OBJECTIVES To evaluate the use of tocilizumab in Russian patients with systemic juvenile idiopathic arthritis (SJIA) in terms of cost-effectiveness and impact on social and economic burden of the disease. METHODS The model was based on TENDER clinical study (De Benedetti F et al., 2012). First, a pharmacoeconomical cost-efficiency of tocilizumab and a standard basic therapy of SJIA were compared. The analysis included direct medical costs in two comparable groups (1st with routine administration of methotrexate and prednisolone, and 2nd with tocilizumab prescribed in case of refractoriness to NSAID and glucocorticosteroids). The efficacy of therapies was evaluated according to ACR  criteria. After that, the influence of tocilizumab on cost and burden of illness was assessed. The analysis included direct medical costs and government expenditures on hospitalization, work incapacity insurance, monthly social pensions, benefits for care for a disabled children below 18 y.o. and GDP losses. 12-week time horizon was adopted in the CEA model, and a 1-year horizon for the assessment of burden of illness. 

RESULTS The cost-effectiveness in terms of ACR 90 and 70 was 4 428 262.96 and 2 952 175.31 RUB for the group of standard treatment, and 1 166 111.66 and 615 218.74 RUB for tocilizumab group. Tocilizumab demonstrated the same benefits in terms of ACR 50, 30. Analysis of burden of illness revealed a different structure of financial expenditures in considered strategies: pharmacotherapy constituted >50% costs in tocilizumab group, but hospitalization costs were 12 times less than in standard therapy. Annual budget losses due to social burden of this disease were 426 144.63 RUB per patient in the group of standard treatment and 226 729.10 RUB in tocilizumab group.  CONCLUSIONS The use of tocilizumab in SJIA is justified by better cost efficiency and reduced of social and economic losses of state budget connected with the burden of the disease.