- Earnings call transcript Q3 2022

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Susan Mesco

Good morning everyone. Welcome to today's conference call to discuss our Third Quarter 2022 Financial Results.

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

Additional members of our executive team will join for today's question-and-answer session.

Before we begin, let me remind you that this call will include forward-looking statements based on current expectations. judgment today our risks may represent uncertainties. and statements as and of involve Such

risk could Stack. available factors please concerning call that, information For that turn now our or website. the filings I SEC will refer to affect SEC which the are Dave from over our With to company, the

Dave Stack

recent We'll discussion with prepared Thank you, and everyone your today's morning before thank you to to begin cover business Susan. Good for highlights turning joining us. remarks questions.

our report across to pleased quarter revenue results increased success are We and a were third all growth, which including measures value adjusted EBITDA, creation.

On milestones Phase the recently X across portfolio. our clinical deliver we reported two nerve regulatory extremity to our studies, durable block opioid-sparing of the front, lower are and near-term positive additional beyond poised results several

$XXX.X EXPAREL growth and care million expanding sites utilization markets a year-over-year environment. quarter target sales challenging with across and all Third macro of despite of X% were

by marked the trends treated mid-August also EXPAREL patients growth with of XXXX exceeding $XX significantly the marking beginning million with We of quarter improvement year-over-year sales consecutive see adjusted average Strong us September EBITDA. to States. third sales to culminating United daily deliver operating discipline positive XXnd our The in million, positive XX in in EBITDA combined adjusted quarter allowed EXPAREL XX%. with began

conditions, to across a market unique in team We unpredictable invest We are say safe pleased gross quarter, further with has of despite we and portfolio. challenging improve margins Throughout operating the key these in environment. to the this our opioid-sparing impressive and record consistently unequivocally continue that execution initiatives our delivered. can Pacira

facility new XXX-liter a margins. will test in be significant gross running now remain Diego in application seeking this in suite step a are manufacturing XXXX, supplemental submission on new EXPAREL of San track approval we batches improving for which and EXPAREL, our for drug For

Our phase. qualification new is line fill ZILRETTA in the

ZILRETTA. for anticipated and future yield to this growth expect quality line to improve We support

new now benefiting fully online lower with our unit to contract Finally, iovera° manufacturer is margins costs demand. future support

more our EXPAREL specifics shifts some based to surgeries. enabling recovery topline Turning with remains drive for blocks, now growth Regional Analgesia care field franchise. and and patient accelerated one EXPAREL our long-acting in to same-day times, nerve driver and paradigm continues number

we in regional recently announced trials market Importantly, following nerve analgesia expect lower expansion blocks. additional the extremity the positive for

importance On the No reimbursement Act D.C. to the XX passage the legislation Washington non-opioid as bipartisan Medicare would commercial In pain from of of policymakers provide payers in EXPAREL advocates reimbursement Congressional provide with follow. self-insured setting. addressable reimbursement front, our Pain market are voice to this of we Hill for in legislation. treatments and states such supporting postsurgical Capitol outpatient for September, with to No CMS on for met expected XX% Pain total

military provide to to initiatives our language in for supporting that also access are government We to Pain to No coverage employees through XX enrolled greater million and and roughly retirees lives TRICARE. provide non-opioids similar a would

drug-free osteoarthritis alternative for programs base for iovera° upside educational of of These options. inbound also programs with to and transversus training There approval visibility growing While plane provide to we is activities their for iovera°. Center would selected blocks of abdominis non-opioid pectoralis the of Training seeking the requested and -- EXPAREL-based spinae regional EXPAREL with and treatment government around education our at in interest to had eagerness approaches. it's market's any action pure Innovation any office-based in in surgery for on business. surgeons for and expand certainty, nerve erector the interest also customer our increased level impossible for with Tampa have underscores training XXX workshops. from and an blocks Year-to-date ZILRETTA most institutions requests frequently be any training these strong for EXPAREL The level predict significant anesthesia teams

we and in nearly open expertise facility remains Our second and positive among on in which December a facility track to of and expanding Houston focus Texas, clinicians, business. to on this impact with XX% our have is expect iovera° on EXPAREL training EXPAREL innovation an equally

