Pacira conducted two real-world propensity score–matched cohort studies evaluating EXPAREL versus comparators in total knee arthroplasty (TKA) and spinal fusion surgeries, tracking outcomes on surgery day and over 30 days. The TKA analyses included 9,463 matched commercial patients and 2,924 Medicare Advantage patients per group, while the spinal fusion study comprised 478 EXPAREL and 1,434 non-LB patients in the commercial inpatient setting.

In the TKA hospital outpatient department setting, EXPAREL lowered mean total costs by $409 for commercial patients ($37,466 vs $37,875) and by $1,359 for Medicare Advantage patients ($19,814 vs $21,173), with index procedure costs down $328 and $781 respectively. EXPAREL also reduced home health utilization, inpatient admissions in the commercial cohort, and outpatient, pharmacy and home health costs across both populations (all P<0.05).

Among commercially insured spinal fusion patients, EXPAREL use cut mean 30-day episode costs by $5,993 ($75,704 vs $81,697) driven by a $6,001 reduction in medical costs, and shortened average hospital stay by 1.83 days (2.56 vs 4.39 days; P<0.0001). There were no significant differences in emergency department visits or inpatient readmissions, though outpatient visits increased by 0.31 per patient (P<0.001).

Findings will be presented at the Orthopaedic Research Society 2026 Annual Meeting in Charlotte, North Carolina, March 27–31. Posters 1224 and 1798, led by Pacira’s Senior Director of Epidemiology, are scheduled for March 30 from 4:45–5:30 p.m. ET.