OBJECTIVES: To quantify the budget impact of introducing rivaroxaban 2.5 mg twice daily (BID) into the Greek market of secondary prevention therapies for acute coronary syndrome (ACS) with elevated cardiac biomarkers.

METHODS: A budget impact model (BIM) with a time horizon of 5 years has been developed. The model runs from 2018 to 2022. The budget impact was estimated from a Greek third-party payer perspective, namely the National Organisation for the Provision of Healthcare Services (EOPYY). Two main cost categories have been considered relevant to this perspective: treatment costs and event costs, while indirect and mortality costs have not been assessed as irrelevant with the perspective. Public sources have been used to estimate the incidence, management and cost of ACS in Greece and expert opinion has been used to cover evidence gaps whenever necessary.

RESULTS: It has been estimated that from an annual incidence of about 21,700 ACS with elevated cardiac biomarkers in Greece in 2017, only about 10,879 would be eligible for rivaroxaban 2.5 mg BID. It has been estimated that the annual budget impact will approximate 77.161,24€ in 2020 and 263.787,98€ in 2022. The cumulative (5-years) budget impact has been estimated at 562.036,11€. The main driver for this (>95%) is the drug acquisition cost of rivaroxaban. The overall resource impact of secondary and adverse events is not significant and does not outweigh the increased drug treatment cost.

CONCLUSIONS: The introduction of rivaroxaban 2.5mg BID into the Greek market is expected to increase the overall budget for prevention of secondary cardiovascular events in ACS patients. The overall resource impact of secondary and adverse events may be underestimated since the model does not consider the potential monetary gain associated with reduced mortality and the cost of rehabilitation therapy after myocardial infarction or CABG because these are not reimbursed by EOPYY.