OBJECTIVES: Rheumatoid arthritis (RA) is a chronic autoimmune disease, despite therapy, it can result in progressive joint destruction, deformity, disability and even death. Costly biologics for treating RA can greatly improve their RA symptoms. The objective of this study is to assess the cost-utility and budget impact of certolizumab pegol versus adalimumab and etanercept, with methotrexate, for the treatment of RA patients in Taiwan. METHODS: RA patients’ medical datum extracted was from the National Health Insurance Research Database (NHIRD) between 2006 and 2013. We applied a Markov model to construct a cost-utility analytical framework, and estimated the impact of the launch of certolizumab pegol in 15 years span on a Taiwan healthcare budget from 2016 to 2020. The cost year of the model is 2015 and the discount rate is assumed x.x%. RESULTS: The average lifetime costs for certolizumab pegol, adalimumab and etanercept in combination with methotrexate were NTD$4,692,909, NTD$4,327,304, and NTD$4,456,631 respectively (USD$1 = NTD$32.5). The QALYs gained were 8.380, 8.041 and 8.316 respectively. The resulting ICERs compared with adalimumab and etanercept were NTD$1,079,501 and NTD$3,726,517 per QALY gained respectively. Probabilistic sensitivity analyses showed that there was a 58.0% and 48.7% probability of certolizumab pegol being cost-effective compared with adalimumab and etanercept respectively on a threshold of NTD$2,062,029 (3 times GDP). In the base case, there was an impact of less than NTD$30 million on annual budgets. With greater uptake of certolizumab pegol in later years, the budget increased from NTD$3.97 million to NTD$23.76 million, which implied that the assumption of market share may be influential in the estimation of budget impact. CONCLUSIONS: The results show that the economic value of certolizumab pegol was cost-effective on adalimumab rather than etanercept, and the introduction of certolizumab pegol into Taiwan market has been justified by the budget impact assessment.