Nurse and patient smiling as patient is discharged from hospital post-nerve block surgery

Clinical and economic value outcomes with EXPAREL

Cost & Value

EXPAREL is available in 133 mg (10 mL) for $180.35 and 266 mg (20 mL) doses for $334.18. The 133 mg (10 mL) and 266 mg (20 mL) doses of EXPAREL are available in cartons of 4 and 10 vials. For more information please visit How to order EXPAREL.

Information below helps review the value of EXPAREL in a multimodal pain management protocol that can lead to fewer opioids, better pain control, and shorter length of stay (LOS). These, in turn, can lead to fewer patient complications and reduced hospital costs per patient.

Minimally Invasive Surgery (MIS)-Transforaminal Lumbar Interbody Fusion (TLIF)1: Medical center in Florida

Study Methods

  • 38 adult patients treated with enhanced recovery protocol (ERP) after MIS TLIF were analyzed retrospectively and compared with 15 adult patients who underwent MIS TLIF before the implementation of ERP (N=53)
  • All patients underwent standard MIS TLIF, but the control group did not receive all ERP components, including EXPAREL® (bupivacaine liposome injectable suspension)

Safety Outcomes

  • The overall rate of complications was lower in the ERP group (12% versus 21%)*

Clinical and Economic Outcomes

Patients who received ERP with EXPAREL to manage pain after surgery had
  • 2.7days

    shorter length of
    stay (LOS)

    • 1.2 vs 3.9 days (P=0.009)
  • $3444

    reduction in total cost for acute-care hospitalization

    • $19,212 vs $22,656 (P<0.001)
  • 100%

    rate of
    discharge home

    • 100% vs 86%


  • Standard surgical protocol utilizing 3 out of 6 ERP components
    • Expandable cage
    • Bone morphogenetic protein
    • Small-caliber percutaneous screws
  • General anesthesia


  • ERP surgical protocol with all 6 components
    • Local infiltration into the surgical site with EXPAREL diluted with saline and bupivacaine hydrochloride
    • Anesthesia without intubation
    • Working channel endoscope
    • Expandable cage
    • Bone morphogenetic protein
    • Small-caliber percutaneous screws

*The statistical significance of decreased complications was not evaluated.

Areas of greatest savings included a reduction in intensive care unit costs, shorter overall LOS, and decreased costs from a reduced operating room duration.