OBJECTIVES: Gelatine-thrombin based active flowable hemostatic matrix (Floseal^Ⓡ) is approved for use in bleeding that is not effectively controlled or uncontrollable by ligature or general procedures during surgical procedures. Floseal^Ⓡ can be used alone or in combination with other hemostatic agents for hemostasis during surgery. This study was performed to evaluate the economic value of using Floseal^Ⓡ (F) alone compared to gelfoam/thrombin + Floseal^Ⓡ (G/T+F) combined use for hemostasis during spinal surgery. METHODS: A cost-consequence model was used for the analysis from a hospital perspective in Korea. Clinical inputs for the model was referred from the literature reporting a five-year retrospective analysis of the Premier Perspective hospital database in the US. The cost inputs included hemostatic agents, operating room, hospitalization, and blood transfusion costs. Costs of hemostatic agents and hospitalization were calculated based on the National Health Insurance service fee for tertiary hospitals. Operating room cost was estimated from expert panel surveys as opportunity cost, and cost of blood transfusion was estimated based on literature and expert panel surveys. One-way sensitivity analysis was performed for variability of clinical inputs. RESULTS: The use of F alone reduced the length of hospital stay by 0.45 days and the operation time by 39 minutes compared to the G/T+F combined use. It also saved the volume of hemostatic agents and reduced the number of patients requiring transfusions. As a result of estimating by applying the corresponding cost, with the use of F alone, it can be expected to save approximately $551 (hospital days= $46, operation time= $468, hemostatic agents= $29, blood transfusion = $8) per spinal surgery compared to the G/T+F combined use in a tertiary hospital. CONCLUSIONS: The use of F only compared to G/T + F combined use could lead to cost savings for tertiary hospitals in Korea.