soon. Importantly, with stream we have we pipeline. management, We in continue of patents revenue to XX no our postsurgical robust commercial which strategy non-opioid viable very notice as received pain expansion and extended allowance commercially and advance the around a a patents EXPAREL our recently as fortifying for for protection will Book products of by well our listed expect Orange XXXX. a long-lasting provides patient for alternative intellectual care, January With continued patent of Xth FDA robust property patent, now durable new EXPAREL to eight issue improved and

systems increase in XX I continue. we in launching and surgery and field a system continue significant or accounts any in program. on agreement offering a pricing, into upside to are care has the this a do EXPAREL low-income down patients block of the using filer health under as last to procedures and within the XXXB Drilling demonstrate the few approaches. access nine any States. centers. one to which states both to As nerve regional be shift or markets, system, positive largest reminder, continued to manufacturing driver of opens regimen to national a great -- EXPAREL opportunity future outpatient to we the upper opportunity within capacity is populations around EXPAREL-based infringe superior EXPAREL block, have plexus the these particularly the every gears growth XX gross ordering example where extremities an painful the improving than more system increased the that with in key orthopedic quarter, ambulatory now are hospitals the reach generic efficiency am patents. patients. approximately faith-based and formulary Switching drive the key. where we With currently to Since that XXX safety repair would of A This extend these uninsured at a of expect on and pricing. pleased continue discussed they and like of cost patents, not to these the we this well that XXX% EXPAREL X,XXX opioid-sparing efficacy, brachial This not to trends accounts, in meaningful vulnerable of key as highly surgeries, customer operates purchasing health with standpoint, provide and margins, this is shoulder pediatric now the United environment will new nerve acquisition surgeries cuff as business XXXB seen report rotator partnership, to solutions is with EXPAREL claim From clinical adult rollout private and hospitals to interscalene of the for education to awareness total arthroplasty. a

of Here, a In procedures market three United we believe become in million health, for women's States. annually entrenched performed an standard shoulder increased we care seeing EXPAREL-based the also as penetration. block will the are

and anesthesia to plastic ways to to anesthesiologists to regional shift leaders to opioids spinal Breast EXPAREL, with optimize the protocols and continuing and and incorporate short-acting blocks of surgeons when key obstetric are including engaging discuss societies by pain even are minimize a utilized. procedures We educate seeking blocks to and is manage the EXPAREL to outpatient their tap value settings.

pain of eliminating in oncology procedures system, to which interest seeing spinae also the in downregulate for and patient's gynecologic important immune can use blocks the management oncology erector especially for optimize patient are We this population, also opioids, procedures. growth

include their These and who Our programs renowned their pristine profile share procedure the pediatric interactive are centered safety programs on our efficacy of insights educational initiatives which exchange techniques on the leaders, monthly EXPAREL. webinars. features via internationally that highlight pediatric thought

this direct several podium Scoliosis Meeting of for result are data presentations at EXPAREL seeing pediatric among scoliosis spine positive spine September. procedures, advocacy a We is with on also the this of past Research presentations Annual Society increased EXPAREL the in and We clinicians. three deformity demand believe use

Turning dental oral ranging agreement for to Sevaredent patients mouth access procedures, will control we and non-opioid where marketplace, provide EXPAREL dentures network. expanded X,XXX practices molar for within and facilitate to and to initiative to undergoing third to extractions over access announced from their This EXPAREL implants. recently pain with easier the our maxillofacial long-acting full

similar sharing and these but approval States, steady continue General soon. with Manager progress. on is these our slow and you make a We and recently Outside for securing hospital United are developing portfolio departments. We we to several the access business across from forward territories working pharmacy to team for new look the partnerships appointed EXPAREL the

after for to for EXPAREL, have opportunity recovery dynamics rapid the to in expand waiting Europe. in lists related We positively and surgery the UK to elective impact these surgery significant markets a

and six indication formal received the older. for to from Medicines use include authorization We expanded children marketing approval Agency in aged also for of EXPAREL, an European

