OBJECTIVES: Biological therapy is a tool to prevent clinical and radiological progression in patients with rheumatoid arthritis (RA). The purpose of this study was to assess the usage of biologic agents in terms of reduction of the Disease Activity Score 28 (DAS28) and medication expenses associated in patients with moderate-severe RA during a 24 month period. METHODS: We conducted a real-world, retrospective, cross-sectional study, based on information from a specialized in RA center in Colombia. Subjects with moderate-severe disease activity received biologic therapy, and were followed-up and treated according to DAS28; therapy had to be adjusted with DAS28 > 3.2 unless the patient’s conditions did not allow it. Descriptive epidemiology was done and the overall drug costs were assessed. RESULTS: CONCLUSIONS: The use of biologic therapies in the treatment of RA continues being evaluated but is associated with high costs; we show real-world drug utilization data in adult patients with moderate-severe RA in a low income developing country. These observations could be used by decision makers in order to consider health decisions; nonetheless, further research based on cost-effectiveness analysis and cost comparison is needed to verify these results.