BACKGROUND: Rheumatoid arthritis (RA) is a systemic autoimmune disease which affects about 0.5% of the population in developing countries. The current biologic DMARDs approved in Brazil as 1st line therapy are: infliximab, etanercept, adalimumab (anti-TNF therapies),   abatacept (T-cell co-stimulation therapy) or tocilizumab (IL-6 receptor antagonist). OBJECTIVES: To assess the budget impact of offering tocilizumab as an option to a pool of patients with rheumatoid arthritis (RA) in Brazil. METHODS: The perspective is private payer in Brazil. Only direct costs were considered which comprised of: drug, management and administrations costs [Scheinberg et al. 2005]. Drug costs were taken from public sources [Kairos magazine. May, 2009]. Base case dosages considered were: tocilizumab (8mg/kg dosage each 4 weeks) and infliximab {4.3 mg/kg (Ollendorf et al. 2005) at weeks 0, 2, 6 and every 8 weeks}, assuming a 70 kg patient, adalimumab (40mg every other week), etanercept (50mg every week) and abatacept (750mg at weeks 0, 2, 4 and then every 4 weeks). The discount rate taken was 5% according to the Brazilian guidelines for Health Technology Assessment (HTA) [Vianna et al. 2007] since a 5-year horizon was taken for this analysis. Both the treatment mix forecast and the tocilizumab penetration change were projected based on market research data. The results are expressed in 2009 Brazilian Reais (US$1 ≈ $Brz2.5). RESULTS: Total annual costs were $Brz81,021for tocilizumab, $Brz92,789 for etanercept, $Brz98,541 for adalimumab, $Brz105,283 for infliximab and $Brz 85,020 for abatacept. Based on the  change in the forecast;, a total savings for a period of 5 years were $Brz1,573,902 for each 100 treated patients, when comparing the group of patients received tocilizumab to the group of patients that did not receive tocilizumab. CONCLUSIONS: : Findings suggest tocilizumab offers potential costs reductions in the private healthcare system in Brazil.