curious means going XXXX If installation will for what be there the market. and in -- one forward?

Dave Stack

you nerve just Yes, yes. where There will can't do be. right. There places block, are some a

It a right nerve is is in have for of now, the PEs, infiltration. first -- so for And we not there's well, indication all, block.

example. canal or might ACL give of doing infiltration direct different we're docs guys knee, the we periarticular and infiltrations. are repair, about the and address an put do of where periosteum knee, they but doing drug inject the have to training into for a talking we're time, the I'll a block. for most do and we gals guys capsule, But example, same for pain periosteum doing you at some the also for adductor they in would a injection an kinds actually the would posterior So infiltration. When example, you anterior either in the

to this that all nerve marketplace, this, blocking because are to think a discussions combination. the define them I you a to you make and all is stupid on lectured my indication, have see calls define going for little the block a so for greater so the opportunity time ultrasound. is that a or you one an them nerves guys. see positioning field the these In can sense nerve I’m in in the But them block the In interesting case, docs these a you block you're the to, forces the FDA And is they're And infiltration the nerve time. blocks. and and see you because we in marketplace block, nerve that It's it anesthesia you're a because any community. nerve with think a one at because define doesn't way FDA nerve can't nonsense, you way the

… So

Serge Belanger

Okay, you. great. Thank

Dave Stack

Serge. Thanks,

Operator

next comes from Our Andreas Argyrides question Wedbush. from

now is open. line Your

Andreas Argyrides

sticking -- this of kind that if asked expect just add to iovera? those from mean I iovera in of expected, and for it to, pardon secondly early on How are Yes, essence, I then late those know this year. next -- what earlier, are PREPARE, And I results going how TKA guess, was add profile the study don't are PREPARE if results? was. the we they when can can results? we topic And year, --

Just on have Remedisc from when we that that timeline? etcetera, we the data still Bio, we Is partnerships can -- with other a from the expect Spine study -- that Are or in data, of program? XXXX. that you sometime kind have

Dave Stack

Andreas. Ron I'm one. comment number Thanks on take going questions. for to the two, number will

right. the for for and really mostly done to PREPARE So study is reimbursement self-insured provide data employers, mostly

I -- to in understands is. and how they self-insured don't what weight the self-insured the and they're how financial important the much now employers in how the sparing opioid the the that marketplace general what in defining general, think use by So community and market carry want way,

working addressing functional does of endpoints. separate direction, -- of And and take that treat drive? to the off we'll outside if groups Those it at you patient who patients pain When that what so if money have not to And long painful HOPD can that you they the And relative the they like were is, commercial really issues, to in get can actually cost does iovera. physician? to do useful with study really is prepared, with be workman's sent those OA ASC. these can will people the And back the them like I better a I a other are then and And into are it Do CMS it now signal looking so current costs PREPARE before how When amount chronic does big what they at have of before to look shape for in do two care but this And us the patient the things reimbursement those get joint same this patients. procedure. payers the this in ambulate? than handle significant patients, that's in pay with those questions is x into done they taking I'm a also to we're looking the PT? turn the the of How are big comp. going long question very you the answer. angles in will look and those

them abusing to story that. alcohol, alcohol. is it's them, and total show, get is think patients talk I who it procedure, reimbursement BMI smoking. And do do we we're to the to allow to trying is a range how get need the doing we arthroplasty opioids the get as knee If trials, So the If they're clinical frankly, idea much them they as showing, efficacy stop that that to we what off are a story. guys to to have them are abusing stop to supports here into because a

wheelchair turn I months, pain, could stairs, in the you to big for could One walk we that's to mailbox mean deal. been could you XX like the I want and walk them of we're get is you mail. wheelchair, start and simple out the things of But we thoughts going like them the a anything if docs, the a let big we doesn't me. if sound down their mailbox. off it get for when Every day can to you've with even your

in patient a is trying almost we the And turn on patient by make are we're itself. the sense? they definition, Does a to why surgery the focused postsurgical for functional become pain patient outcomes. the to be off, signal so better that better get which And environment, then

Andreas Argyrides

color. Yes, very helpful

Just Remedisc question -- on a on quick progress that program. of the

Dave Stack

Yes.

Ronald Ellis

Andreas, it's Ron.

expect then we the Remedisc, Phase the XXXX program in timeline III open on to and Just early …

Dave Stack

'XX.

Ronald Ellis

for 'XX. first yes, half the results then in of and 'XX,

Andreas Argyrides

color progress. Thanks, on and helpful Fantastic. Very guys. the congrats

Dave Stack

Great. Andreas. Thanks,

Charlie Reinhart

Thank you.

Operator

back over Q&A remarks. this Dave our to turn time, At like concludes Stack closing the I'd This to for session. call

Dave Stack

and thank to call. updated would keeping Thanks, Amanda. our on I progress. like look forward participating you for you all to conference listening to We today’s

us the later stay Conferences for well. all, up month. and Thank is this Berenberg you Jefferies the and Next

Operator

This you for concludes today’s call. conference Thank participating.

You may now disconnect.

Pacira BioSciences (PCRX) 3 Nov 212021 Q3 Earnings call transcript