OBJECTIVES

: To estimate the direct medical and non-medical costs of managing severe rheumatoid arthritis (RA) in the Kingdom of Saudi Arabia (KSA) and to assess the budget impact of introducing the new oral advanced treatments (OATs) in KSA from a payer's perspective.

METHODS

: A budget impact model was developed to assess the costs of current practice in the KSA Ministry of Health hospitals for treating severe RA patients, compared with three alternative scenarios. Scenario 1 (S1) assumed switching 100% of current severe RA patients to OATs over 1 year. Scenario 2 (S2) assumed switching 30% of current severe RA patients and 50% of those newly-diagnosed to OATs, while scenario 3 (S3) assumed switching 30% and 100%, respectively to OATs, both over three years. All scenarios assumed that OATs had equivalent safety and efficacy to biologics. The cost categories considered included drug acquisition, preparation and administration, medication transportation and cold chain storage among others. All assumptions made were based on literature review and key opinion leaders’ interviews.

RESULTS

: The current practice total cost was estimated to be over SAR 361 million /year ($1=3.75 SAR). Drug acquisition, monitoring, travel and accommodation costs for the parenterally-administered biologics were the main drivers of cost. S1, S2 and S3 showed cost savings of 35%, 10.6% and 10.8%, respectively. The average cost /patient/year decreased from SAR 64,000 in the base case to SAR 45,000 in S1 and to SAR 55,000 in S2 and S3.

CONCLUSIONS

: Switching severe RA patients to OAT would significantly reduce the cost of severe RA management in KSA. The use of OAT will significantly reduce the costs associated with parenteral and subcutaneous RA drug administration (travel, accommodation, hospital visits for drug infusion and outpatient visits) for both the patients and the health systems, freeing-up healthcare resources for other medical needs