OBJECTIVES : To conduct budget impact analysis from public health system perspective of the implementation of recently authorized in the Russian Federation baricitinib in the treatment of moderate to severe rheumatoid arthritis in adult patients

METHODS : We conducted budget impact analysis for public health system medicine provision, therefore we considered only direct costs for medicines. Based on available data of patient distribution through alternative treatment options in the Russian Federation, we setup current distribution in the budget impact analysis: of the total 8601 patients, 2337 received adalimumab, 4018 – golimumab, 1332 – certolizumab pegol, 512 – tocilizumab, 282 – abatacept, 130 – tofacitinib. We defined budget impact of switching to baricitinib 40% of patients from adalimumab, 15% - from certolizumab pegol, 10% - from golimumab and 5% - from tofacitinib and tocilizumab. Time horizon was 1 year. National essential drug list (wholesale) prices were used (including VAT). Exchange rate 1 euro = 72 RUB.

RESULTS : Annual cost of treatment of one patient with adalimumab, abatacept, baricitinib, golimumab, tofacitinib, tocilizumab and certolizumab pegol is 12607 euro, 14100 euro, 9629 euro, 12511 euro, 9629 euro, 13496 euro and 13260 euro respectively. We defined budget for the treatment with adalimumab, abatacept, golimumab, tofacitinib, tocilizumab and certolizumab pegol with the current distribution of patients amounts to 105,2 mln. euro per year. Budget of the simulated distribution of patients using baricitinib, described above is 101,2 mln. euro per year.

CONCLUSIONS : With a simulated distribution of patients, budget savings of 4 mln. euro are achieved or 3.82% of current distribution budget.