OBJECTIVES : To analyse the effects in patient access, treatment costs and annual expenditure with biologic drugs for rheumatoid arthritis after the inclusion of 5 biologic drugs in 2014 in the Brazilian Public Health System.

METHODS : The number of rheumatoid arthritis patients receiving treatment with biologic drugs from 2011 to 2016 as well as the proportion of patients on each of the 3 treatments available in 2013 (Adalimumab, Infliximab and Etanercept) and the 5 new treatments available from 2014 onward (Certolizumab, Abatacept, Golimumab, Tocilizumab and Rituximab) were observed using data provided by DATASUS. Annual treatment costs for each treatment from 2013 to 2016 and a weighted average based on the proportion of patients observed were calculated. The weighted average treatment cost and the number of patients receiving treatment made it possible to estimate the annual expenditure on biologic drugs for rheumatoid arthritis from 2013 to 2016.

RESULTS : A reduction of 34.6% in the weighted average treatment cost was observed from 2013 to 2016 . Patient access to biologic treatments increased substantially from 25.551 patients observed in 2011 to 52.494 in 2016. Annual expenditure also showed an increase, with estimations of R$ 839 million in 2013 to R$ 920 million in 2016.

CONCLUSIONS : Our results suggest that the inclusion of 5 new biologic drugs to treat rheumatoid arthritis in 2014 helped decrease the average treatment cost per patient as a result of the lower costs of the new drugs introduced in 2014, price reductions from the treatments available before 2014 and a gradual increase on the number of patients receiving less costly treatments. Patient access significantly improved, with more than twice as many patients receiving treatment in 2016 compared to 2011, while annual expenditure only showed a slight increase of 9.7% between 2013 to 2016.