BUDGET IMPACT OF BIOLOGIC THERAPIES FOR INFLAMMATORY BOWEL DISEASE IN SAUDI ARABIA: A 5-YEAR ANALYSIS SUPPORTING FORMULARY MANAGEMENT
Author(s)
Wejdan Aburas, PharmD1, Rawan Almasuood, PharmD, MSc.1, Shakir Bakkari, M.B.B.S.2, Mahmoud Mosli, M.B.B.S., MSc.3, Nancy Awad, BPharm4, Hind Hajj, Bsc, BPharm, MSc4.
1Ministry of Health, Riyadh, Saudi Arabia, 2King Saud Medical City, Riyadh, Saudi Arabia, 3King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 4Masdar Al Hekmah, Riyadh, Saudi Arabia.
1Ministry of Health, Riyadh, Saudi Arabia, 2King Saud Medical City, Riyadh, Saudi Arabia, 3King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 4Masdar Al Hekmah, Riyadh, Saudi Arabia.
OBJECTIVES: Inflammatory bowel disease (IBD) in Saudi Arabia is projected to reach an estimated 18,077 Crohn’s disease (CD) and 21,579 ulcerative colitis (UC) adult cases by 2029, and with new biologic therapies integrated into treatment guidelines, a growing clinical and economic burden is expected, highlighting the need to evaluate their financial impact to support formulary decision-making. The objective is to estimate the budget impact of introducing new biologic therapies for moderate-to-severe UC and CD in Saudi Arabia, compared with standard of care, from the perspective of the Saudi Ministry of Health (MOH) over a 5-year time horizon (2025-2029).
METHODS: Two separate dynamic budget impact models were developed for moderate-to-severe UC and CD. The eligible population included adults (14+ years) receiving care within the MOH system after failure of conventional therapy. Inputs included patient distribution across health states, healthcare resource utilization, adverse events, and treatment costs, including managed entry agreements (MEAs). The analysis compared current practice with a formulary-aligned biologic scenario including infliximab SC, vedolizumab SC, guselkumab, risankizumab, and upadacitinib. Other biologics currently used in clinical practice were excluded from the final formulary-aligned scenario. Outputs included total direct costs and budget impact over the 5-year horizon.
RESULTS: For UC, with MEA implementation, costs decreased to SAR 1.022B, generating SAR 155.3M savings, primarily due to reduced drug acquisition costs (−SAR 181M). For CD, total costs declined from SAR 1.18B to SAR 1.036B under MEA, resulting in SAR 147M savings, driven mainly by a reduction in drug acquisition costs of SAR 157M. Across both indications, there was 70% shift from infliximab and vedolizumab IV to subcutaneous formulations.
CONCLUSIONS: The introduction of MEA with a streamlined biologic formulary resulted in substantial cost savings in both UC and CD, driven by reduced drug acquisition costs and a shift toward subcutaneous biologics.
METHODS: Two separate dynamic budget impact models were developed for moderate-to-severe UC and CD. The eligible population included adults (14+ years) receiving care within the MOH system after failure of conventional therapy. Inputs included patient distribution across health states, healthcare resource utilization, adverse events, and treatment costs, including managed entry agreements (MEAs). The analysis compared current practice with a formulary-aligned biologic scenario including infliximab SC, vedolizumab SC, guselkumab, risankizumab, and upadacitinib. Other biologics currently used in clinical practice were excluded from the final formulary-aligned scenario. Outputs included total direct costs and budget impact over the 5-year horizon.
RESULTS: For UC, with MEA implementation, costs decreased to SAR 1.022B, generating SAR 155.3M savings, primarily due to reduced drug acquisition costs (−SAR 181M). For CD, total costs declined from SAR 1.18B to SAR 1.036B under MEA, resulting in SAR 147M savings, driven mainly by a reduction in drug acquisition costs of SAR 157M. Across both indications, there was 70% shift from infliximab and vedolizumab IV to subcutaneous formulations.
CONCLUSIONS: The introduction of MEA with a streamlined biologic formulary resulted in substantial cost savings in both UC and CD, driven by reduced drug acquisition costs and a shift toward subcutaneous biologics.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE642
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Biologics & Biosimilars, Gastrointestinal Disorders