On studies September we lower Phase our registration of EXPAREL positive the for clinical two line front, top nerve extremity in announced for III block procedures. data

in we XX opioid color planning hours. submit support, Medical couple these will single-dose our nerve Winston, nerve and the and strong primary endpoints additional in to postsurgical was thermal block single-dose study canal studies statistically on for second first of achieved the consumption the in new drug secondary the supplemental significant The reductions studies Chief minutes. for Both quarter sciatic first in and for arthroplasty, a through popliteal Roy data XXXX. Officer total in knee block fossa a was are application, of These provide provide a bunionectomy. the a adductor of pain

We spine value well low pain programs of for also treatment smart creation of as and exciting very well near-term as spasticity, back for program have iovera for additional a a of number spasticity. as pain, tips with the as the

as clinical of these a launch trial. as pain, osteoarthritis treatment well will for we programs patients will ZILRETTA, knee on arthroplasty well. Roy comment For as with programs the shoulder diabetic

proprietary our continue We advance pipeline. to liposome multivesicular

complete We the expect program quarter intrathecal EXPAREL in first XXXX. X study of to our administration our for of Phase

formulation pain, as in for liposome as low expect and initiate block multivesicular multivesicular XX-milligram or bupivacaine quarter dexamethasone of and for pain XXXX. block nerve pain chronic a We formulation third also the second a XXXX, to the as well our a longer-lasting quarter field liposome in trials back of

working our we of analyzing and clinical osteoarthritis. from administered inhibitor NavX.X to data our extended earlier-stage PCRX-XXX, a Flexion of path product our which of candidate to to XXX addition osteoarthritis durable assets, Turning meeting gene to regulatory knee viability investigators a and a the the transaction. efficacy we Phase formulation for the clinical Based acquired development Due XXX. provides to pursue locally decision challenges XXX, no safety strategic we intra-articular part hydrogel. initial the efficacy for lack studies with the acquired pain work and is compelling we are finished an thermo-sensitive PCRX-XXX formulated non-opioid the candidate of forward X IL-XRA of and novel pipeline. a upon Phase exciting release important for a as very and discuss data longer is and therapy made XXX that scheduling commercial have FDA for very I recently product management

In also health. taking addition commercial pain our to place progress, regenerative portfolio important management several exciting care our have near-term opportunities, stage pipeline, patient within and within we low-risk earlier improve expansion for to this

to over like to turn Chief deliver some Winston, Officer value-creating expect of we Medical I'd year. call Roy? these that Now, in the summarize to Roy to milestones our key next the

Roy Winston

an I'll block for time pain extremity start is options This at safe nerve and management. and us payers providers Dave. patients but Thanks, the Dave Pacira, lower effective only for not opioid-free mentioned. seeking with many as exciting for

received require patients, less undergoing fewer EXPAREL less with than than lower X.XXXXX. sciatic studies recent X.XX. significantly These significant and of of bupivacaine and our data the canal single-dose than versus significant arthroplasty, block achieved a is nerve meaningful patients adductor the block highly knee femoral in who fossa statistical who reported clinically XX two In while has most significantly hours EXPAREL our significantly study, the p-values a both surgery. registration pain with EXPAREL pain patients hours also terms were has bupivacaine the successful. for in popliteal opioid-free a received were total scores, after fewer study of nerve significantly In after lower scores block XX opioids block results superiority versus in demonstrated a the were opioids highly requiring bupivacaine. group also p-value patients These for for surgery. Our

will block the femoral sciatic we to sNDA steps, for FDA of nerve both canal. next an our label include for the submitting expansion to in and As adductor be

knee, These extend meaningful will versus our to excess first of lower active million medial We believe clinically the of we planning representing days comparator in submission nerve the of reductions in of these label quarter annual both additional procedures. reach date significantly XXXX. surgeries additional opioids bupivacaine. are fourth block three the adding into in approval demonstrate next in ankle, leg two With indications our four the and for the clearly year pain quarter studies and of

