OBJECTIVES:  Two 2-years budget-impact models (BIM) were developed to estimate the impact of introducing secukinumab for the treatment of patients with ankylosing spondylitis (AS) or with psoriatic arthritis (PsA), both with inadequate response to previous DMARDs and NSAIDs on the Italian health care budget. METHODS:  The models considered patients with AS or PsA aged ≥18 years and the perspective of the Italian National Health Service (NHS). Only direct medical costs were considered: drug costs (secukinumab and all reimbursed biological drugs), administration costs per IV infusion, management disease-related costs and adverse event costs (infection malignancy). 2015 market share was assumed to be the starting year. Ex-factory list prices and Italian National Tariffs were considered to estimate costs of drug and medical resource used, respectively. Costs were assessed in Euros (2015 values). Secukinumab dosage is 300mg for PsA with moderate/severe psoriasis or antiTNF inadequate response (assumed 60% of PsA total), 150 mg for all other (assumed 40% of PsA total) and all AS population. RESULTS:  Total number of patients treated was estimated to be 18,788 (AS: 7,214; PsA: 11,574), with 907 receiving secukinumab in the first year, increasing to 2,891 in the second year. Considering total direct medical costs, cumulative saving is €23.5 million after two years from secukinumab introduction (AS: -3.96 Y1, -11.78 Y2; PsA: -1.83 Y1, -5.93 Y2). In terms of drug costs only, the budget impact of introducing secukinumab to the current biological market share was estimated to save €4.93 million (71% in AS and 29% in PsA) in the first year, increasing to save about €15 million (69% in AS and 31% in PsA) in the second year. CONCLUSIONS:  <span">Use of secukinumab in its rheumatological indications is a budget-saving option for the Italian NHS, potentially increasing when 150mg dosage is used for more AS patients and PsA naïve.