OBJECTIVES: Biologic treatments have reformed the management of autoimmune diseases. Biosimilars offer similar efficacy and safety at a lower cost than the reference drug, thus potentially reducing the per-patient costs and expanding treatment access among patients. The study aimed to estimate the budget impact of adopting adalimumab-biosimilar Sandoz in the management of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, uveitis, hidradenitis suppurativa and Crohn's disease from a healthcare system’s perspective for selected sectors in five countries of Middle East (ME): the Kingdom of Saudi Arabia (KSA), United Arab Emirates (UAE), Qatar, Kuwait, and Lebanon.

METHODS: A decision-analytic economic model was developed to evaluate the potential effect on costs associated with the use of adalimumab-biosimilar Sandoz over a five-year time horizon. The number of eligible patients and other model inputs, including market shares and drug acquisition costs, were derived from national epidemiology statistics, published literature, and opinion of 31 experts. In addition, the experts were also asked about their perception of the biosimilars. The model compared the following scenarios: Scenario 1 (initiation in all biological-naïve patients only), Scenario 2 (initiation in all biological-naïve patients and gradual switching of current patients), and Scenario 3 (total switching of all patients).

RESULTS: At ME level, adalimumab-biosimilar Sandoz was associated with budget savings of $36,058,726, $123,606,365, and $181,971,458 for Scenarios 1, 2, and 3, respectively. For scenario 3, country-specific savings were as follows: $116,038,961 (KSA, multiple sectors), $25,148,340 (Kuwait, MOH), $21,926,107 (Lebanon, private sector), $11,429,100 (Qatar, Hamad), and $7,428,950 (UAE, SEHA of Abu Dhabi). Furthermore, based on the analysis, willingness to use biosimilars appeared to exist as 45 % of respondents were likely to opt for a biosimilar over originator.

CONCLUSIONS: At ME level, the model estimated substantial budget savings of adopting adalimumab-biosimilar Sandoz over originator with scenario 3 resulting in highest savings of 39%.