OBJECTIVES: Rheumatoid Arthritis (RA) is a chronic, inflammatory disease, affecting 0.68% of adult population in Greece. RA is associated with decreased quality of life and a significant economic burden. The intravenous (IV) formulation of Tocilizumab (TCZ) has already proven its efficiency and thus the aim of this study is to evaluate and confirm the cost-effectiveness of the subcutaneous (SC) formulation as first line biologic monotherapy. METHODS: Lifetime costs and outcomes for 10,000 patients were projected through an individual simulation model. The analysis compared a standard treatment pathway (STP) (Adalimumab, Etanercept and Palliative care) with a similar pathway where treatment was initiated with TCZ SC. Health Assessment Questionnaire (HAQ) scores were used to reflect disease severity. The primary efficacy outcome considered was American College of Rheumatology (ACR) response. Patient baseline characteristics derived from the ADACTA trial. Efficacy data were elicited from a network meta-analysis. A mapping model transformed HAQ scores into QALYs. Clinical practice standards were determined by Expert Opinion (12 Rheumatologists). Costs for pharmaceuticals and unit costs for resources were obtained from official price lists. Estimated mandatory rebates for new products were taken into account. A third-party payer (Social Insurance) perspective was employed. Costs and QALYs were discounted at 3%. RESULTS: The treatment sequence starting with TCZ SC yielded 0.98 more QALYs (9.08vs. 8.10) at an additional cost of €27,442.5 (€132,733.78 vs. €105,291.27) compared to the STP.The Incremental Cost – Effectiveness Ratio (ICER) was estimated at €27,974.28 per QALY gained which is below the national commonly used threshold. Probabilistic Sensitivity Analysis confirms robustness of findings below a threshold of €45,000. CONCLUSIONS: The results of the analysis suggest that TCZ SC can be a cost-effective alternative and provide both patients and health care system with more options for RA management due to dual formulation’s effectiveness and efficiency.