OBJECTIVES: In 2013, NCPE assessed the cost-effectiveness of subcutaneous (SC) abatacept as a first line biologic for the treatment of rheumatoid arthritis (RA), compared to existing biologics. It was necessary to consider the treatment pathway beyond first line biologics. We therefore built a model to match the treatment pathway for first line biologics and beyond. METHODS: We used our individual patient sampling model for England and Wales as a starting point to create a model which considers biologic cycling, to match the treatment pathway in Ireland. We differentiated between the efficacy of a biologic at first line, and at second line or later.   RESULTS: We created a model which could be used to calculate the cost-effectiveness of biologics for the treatment of RA in Ireland. Patients first received treatment with SC abatacept, intravenous abatacept, adalimumab, etanercept, infliximab, certolizumab pegol or golimumab.  If they experienced an adverse event (AE) on that treatment within 6 months, they switched to another biologic at first line efficacy. If not, their response to treatment was tested using the DAS28: if this improved by 1.2 or more, their time on treatment was sampled from a Weibull distribution, otherwise they discontinued at month 6. The patient then moved onto a randomly sampled second line biologic, which was either one of the first line biologics or rituximab. The time on second line biologic was sampled from a Weibull distribution, and then the patient moved onto a third line biologics (second line biologics and tocilizumab). The patient cycled through the biologics until they died, or had received all 8 treatments. After 8 biologics, remaining patients received leflunomide, cyclosporin, azathioprine and palliative care. CONCLUSIONS: We used robust methodology and clinical rationale to model the treatment pathway of biologics for RA in Ireland and facilitated cost-effectiveness comparison between first line biologics.