OBJECTIVES: Anti-inflammatory drugs are widely used in the post-operative analgesia. This study aims to compare acute post-surgical pain management costs and resource utilization with parecoxib versus ketoprophene, ketorolac, and tenoxicam from the perspective of Brazilian private hospitals. METHODS: A cost-minimization analysis was performed to compare intravenous parecoxib 40mg/day (PB), and parecoxib 40mg/day in bolus (PBbl) versus ketoprophene 100mg/day generic (KPg) and branded (KPb), ketorolac 30mg/day generic (KLg) and branded (KLb), and tenoxicam 40mg/day generic (TNg) and branded (TNb), in a 3-day hospital stay after an orthopedic surgery. Direct medical costs included drug acquisition, nursing fees to administration, infusion supplies, complications associated to treatment and adverse event management (constipation related to opioid rescue medication, antacid and antiemetic drugs, gastrointestinal and surgical-wound bleedings). Resource utilization was estimated through literature review and expert opinion. Unit costs were obtained from Brazilian official price lists (2012 USD values) for each cost component. RESULTS: PBbl was the least costly treatment, with overall costs per patient of 80.82USD, versus 117.92USD, 173.29USD, 182.56USD, 126.86USD, 133.39USD, 125.27USD, and 131.67USD, for PB, KPg, KPb, KLg, KLb, TNg, and TNb, respectively. Incremental costs of comparators driven by surgical wound and gastrointestinal bleeding was responsible for 38.99USD or 22.5%, 21.4%,  30.7%, 29.2%, 31.1%, and 29.6% with KPg, KPb, KLg, KLb, TNg, and TNb, respectively. No bleeding was reported for parecoxib. Adverse event management (antacid, antiemetic, constipation) was responsible for 6.37USD(7.9%), 6.37USD(5.4%), 11.34USD(6.5%), 11.34USD(6.2%), 13.31USD(10.5%), 13.31USD(10.0%), 8.74USD(7.0%), and 8.74USD(6.6%) with PBbl, PB ,KPg, KPb, KLg, KLb, TNg, and TNb, respectively. Drug acquisition, fees and supplies were responsible for 74.45USD(92.1%), 111.5USD(94.6%), 122.96USD(71.0%), 132.24USD(72.4%), 74.56USD(58.8%), 81.09USD(60.8%), 77.53USD(61.9%), and 83.93USD(63.7%) with PBbl, PB, KPg, KPb, KLg, KLb, TNg, and TNb, respectively. CONCLUSIONS: Parecoxib exhibited a cost-saving profile over branded or generic ketoprophene, ketorolac, and tenoxicam in post-surgical pain management, from the private hospital perspective in Brazil.