OBJECTIVES : Psoriatic arthritis is a chronic immune-mediated inflammatory arthropathy, that belongs to the group of spondyloarthritis and occurs in association with psoriasis. This study aims to evaluate the budget impact of tofacitinib, in the treatment of moderate to severe active psoriatic arthritis in the Brazilian public health system.

METHODS : A budget-impact analysis model was developed considering a five-year time horizon including only direct costs of medicines. The eligible population was obtained using data from DATASUS on reported psoriasis outpatients with ICD of psoriasis arthritis (ICD 10 - M07). Subsequently patients affected by psoriatic arthritis were stratified by the market share the biological drugs used in the analysis: adalimumab, etanercept, secukinumab, infliximab and golimumab. Two scenarios were evaluated, one including patients being eligible for treatment with biological drugs for the first time (scenario 1), and an alternative scenario also including patients already treated with biological drugs and failed (scenario 2).

RESULTS : On scenario 1 where tofacitinib would be used following in patients being treated with biological drugs for the first time, 4.285 patients were included on year 1, up to 5.717 patients on year 5. It was estimated BRL 1.14 million in savings in the first year, reaching a cumulative saving of BRL 13 million in five years. For Scenario 2 where patients that already were treated with biological drugs and failed were included, 21.844 patients were included on year 1, up to 36.068 on year 5. The impact estimated in the first year was BRL 26.8 million and BRL 77.4 million in the accumulated five-year period.

CONCLUSIONS : Considering only drug acquisition costs, the treatment with tofacitinib were associated with savings for the Brazilian Public Health System budget in both scenarios evaluated, contributing to the rational use of health resources and to ensure access to the treatment of psoriasis.