OBJECTIVES: The prevalence of rheumatoid arthritis (RA) was estimated to be 1.93% in the Iraqi adult population. RA is associated with increased disability and morbidity, and impaired health-related quality of life. Tofacitinib, an oral JAK kinase inhibitor, is as effective and safe as disease-modifying antirheumatic biologic drugs (bDMARDs) in the management of moderate to severe RA and it is less costly in terms of storage and administration. However, the widespread use of this new therapy for RA management is still not achieved due to its perceived high cost. Therefore, this budget impact analysis aims to estimate the budgetary impact of adopting tofacitinib on payers’ budget as a treatment for moderate to severe RA in the Ministry of Health (MOH) in Iraq.

METHODS: A budget impact model was developed to estimate the budgetary impact of adopting tofacitinib on payers’ budget as a treatment for Iraqi adult patients with moderate to severe RA treated at MOH facilities over a 5-year time horizon.

RESULTS: Compared to the ‘World without Tofacitinib’ scenario i.e. the current scenario (total cumulative cost: $USD 143 million), the ‘World with Tofacitinib’ scenario (total cumulative cost: $USD 133 million) resulted in a cost saving ranging from $USD 1 million in year 1 up to $USD 3.6 million in year 5, yielding cumulative savings of $USD 9.8 million over 5 years’ time horizon. Results suggest that cost savings were primarily driven by the lower annual drug acquisition cost of tofacitinib compared to other bDMARDs.

CONCLUSIONS: The introduction of tofacitinib to the current treatment scenario demonstrated a considerable reduction in healthcare utilization and the overall cost for the payer. Hence, its addition to the RA drug formulary could be a valuable option for optimal resource allocation as it has the potential to reduce RA related healthcare expenditures for the MOH in Iraq.