OBJECTIVES: Following a recent price regulation for biopharmaceutical products in Colombia, we aimed to determine the impact on the cost of treatment with biologic therapies for rheumatoid arthritis in patients who failed to respond to oral DMARDS.   METHODS: Current guidelines and evidence suggest similar efficacy and safety among 7 biologic products available in Colombia for the treatment of rheumatoid arthritis following DMARD failure: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab and tocilizumab.  We compared the annual direct medical cost of treatment (including drug costs, administration and monitoring) for intravenous (IV) and subcutaneous (SC) injections of these biologics. Dosages were determined based on the approved product labels and the average weight (62 Kg) for a cohort of 275 patients with rheumatoid arthritis from a private institution in Bogota, Colombia. Costs were calculated using the data from most current price regulation guidance from the Ministry of Health (Circular 04-05/2013) and official sources for payments of treatments and procedures (SISMED). Sensitivity analyses were performed using different dosages and patients’ weights. RESULTS: Direct annual cost of treatment with biologics was higher in the first year than in subsequent years, except for tocilizumab, etarnercept, adalimumab and golimumab which do not need additional dosages in the first year.  Abatacept, both IV and SC, consistently showed the lowest direct medical cost after 3 years. The additional cost of treatment with other biologic therapies compared to abatacept ranged from 11% to 48% after 3 years. Despite having additional costs of administration, IV biologics had lower total direct medical cost compared to SC, mainly due to higher cost per dosage of the drugs. CONCLUSIONS: Under the current price regulation for biologics in Colombia, the cost of treatment for rheumatoid arthritis favors the use of abatacept as a first line biologic after DMARD failure.