Pacira BioSciences NASDAQ: PCRX reported first-quarter 2026 results that management said reflect continued momentum under its “5x30” strategy, highlighted by year-over-year growth across its three commercial products and reiterated full-year guidance.
Chief Executive Officer Frank D. Lee said the company’s 5x30 plan, introduced a little more than a year ago, is designed to drive progress across five goals—patients served, product revenue, profitability, pipeline, and partnerships—through 2030 and beyond. “I’m pleased with our first quarter results,” Lee said, adding that the company is seeing “clear” progress across all five areas.
EXPAREL growth supported by reimbursement changes and expanded IP
Pacira’s flagship product, EXPAREL, generated first-quarter net sales of $143.3 million, up from $136.5 million in the prior-year quarter, according to Chief Financial Officer Shawn Cross. Cross said volume growth of approximately 7% was “partially offset” by a shift in vial mix and discounting tied to a third group purchasing organization (GPO) that went live last year. He also said winter storms disrupted shipping and triggered returns during the quarter.
Lee pointed to several factors he said are strengthening the durability of the EXPAREL franchise, including Medicare coverage outside the surgical bundle following implementation of the NOPAIN Act at the start of 2025, as well as a new product-specific J-code that management said supports streamlined billing and reimbursement.
On the commercial side, Chief Commercial Officer Brendan Teehan said demand in hospital outpatient and ambulatory surgery center settings remains strong and that Pacira is emphasizing both clinical outcomes and the economic value of EXPAREL. Teehan said Pacira has presented real-world evidence and health economics and outcomes research at several medical and managed care meetings, and noted that the company’s real-world IGOR registry has enrolled more than 3,500 osteoarthritis (OA) patients.
Teehan also highlighted growth in commercial reimbursement beyond Medicare. “We have now surpassed 110 million covered lives with separate reimbursement outside of the bundle for EXPAREL,” he said, adding that Pacira expects “accelerating change” in the market as coverage expands.
Lee also emphasized intellectual property developments around EXPAREL. He said Pacira now has 21 Orange Book-listed patents across two families protecting the product. Lee described this as a significant change from “the single patent previously litigated,” and referenced a “favorable volume-limited settlement” in 2025 following multi-year patent infringement litigation that began in 2021 and extended through 2024.
Zilretta and iovera post double-digit gains; label expansion studies progress
Pacira’s osteoarthritis products also delivered year-over-year growth in the quarter. Cross reported Zilretta sales of $26.8 million, up 15% from $23.3 million a year earlier, and iovera sales of $6.2 million, up 21% from $5.1 million.
Lee attributed Zilretta’s performance to initiatives launched last year, including a dedicated Zilretta sales force, expanded patient access programs, and extended promotional reach via a collaboration with Johnson & Johnson MedTech. Teehan said Pacira “essentially tripled” its U.S. commercial reach for Zilretta through that collaboration.
On development progress, Lee said enrollment has concluded for a Phase III registrational study evaluating Zilretta in shoulder OA, and Pacira expects top-line results later this year. Lee said the company views shoulder OA as a significant unmet need and noted that about 1 million injections for shoulder OA are administered annually in the U.S. despite the lack of FDA-approved products.
For iovera, Lee said growth is being supported by a product-specific reimbursement code introduced last year and a dedicated sales force. He added that Pacira’s registrational study in spasticity remains on track, with top-line results expected by year-end.
Pipeline updates: PCRX-201 data expected later in 2026; PCRX-2002 Phase II planned
Lee said Pacira is prioritizing “mechanistically de-risked assets” as it advances an “innovative clinical-stage pipeline.” Key milestones discussed on the call included:
- PCRX-201, a locally administered gene therapy candidate for knee OA, which management said remains on track for top-line data later this year from the Phase II ASCEND study.
- PCRX-2002, a hydrogel formulation of ropivacaine intended to provide rapid onset and long-acting post-surgical analgesia, with Pacira expecting to begin Phase II development later this year.
Lee said ASCEND Part A is fully enrolled with 49 patients and is a 52-week study. He noted that the study’s primary objective is safety, with secondary endpoints including changes in pain and function using measures such as numerical rating scale, WOMAC, and KOOS scores. Lee also said Pacira is working on a commercially viable manufacturing process to support initiating Part B around mid-year, with Part B expected to enroll about 90 additional patients across three arms, including two dose levels of PCRX-201 and an active steroid comparator.
