OBJECTIVES: Different biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) are indicated for moderate-to-severe Rheumatoid Arthritis (RA) patients, who fail on conventional DMARDs (cDMARDs). This study aims to compare the annual treatment costs of the bDMARDs dosing according to the clinical treatment guidelines.

METHODS: We were comparing three bDMARDs from the Egyptian public healthcare system perspective: adalimumab (ADA), etanercept (ETN), and infliximab (IFX). Annual treatment costs were calculated for a patient of 80 kg. Direct medical costs were considered in the analyses from the public local hospitals. Probabilistic sensitivity analysis (PSA) was carried out to determine the impact of different parameters simultaneously on the results.

RESULTS: IFX currently presents the lowest annual treatment cost among bDMARDs at EGP 30,812/patient/year, 56%, and 58% lower than ADA, and ETN, respectively. The PSA shows that IFX is 100% more likely to achieve the lowest annual treatment costs, and be the cost saving option for moderate-to-severe RA Egyptian patients.

CONCLUSIONS: It is more appropriate to analyze each research question due to the fragmented healthcare system in Egypt. IFX represents an important treatment option for RA patients in Egypt, as it has the lowest treatment cost among available bDMARDs but there’s no evidence on the similar effectiveness of bDMARDs among Egyptian patients.