OBJECTIVES: Determine the persistence, clinic and economic impact of Etanercept (ETN) y Adalimumab (ADA) reduced dose in Rheumatoid Arthritis (RA), Psoriatic Arthropathy (PA) and Ankylosing Spondylitis (AS) Patients with at least 1 year in Clinical Remission METHODS: Observational, retrospective cohort of patients in off-label program receiving ETN or ADA at reduced dose for at least 6 months (Jan2010 to Dec2014). Inclusion Criteria: patients treated with ETN or ADA at standard dose that achieve and maintain clinical remission (DAS28<2.6 or BASDAI<2) during at least 1 year were selected to reduce their standard dose.We collected age, sex, indication, persistence of ETN or ADA at reduced dose during the study period. In these patients, we simulated the cost of treatment with ETN or ADA as if they had received ETN or ADA at standard dose during their ETN or ADA at reduced dose respective periods. Economic impact was assessed using Enbrel^® and Humira^® Spanish official prices. RESULTS: From Jan2010 to Dec2014, 144 patients (51% women; age 51±9 years; 75 RA, 37 PA, 32 AS) received ETN or ADA at reduced dose for at least 0.5 years. 80 (56%) patients received ETN reduced dose and 64 (44%) patients received ADA reduced dose. Patients with ETN reduced dose presented a persistence of 2,71±1,37years (AR 2,64±1,54, AP 2,56±0,80 y EA 3,04±1,31) and with ADA reduced dose presented a persistence of 2,07±0,96years (AR 2,37±0,92, AP 1,86±0,73y EA 1,74±0,81). Total cost of this low dose strategy throughout the observation period were 1.485.510€. If these patients had been treated with ETN or ADA standard dose, the total cost of therapy would have been 2.971.020€. The implementation of the optimized therapy of ETN or ADA saved 1.485.510€.  CONCLUSIONS: Reducing the dosage of ETN and ADA in selected patients could make treatment more cost-effective and allow physicians to treat more patients with a fixed budget.