We strong to leaders are the in a EXPAREL deliver practice for block now in literature opinion implement as nerve to working evidence with them these publish key guidelines lower procedures. into data and extremity single-dose

have we and expected exposure of the and now regarding next next adding EMA US to is three to front, six EU begin alignment look with pediatric for patients FDA The study this population. On year We forward cohorts. tests the zero our to age to age-based labels. vulnerable years will involve for opioids minimizing to and

Turning ZILRETTA. to

are preparing year. We two label launch expansion to studies next

providing we an there in acetonide. and diabetic reduced osteoarthritis analyzing in community be diabetics is safer glycemic the steroid knee will After improves the Flexion to previously believe compare our completed, with significantly study that first a spikes. intra-articular from tremendous pre-diabetic will is immediate-release The and with opportunity data triamcinolone and ZILRETTA study efficacy

finalizing are ZILRETTA protocol feedback could shoulders. approved ZILRETTA key leaders. our shoulder the and osteoarthritis, receiving also only in We steroid for study This make in to use positive from first opinion after study

first trial the superiority shoulder in acetonide. in expect XXXX for both the trial immediate establish will ZILRETTA XXXX. demonstrating the These diabetes as the and studies knee and of in standard diabetes triamcinolone versus half We complete gold to with release by patients shoulder

commercial for Importantly, these may two provide studies enhancing incremental also opportunity ZILRETTA reimbursement.

end pathway to on enrollment patients value around We adult approve will significantly tremendous for already pain will believe and the We conclude with is spasticity. evaluate using activities approval. XXX(k) a specialists to is Pacira to of design the disrupt completely we and and the in as iovera° spasticity. track iovera° XXXX the clarity associated shareholders. with study registration have creation regulatory potential started before with you, September, FDA physician, To early current advanced bringing In in spasticity spasticity and we for iovera° on year remind iovera° a to in label study and iovera° launch treatment value to met marketing educating also now our paradigm, of in sham versus for The the setting. on currently treatment this support for relief patients to treat

treat Lastly call new Smart XXXX. iovera° to over low for completed for launch in evaluating I'll pain a enrollment and expect a block iovera°, that, highlights. back data we recently report his to as in study With branch the and Charlie the medial to turn Tips financial

Charlie Reinhart

an continue with million US, exclusivity a a Thank good Starting patients providing you, facilitating on significant safety than XX runway Roy, and shift morning, trends. and sales everyone. conditions. the given efficacy significant to for to a to EXPAREL the market I'll care. of margin year-over-year million. sales outpatient in and sales We had barriers treated from continues well-established regional long-term EXPAREL. Pacira with more leadership market's in With in challenging X% despite entrants solid generate with and portfolio great is meaningful with business we analgesia to To-date, business, confidence update our in be we profile impact ongoing new EXPAREL on that of have quarter to sites the any to of third the entry, EXPAREL. start ability role quarter and addition base increase ZILRETTA $XX.X a surprising seen not not market new or the our which have plays market

as care education its ZILRETTA awareness unique We in needs to patients value patients. improving trends around continue we as expect sales treating broaden diabetic such with and

that demand base sales improved and of is the our customer the momentum growth gain device, of continue to and going forward. expect device rollout this the now iovera°, we to underway For transition X Gen we

and opportunity, are also in we We new clinical iovera° making indications blocks such investments. new as optimistic remain the spasticity branch medial where

for XX% our Turning gross third to non-GAAP comprised total EXPAREL, was margin which gross for of margins. ZILRETTA On basis, margins XX% is XX%, a and XX% consolidated iovera°. non-GAAP of gross for quarter percentage

gross X current to with margins handheld cost the include replace device. Gen planned of Generation X devices For estimate the iovera° new an

manufacturing aligns Third of our expectations. were which by margins impacted full failed with quarter timing one line, the ZILRETTA year

this third XX%. non-GAAP quarter Excluding have margins would lot, ZILRETTA exceeded

third quarter, caused impacted released. as failures certain supply backup several specific supply chain EXPAREL in margins with no by purchased write-offs were previously the potential with quarter Lastly of were risk. lot COVID-related by on third well faulty lots – chain the issues to as that quality parts These were charges mitigate to the impact

until high year XXXX to into resume ahead, at points better resulting Looking full margins we the in year quarter mid-XX% per point to full rebound margins in the than gross then improvement fourth year margins expect to three we and two one range. XXs total two reach

currently market reporting the preliminary we monthly guidance, XXXX providing not uncertainties, transparency sales continued to gross trends we While product share you. margin are to given revenue inter-quarter committed of remain or with

consider adjusting will We all products improves. as three this practice for visibility

