Cost and Value

EXPAREL is available in 133 mg (10 mL) dose for $227.63 and 266 mg (20 mL) dose for $376.12. 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 LOS. These, in turn, can lead to fewer patient complications and reduced hospital costs per patient.

Minimally Invasive Surgery - Transforaminal Lumbar Interbody Fusion: Medical center in Florida

Study Methods

  • 38 adult patients treated with enhanced recovery protocol 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

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

    • 1.2 vs 3.9 days (P=0.009)
  • $3,444

    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 expanded 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.

MIS, minimally invasive surgery; TLIF, transforaminal lumbar interbody fusion; ERP, enhanced recovery protocol; LOS, length of stay.