During Q&A, Chief Medical Officer Jonathan Slonin said the company would evaluate “the totality of the data” from Part A in a randomized clinical trial with an active comparator, and said Pacira would look for trends “consistent with durability and efficacy from our phase I trial.” Slonin declined to comment on a specific outside company discussed by an analyst but said Pacira remains confident in its HCAd platform approach.
Financial results, share repurchases, and 2026 guidance reiterated
Cross reported consolidated first-quarter non-GAAP gross margin of 80%, compared with 81% a year earlier, and said margins continue to benefit from improved cost and efficiencies in EXPAREL manufacturing along with continuous improvement initiatives at both manufacturing facilities.
First-quarter non-GAAP R&D expense increased to $25.4 million from $23.1 million, which Cross said reflects advancement of the PCRX-201 Phase II program, label expansion studies with top-line readouts expected later this year, and work supporting three HCAd-based preclinical programs. In response to an analyst question, Cross said R&D spending is expected to rise into the “low $30 million range” in the second quarter before returning closer to first-quarter levels in the third and fourth quarters.
Non-GAAP SG&A expense was $83.9 million versus $76.2 million in the prior-year quarter. Cross noted last year’s SG&A benefited from a favorable litigation outcome and recovery of $5.2 million in legal fees, and said that, adjusting for that, spending is “largely in line” with last year. He also said the first half of 2026 is expected to be higher than the second half due to proxy-related activities, with spending anticipated to come down in the third and fourth quarters.
Pacira reported adjusted EBITDA of approximately $40.2 million for the quarter. The company ended the quarter with $202 million in cash and investments.
Cross said the company repurchased $50 million of stock in the first quarter, retiring approximately 2.2 million shares. Since the start of the repurchase plan last year, Pacira has reduced share count by about 9 million shares to 39.3 million outstanding common shares. As of March 31, Pacira had $100 million remaining under its authorization, which runs through the end of 2026.
Management reiterated full-year 2026 guidance, including:
- Total revenues: $745 million to $770 million
- EXPAREL net product sales: $600 million to $620 million
- Non-GAAP gross margin: 77% to 79%
- Non-GAAP R&D: $105 million to $115 million
- Non-GAAP SG&A: $320 million to $340 million
- Stock-based compensation: $54 million to $62 million
Cross said guidance for Zilretta and iovera assumes 2026 will be largely in line with 2025, and that while the company is encouraged by the start to the year, it plans to wait for more visibility before changing assumptions. He also noted $7 million of expected revenue from a veterinary-market licensing agreement.
Procedure trends, winter storms, and partnership outlook
In the Q&A session, Teehan said procedure volumes in the relevant market have been relatively stable, describing the moving annual total as “largely flat year-over-year,” while noting first-quarter market procedures were up in the “mid-single digits,” around 4% to 5%. He said winter storms affected shipments and led to surgery rescheduling that did “not necessarily” occur within the quarter, with some carryover expected as patients are rebooked.
Asked about potential macro impacts tied to changes in health insurance subsidies, Teehan said it was “too early to say,” and that the company would monitor procedure areas where EXPAREL is commonly used.
On partnerships, Lee said business development remains focused on strategically aligned, financially accretive assets and on expanding commercial reach into new U.S. and international markets. He cited collaborations with Johnson & Johnson MedTech and LG Chem as examples, and said Pacira intends to pursue similar arrangements in other major geographies. While he said it is premature to provide guidance on the revenue contribution, Lee described the potential as “not insignificant,” and said the company would begin providing updates related to guidance starting in 2027.
Lee closed by saying the company is operating with “momentum, clarity and discipline” and that Pacira is focused on building on its first-quarter performance through the remainder of 2026.
About Pacira BioSciences NASDAQ: PCRX
Pacira BioSciences, Inc is a specialty pharmaceutical company focused on developing and commercializing non-opioid, non-addictive pain management and regenerative health solutions. The company's flagship product, EXPAREL, is a bupivacaine liposome injectable suspension designed to provide long-lasting postsurgical analgesia. EXPAREL is used by clinicians across a broad range of surgical procedures to reduce reliance on opioid medications and to help manage acute postoperative pain.
In addition to its marketed offering, Pacira maintains an active pipeline of investigational products aimed at addressing unmet needs in pain management and inflammation control.
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