Baricitinib in Alopecia Areata: A Budget Impact Analysis in Saudi Setting

OBJECTIVES: Baricitinib is among the few approved treatment options for the management of alopecia areata. This budget impact analysis aims to assess the budget impact of introducing Baricitinib to the formulary of a Saudi tertiary hospital compared to the topical Minoxidil.

METHODS: A budget impact model was developed to compare the costs of two scenarios: the ’formulary with Baricitinib and Minoxidil’ and ’formulary with Minoxidil only’. The topical minoxidil 5% spray and Baricitinib 4 mg tablets purchasing prices were obtained from the National Unified Procurement Company (NUPCO). We estimated the population eligible for treatment to be 40 patients, with an estimated uptake rate of 10 % in year 1 and 50% in year 5.

RESULTS: The cost of Baricitinib significantly outweighed that of Minoxidil, with the total budget impact for Baricitinib starting at SR 165,838 in year 1 and increasing annually to reach SR 829,192 in year 5. In contrast, Minoxidil costs start at SR 7,866.72 in year 1 and reach SR 4,370.40 in year 5. The difference in costs between Baricitinib and Minoxidil, showing a negative of SR 157,971.68 SR in year 1 and SR 824,821.60 SR in year 5.

CONCLUSIONS: For the analysis population, the use of Baricitinib was associated with substantially increased costs. There is a need for studies that go beyond direct cost comparisons to include a comprehensive cost-effectiveness analysis for the Saudi setting.