Turning to expenses.

was million R&D full in we of $XX non-GAAP quarter stage to $XX.X reiterating investments guidance Third reflecting are our non-GAAP clinical Today, expense pipeline. R&D year our million. $XX million ongoing expense

floating our third of related was B full million primarily expense The of remind expect non-GAAP low was you, range of basis third $XXX interest remainder To interest notes. plus SG&A financing, expense to XXX rate currently relates guided the most Our the $X.X million. our is expense interest XXXX. million has in come expense non-GAAP at for to Term of of to quarter SOFR to of Interest end $XX Loan points. a convertible expense SG&A which We $XXX our million. quarter year the

quarter and impairment an interest for going million interest investment. on will million includes was Other $XX quarter. a approximately current equity the based forward, per purposes charge million expense modeling $XX be For for rates, $XX.X expense

to Turning taxes.

a third XXX%. GAAP operating investment. $X.X includes permanent allowed ex-US our into equity P&L expense million, and loss the of namely which differences our was the the driven US related This business tax write-off not a tax rate tax effective quarter to expenses GAAP by translates for purposes, of Our – of of

non-GAAP the XX% rate For for our purposes, and tax third effective results quarter of XX% adjusted an year-to-date. reflect

our deliver our EBITDA financial results adjusted positive and We despite million. beyond, Pacira gross of position turn mid-teens delivered impressive XX%. full of $XX headwinds, net in Q&A we year-over-year top to year lastly, the I'd XXXX financial improvement the Question-and-Answer modest to expect X-year operate effective and ongoing that our margin market the another mid-XX% session. operating like rate now continues we That in to year-over-year Operator? in In for EBITDA to to line tax for and XX%. to summary, adjusted XXXX for challenging significantly increases a margins prepared growth quarter conditions, on exceed over Despite bullish operator remarks. plan remain of concluded our continue the Session income from call strength. range, of adjusted expenses And begin

Operator

conduct first Thank you. Our open. time Gregory, this Gregory session from Capital your Markets. question At Renza a is we line Instructions] comes RBC will [Operator question-and-answer of

Gregory Renza

those team. And and quo question the process Thank the and in larger and a greater be the maintain how as maybe Good dynamics how thanks. predictability taking progress. pushes pulls? uncertainty status with XXXX. there? Charlie would And for just business for fourth very that comfortable thinking on and more beyond morning, are appreciating with of for while Thanks are question I monthly? understanding about for forecasting of with What dynamics, the you Dave, you and you Dave you'll pre-reporting course increments much. the and I'm evolving congrats the influenced the the on all process appreciate the getting curious, to all Great, about my quarter look as color well,

Dave Stack

week. we just we've week strong what question, the predictable. will if is the expecting about were by week a not we Greg. in and months recent see we And for not what seen still market What by talk followed Thanks a have even a followed that strong is we very

what's some weekly terms outlook the a we're like short-term. we improving feel number going able numbers, And we're certainty that that predict to can some the give the so for looking to happen really so with of consistency in on is, in what can we just

we between so, an much that now, just And and XX%. to really foster out Monday-to-Monday if we It community. be numbers very would be very good for last you to right two an example monthly numbers. weeks difference giving conservative the discussion give those Greg, analyst can I was I We with like would Mondays comfortable. come the you And revenue. But would just have guidance delta does exchange the were to tell because like two over providing we the of annual a with

we October. being And at so strong the first two couple very And then, all really weeks good not a the last -- October weeks September. strong end in weeks up of after a were in had

know an don't Everything growing. I to The is So confidence week-to-week It's just when not to predictable way some this on business carry give just that the basis. market variability. see to appropriate Everything strong. how fine. in we forward is doing continued is a

