OBJECTIVES: To measure the economic impact of conditionally essential amino acids (CEAA) among patients with operative treatment for fractures.

METHODS: A decision tree model was created to measure the impact of CEAA among patients with fractures to the pelvis or extremities aged ≥18 who were admitted to a Level 1 trauma center. Efficacy was estimated from previously published rates of injury-related complications. Economic impact based on changing rates of post-operative complicates was assessed based on estimated changes in annual health care costs (2022 USD) and quality of life measuring using quality-adjusted life years (QALYs).

RESULTS: The per-patient cost of complications under CEAA use was $12,215 compared to $17,118 under standard of care without CEAA. The net incremental cost savings per patient with CEAA use was $4,902, accounting for a two-week supply cost of CEAA. The differences in quality- QALYs under CEAA use and no CEAA use was 0.739 and 0.726 person, respectively. Modeled to the US population, the total value of CEAA use compared to no CEAA use was $316 million with an increase of 813 QALYs. The incremental cost effectiveness ratio showed that the use of CEAA dominated standard of care. With a gain in 0.013 QALYs per person, valued at $150,000, and the incremental cost savings of $4,902 resulted in the net monetary benefit of $6,852 per patient.

CONCLUSIONS: This study shows CEAA use after fracture fixation surgery is cost saving and improves patient quality of life. Health care systems may find use of CEAA supplementation increasingly attractive as payment models focus on treatment value linked to quality of care and cost. Future work should identify processes to incorporate CEAA supplementation into patient care effectively and efficiently.