OBJECTIVES: To estimate the economic impact for Colombian health budget by including frontline tocilizumab used as monotherapy or in combination with methotrexate in patients with RA refractory to treatment with non-biologic DMARDs. METHODS: The population over 18 years  reported by DANE, for the period 2013-2017 was used as population risk of developing RA. This was discriminated by age, sex and type of affiliation. The target population were considered patients over 18 years with RA refractory to treatment with non-biologic DMARDs. We used a prevalence of 0.5% and a range for sensitivity analysis of 0.25% and 1%; the percentage of patients with RA using biological (4.7%) corresponded to that reported by literature.  Intervention evaluated was: tocilizumab 8mg/Kg each 4 weeks and  tocilizumab 8mg/Kg each 4 weeks +metotrexate 15 mg/week. Actual technology: adalimumab 40 mg/ sc/biweekly +metotrexate 15 mg/week ; adalimumab 40 mg/ sc/biweekly; etanercept 50 mg/sc/week +metotrexate 15 mg/week ;  etanercept 50 mg/ sc/week; infliximab 3 mg/kg IV induction regimen at 0, 2 and 6 weeks followed by a maintenance every 8 week +  metotrexate 15 mg/week. This analysis was development for perspective of third payer. Only direct costs was used in the model: sourced drug acquisition and administration costs. RESULTS: Inclusion of tocilizumab does not imply additional costs to the Colombian health system and may even save resources by 17 million dollars until 2017. In the probabilistic model, tocilizumab has a thrifty impact in most years. This model shows that yhe inclusion of Tocilizumab saves costs for the Colombian health system (with increases of the inclusion, more saves) versus capitation payment unit (UPC). CONCLUSIONS: Inclusion of tocilizumab to mandatory health plan Colombia, would have an impact thrifty indicating that the health budget would not increase with inclusion.