OBJECTIVES: This analysis was designed to estimate the budget impact following the introduction of apremilast in the treatment of active psoriatic arthritis (PsA) for adult patients who have failed to respond to or are intolerant of disease-modifying antirheumatic drugs (DMARDs) in Spain. METHODS: A budget impact model was developed to estimate healthcare costs for adults with PsA during a 3-year period from the NHS perspective. Target population was defined based on epidemiological criteria; PsA prevalence (0.2%) and proportion of patients on biologic treatment (13.5%) were applied to national adult population statistics. Addition of apremilast to the therapeutic arsenal (adalimumab, etanercept, golimumab, infliximab, ustekinumab) was explored. From the annual eligible population of PsA patients (N=8,122), 5% (n=406), 11% (n=893), and 18% (n=1,462) were assumed to be treated with apremilast for the first, second, and third year, respectively. A local expert panel provided detailed resource consumption information. Total cost included drug acquisition based on drug doses from the summaries of product characteristics (ex-factory price with mandatory deduction), administration (parenteral drugs), and monitoring costs. Unitary costs (€, 2014) were obtained from national databases. RESULTS: The total budget for the scenario without apremilast was €101,104,837, €101,082,349, and €100,875,977 in the first, second, and third year, respectively. The pharmaceutical cost represented 95% of this total cost. Following apremilast introduction, total budgets were reduced by €1,244,342, €2,735,080, and €4,438,438 in the first, second, and third year, respectively. Incremental costs per patient comparing the scenario with apremilast vs. the scenario without apremilast were €−153.21 (−1.23%), €−336.77 (−2.71%), and €−546.50 (−4.40%) in the first, second, and third year, respectively. CONCLUSIONS: Apremilast treatment for PsA patients who have failed to respond to or are intolerant of DMARDs would imply a budget impact decrease on overall healthcare expenditure for the NHS.