Economic and clinical value of hydrolyzed collagen in the management of spine surgery wounds: a cost-effectiveness analysis.

AIMS: To assess the cost-effectiveness of hydrolyzed collagen as an adjunct to standard care for reducing postoperative complications in high-risk spinal surgery patients.

METHODS

A decision tree model was developed from the U.S. healthcare sector perspective to compare hydrolyzed collagen with standard care alone over a one-year time horizon. The model followed a cohort of high-comorbidity patients undergoing complex spinal procedures, capturing postoperative infections, seromas, hematomas, readmissions, and revision surgeries. Clinical inputs were derived from published evidence, and costs were reported in 2025 U.S. dollars. Outcomes included direct medical costs, QALYs, and net monetary benefit (NMB) at a willingness-to-pay threshold of $100,000/QALY. Univariate, probabilistic, and threshold sensitivity analyses assessed parameter uncertainty.

RESULTS

Hydrolyzed collagen dominated no treatment, generating $3,853 in cost savings and a 0.007 QALY gain per patient over one year, yielding an NMB of $4,542. Avoided readmissions and revision procedures were the primary contributors to cost savings. Baseline complication rates, relative risk reduction, and complication persistence rates were the most influential parameters. In probabilistic analysis, hydrolyzed collagen was cost-effective in more than 99% of simulations.

LIMITATIONS: The analysis applies simplifying assumptions, a one-year time horizon, and heterogeneous clinical inputs, factors that may limit the generalizability of the findings.

CONCLUSIONS

Compared to standard care alone, hydrolyzed collagen demonstrated a dominant strategy associated with cost savings and improved health outcomes for high-risk spinal surgery patients. These findings support its consideration as a value-enhancing component of the spine surgery care pathway, particularly for patients with elevated complication risk.