Gregory Renza

And excess the maybe makes mentioned a does $XXX sense. factor When I'm business term appreciate the that? targets. into aspects nice collective in various that. laid certainly top of great of I recall had nicely those That contribution how progress your expansion could with Thanks. about we as think and million. spasticity Dave course longer-term past there. longer just of out any on you the see you updated one iovera° presentations seeing XXXX iovera°. sneak X have the of just to And about think line if Yeah. of and some across I you do curious, in opportunity to the in thoughts iovera° Gen and of I We if on deal the

Dave Stack

bought times. small about a think sales anybody you, MyoScience Greg. we ran COVID we indications the system be iovera° from that dedicated $XXX When will twice product into had. this I it launched to talked initial -- of surprise million both Yeah. we dedicated that team don't a Yeah. the Thank we that with

certainly when as not a we it straight the significant now quite places iovera° not see total from Greg $XXX million predicted is we we candid gave be the gone very interest been Right never line what has planned. it and and indication with first of in marketplace value. has of to so And that

there from of with very So or for to see surgical brain. sort wound is iovera° a marketplace some a what is pain the signal we blocking the investigators body the average us marketplace have an in the marketplace signal the part. taught there's a viable blocking for pain more an even brain pain is What viable the signal from to brain that from

frankly what surgeries bought we this And testing. for better spasticity so when and and marketplace a Charlie we we that indications as off pain like the device, becomes so with well, I where it for performed tip clinical in impression you the spine are wrong signal and the both And in a guys pain spine very have curves low branch human the number in -- we of the around continue we investigations Roy application to pain. to treatment turn use for originally got we stuff a in have give to on well. the that product it tried for fine a iovera° don't of work But develop go want which And of and where medial now separate will didn't and can block pain. have back it we touched out the of

consistent the Greg indications in that that's months. these much spastic look more to spasticity When demanding is and we reliability support. at terms the we pain basically and that pain of several of more from for So for predictable them turn coming much customers a our that in marketplace how is teach new off the signal device

in to relatively we've -- we that on the while trial us the the XXX(k) is a sham, will comparative as a that a then we study we relatively we earlier, think us come boards trained trained of the the modest spasticity. treatment can ad short the had label so outlined as the the time for device get frame, to said drugs have be device techniques trials. an move back that so of And indication pain device allow and that sized and on in on and spasticity against Roy basically to And studying studying while on

would giving we specific care and in turn of we the bought $XXX turns TKA plan I are So I blockade the brain guidance asset for have knee when without tell numbers, indication the iovera° five-year want body. off peripheral any where the our any kinds a for below forward. million expectations the trained A again brain question, and that people pain. long interested signal pain violating going aberrant you they but you how tell now really are off patient I had cardiac they And interesting lot or of lot would units an months in a positive with dysrhythmias, out to signal the simple about how well-beyond stellate important different the calling will just and when of there's fairly it's Winston a it's all use device. within to that answer to anywhere be it world, to studied they what iovera°. turning signal implications And think talked a going this in because hours applications to Paul know to the ganglion we a be talk the on gives we want that for there's on about come spasticity, very The world but experts parts in for are

Operator

moment next loaded. Thank question is while One our you.

open. line Belanger Serge from Serge, is your of comes Needham. question next Our

Serge Belanger

question start guess morning. Dave a good Hi, for to off. I

Just volatility? still that on Is little ASCs on a and just the driving give HOPDs to regarding your down shortages? capacity? you And it color your what us can answer you operating at continuing not drill or prior think whether volatility in are market, the is staffing

Dave Stack

running ASCs primarily are is and PACU procedures nursing to to the and opening longer we both they spine when off hours normal inability for And on country where in your certain And those do. number coverage CEOs in the of knee improvement It's see for earlier shortages and the some things for we that can cutting and answer who staffing practice. surgery staffing RNs procedures the surgery basically centers, surgery really limiting Yeah. surgical an to and were of for like areas and they have modest do be hospitals would Serge. people reason question than is talk the the having ambulatory weekends day was anesthesiologists

hospital back to I report Kruger marketplace the we having mean, elective nobody people last talking not had the a before afternoon. in and same to the to tell COVID. -- where dinner add every would just that would is that I with clinicians are We XX were other that back CEOs we We are there color you tell every Friday day are two little normal. this see see. numbers in surgeries they Serge And you days to get

Serge Belanger

Okay.

