OBJECTIVES: This study aims to evaluate the cost-effectiveness of Tocilizumab-based-regimen and other four biologic-based-regimens for the treatments of DMARD-IR rheumatoid arthritis patients in China. METHODS: A network meta-analysis (NMA) was performed to combine and compare ACR response rates across all relevant RCT evidences. The real-world treatment fees, including drugs, monitoring and administration fees, were collected through expert interviews in Beijing, Shanghai, Guangzhou and Chengdu city. All Patient-Assistant-Programs were considered in drug-cost calculation. The cost-effectiveness analysis was conducted to evaluate average costs per ACR20/50/70 response among five regimens. RESULTS: The NMA analysis included 28 eligible RCTs. The results indicated that ACR20/50/70 response rates of Tocilizumab-based-regimen were 74%, 56% and 28% respectively. While the ACR20/50/70 response rates of other four regimens (Adalimumab, Infliximab, Etanercept and Etanercept-NCB (Non-Comparable-Biologics)) were 77%, 55% and 19% respectively. The total treatment fees of these five regimens within 48-weeks were calculated to be RMB 87,384, RMB 113,162, RMB 82,386, RMB 154,894 and RMB 93,582. The cost-effectiveness results demonstrated that, compared with other four regimens, Tocilizumab-regimen cost the average of RMB 312,087 (USD50,336) to achieve an ACR70 response. It cost RMB 118,087 (USD19,046) per ACR20 response and RMB 156,044 (USD25,168) per ACR50 response, which were comparable with Infliximab-regimen, but less than others. Tocilizumab could save costs ranged from RMB 3,449 (USD556) to RMB 503,147 (USD81,152) in order to fully achieve ACR20/50/70 response rates compared with other regimens. CONCLUSIONS: The study demonstrated that, compared with other available biologicals in China, Tocilizumab-regimen was the most cost-effective to achieve ultimate ACR70 response for DMARD-IR rheumatoid arthritis patients. It also suggested that it had similar cost-effectiveness results to Infliximab to achieve ACR20/50 responses.