OBJECTIVES: Biologics, such as etanercept, are efficacious in reducing disease activity in their authorised indications, but are considered costly treatment options. The study’s objective was to assess the budget impact of introducing Benepali^®, an etanercept biosimilar, in 3 European countries for all licensed adult etanercept indications. METHODS: A budget-impact model (BIM) was used to estimate the cost saving potential of introducing Benepali in France, Italy and Sweden over a three-year horizon from the payer’s perspective. Current etanercept-treated population was estimated through GERS data for France, IMS sales data for Italy and Reveal sales data for Sweden, and projected over 3 years using the trends observed in the past 2 years in each country. Three model scenarios with different etanercept biosimilar penetration in these three countries were developed: slow (10%; 20%; and 30% of total etanercept sales at year 1; 2; and 3), medium (15%; 30%;45%) and rapid (20%; 40%; 60%). Prices were obtained from published sources (with the exception of the Benepali Swedish price), and a price erosion of 10% per year was assumed. RESULTS: Introduction of Benepali in the biologic treatment setting for scenarios with different biosimilar penetrations, current prices and a 10% yearly price erosion, resulted in projected budget-savings of: (1) France €25.8m–51.5m (2) Italy €31.5m–63.0m, (3) Sweden €15.4m–30.7m over the model time horizon. This would allow for savings equivalent of 3,850 to 7,676 patient-years in France, 4,420 to 8,840 in Italy and 2,050 to 4,088 in Sweden. CONCLUSIONS: The introduction of an etanercept biosimilar represents substantial cost-saving potential for healthcare systems in the studied countries; budget impact was sensitive to Benepali market uptake rates and discounts versus Enbrel^®, etanercept reference product. These savings could be used to treat additional patients within the same therapeutic area, fund novel therapies for other disease areas, and/or potentially fund other hospital or medical department needs.