XXXB a little targeting that of bit that about represents in potential the talked what what's EXPAREL? for capturing And hospitals. Maybe little You lines opportunity?\ bit the to process terms about tell TAM just us and a time

Dave Stack

who the are EXPAREL, it XXXX have but and actually So current who several got response there's X,XXX There's ordered not customers. already. dozen the who And another accounts roughly that well out who we customers. purchased there's been month has then We've buy started rolling it impressive. through over XXXB Serge program mid-last don't people -- are

we force And so all as and so we in they are make we they and for get innovation team an these primarily with can hospitals handle contract the information working with deal inquiries to and that appropriate these sure come desk the we XXXB. have field a

I the come currently under hospitals not that primarily a the that Serge And few is out color purchasing at these not with facility number using online. this next all it over will the to opportunity. And timing. add We our surprise. So just is the months we then very XXX-liter are it different purchase under EXPAREL, that EXPAREL little program expectation have Swindon. that to in of expect now It's program -- and the that's this will that people are guidelines a mean viable just and of started a

to program capacity through And San be facility the producing of XXXX. part XXX-liter able another way to we ZILRETTA. Diego as changes. XXXB of us these also gives make by That have kinds will We the in the be through we product are go that

a So opportunity. in a staffing it's already is the company where XXXB position

time to So it of made at back EXPAREL on the this add that. sense side

Serge Belanger

you. Thank

Dave Stack

Thanks, Serge.

Operator

loaded. question is while our moment, One next

next Capital is Gary your Nachman open. Our line Markets. comes BMO Gary, from at question

Gary Nachman

Hey, morning. guys. Good

Dave Stack

Hi, Gary.

Gary Nachman

much help you seeing good block be market relative would the little quantify extremity nerve then uptake a it bit your women's markets? doing terms of much Maybe Is how EXPAREL, in you Are a you you relatively just would And And with would relative Are Can quickly about those in in the it any there expectations? challenges talk upper seeing penetrating that how you've to those? and indication? think also opportunity been all peds? that with nerve the anesthesiologists do bit. extremity adopted if you get to block? be lower that you same health

Dave Stack

Yes. Thanks, Gary.

me take let them separately. So

got we approval XXXX. April So for in pediatrics of

hospitals like because been in pediatric procedures progress some full there and than on was even now Shriners' It's in these more teams that basis, require we of things Gary were have dad largely but sure the good to that and teach opioids And surgical one I'm same-day we XX are we've about the understood not NPs concern the immediate next is are around biggest repeatedly cleft adults the could working kids is that appendicitis surgical -- driver -- around OR. we that whether of the we about people is requesting to and who the more their we things surgery there made uptake treat than chest fully system the a profile and exposed night. really desire was been of would have the there in and spine in foot and and mom over a scenarios real period few a the palate this years the to visit different opioids that so short-term where they're them What actually patients was special use surgery on that first without -- like surgeries. expensive pain And see handle around that. that's and America And kind right, scoliosis with clubbed these are situations and expanding a where largely there Gary. where we focused

shorter-term little still and which like stay, a do today for interested are experience system surgery these different baby you like breast Mayo significant of the first can working pec need for they Mom that the it's So In that folks that they're of are on don't basis into reconstruction a associated and we night a don't get pretty do obstetrics that way number to around to some they're we these things actually is protocols right? a for halo the and provide a blocks is post-surgical have have can train women's bit in. systems the people right? a obstetric little It C-section generally leading want here. we and blocks situation. we and of so And that's Anderson where to folks on reconstructions obvious really see and mastectomies reasons, And where a bit have and control infiltration outpatient confidence stay the plastic an centers see going that. places but are and the is in planned we when here a using that MD is we train doing for it what shorten all with can a best when COVID we is Cleveland What motivator be surgeries health, pain the environment. and and we do

the with in customers all I that in marketplace. So, we're a remains mix a don't process. We're of our are Staffing hospital the it's continuing are Gary, in dissatisfied the a it not It's but difficult it's grow. going position. other it's financially things issue. on to major

so things And lot going on there's a of here.

