OBJECTIVES: To estimate the budget impact of adopting golimumab for the treatment of rheumatoid arthritis (RA), akylkosing spondilitis (AS) and psoriatic arthristis (PsA) in the Brazilian public healthcare system (SUS). METHODS: In Brazil, four anti-TNF biologics are approved for treatmenting RA, AS and PsA: adalimumab, etanercept, infliximab, and golimumab. However, only the former three are reimbursed in the SUS. Using the public database, DATASUS, the number of patients receiving anti-TNF treatment for RA, AS and PsA (based on ICD9 codes) was gathered for the last 12 months, along with the associated drug costs. As golimumab is not yet reimbursed, treatment cost was defined according to law, based on the mandatory government discount of 21,87% . RESULTS: Around 38.687 patients received treatment with adalimumab (18.802), etanercept (14.614) and infliximab (6.840) between March 2011 and February 2012 in the SUS for RA, AS and PsA. In total, public health care spending with these treatments was about R$ 1.005.311.920,00 for the three indications in the same period (average treatment cost/patient R$ 25.985,78). Assuming the adoption of golimumab in 30% of patients receiving subcutaneous treatment (adalimumab and etanercept), the budget will be reduced by about R$ 101 million (11%) in the first year, excluding taxes. These savings represent over 6.238 new patients/year that can receive treatment with golimumab for RA, AS, and PsA. The savings can reach up to R$ 303 million /year, if golimumab is adopted as first choice among subcutaneous anti-TNF treatments. CONCLUSIONS: With the lowest treatment cost, golimumab has the potential to reduce public expenditure across all three indications in the SUS. These savings have important benefits for payers and patients, such as an increase in access to treatment or investment in other health priorities. Furthermore, with the least frequent dosing, golimumab presents important advantages in terms of patient commodity and logistics.