before the and and bit Lower that. So, a that I very say nerve say because that think are of with extremity this I into both many significant in in because X% a far it my worked. was Very use would they and or the tell they're than years docs hospital knew situations ago willing FDA anesthesiologist were is we've different XX we're clear. situation I approval to part old growth launched women's And pharmacy new little the for looking health young pediatrics product. environment a I product it happy using you year would a so when given block is a

Now an the they're cover of FDA for approval. looking

So for and is cc mean XX then providing nerve And alternative. think another here. XX in pain control hours and that periosteum. adductor an relatively that's we The we opportunity advance mimics folks A lower adductor when block an I the dose actually canal really the block extremity at injection our business nascent. are is ankle there XX mL marketplace of into it's doing in look that viable canal XX a are doing mL periarticular best into in and as a all XX today. doing procedures posterior the they're practice XX capsule foot blocks

capsule in still mL cc cases pain. then they're adductor XX and the canal into many XX posterior dose So, to using cc a XX the cover

there's size as extremity. and the in Roy million the lower pointed out opportunity three it's so And procedures

in Just is be of to clear very those cases. already roughly XXX,XXX used EXPAREL

it's is pharmacy quicker because available it's extremity This the million or roughly the dose take this a go So in the much XX nerve canal. opportunity and lower say already opportunity EXPAREL mL patients delta not will to will using adductor block marketplace X.X not peds is the than new of approved. as because for

who to also will the to younger And be use some product. for are the folks the FDA looking able actually guidance of

than will this had. reference procedures we go other the much So faster

Gary Nachman

quick That's And squeeze just one really I Okay. more helpful. ZILRETTA. on if could one

use awareness of think patients? potential how already the benefit that is with I'm with data had important there know accelerate about. it current used will something talked any how company having curious be previous to of Just that for being diabetics? I just diabetic you diabetic much product? that's that Is there

Dave Stack

It's caused very company folks KOLs and the to understanding us of these of IR idea the when are clinical of in very by us the treating the the protocols because with this glycemic well that understood being ICU, spikes helping are spikes. glycemic even they most these actually Gary friendly the by diabetic our surprising up a help how folks patients end are marketplace. our are all no little and that triamcinolone in endocrinologists It's the that had these write protocols acetonide. Even was issue of who some

to a in So J-code, seen is out can because docs treat other relative the my have office. are hell, diabetic all treating So the we It's data they've they start the patients, that right? that and think it's quite said, the displacement way going in for important. And well, have a They going some when of the I'm this an we J-code. crazy. to easy because the on. of them issues, marketplace, have HA things especially

treated who patients really think are we So this of system are -- pain, and just who that knee being be for of to part And here put it by adult about medical is have to on OA the care. going the physicians patient who XX% diabetics. important stamp a are

So It's it's millions. a big number.

Gary Nachman

Yes.

Dave. Thanks, Great. Okay.

Dave Stack

Okay.

Operator

At End Stack, remarks. would to turn like for it closing and your for I back you David Q&A Chairman of questions. time, this Thank to CEO

Dave Stack

Amber, call for your your time. and thanks questions the you Thank today to and on all

and setting for great is we're can all XXXX you exciting stage fronts XXXX making an progress even beyond. more see, As and on the

to well penetration, with through indications forward, to reimbursement, we're opportunities you years flows, to portfolio The look and us our progress. Moving this position our in unequivocal simultaneously pain for opportunities. and enhanced updated EXPAREL near increased offers product acknowledgment field development on cash long-term drive non-opioid value growing and advancing positioned significant market new leadership continuing growing significant for for We and need global management by keep forward operating of and come. the durable creation new while commercial is our

for in and Bye the Conference Next Piper Conference Stay for you. well. New us London in now. Thank Jefferies the is, York.

Operator

for participation disconnect. conference. This may you in program you your and now Thank the today's does conclude

Pacira BioSciences (PCRX) 3 Nov 222022 Q3 Earnings call transcript