Budget Impact Analysis Of Tofacitinib For Rheumatoid Arthritis From The Perspective Of The Brazilian Private Healthcare System

Abstract

Objectives: To assess the budget impact of tofacitinib standardization in Brazilian private healthcare system for the treatment of moderate to severe Rheumatoid Arthritis (RA). Method(s): An analytical decision-making model was developed in order to simulate the costs of standardization of tofacitinib in the list of therapies available for the treatment of moderate to severe RA in the supplemental healthcare system (SS) in a time horizon of five years. The reference population was composed by applying the RA prevalence in the Brazilian population to the number of SS beneficiaries for the year of 2015 which result n= 233,722 beneficiaries. For the analysis, the tofacitinibe cost of treatment was compared to the average cost of the therapy with a biological DMARD. For both, the following were also taken into consideration: (i) drug cost - an estimate through the technology list price; (ii) assumed projection for tofacitinib diffusion rate in the private healthcare system; (iii) micro-costing of disease follow-up costs; (iv) micro-costing of (subcutaneous and intravenous) administration costs; (v) market share of biological therapies in the Brazilian market, for which projection was obtained from IMS Health data (2014). All monetary units were in BRL. Result(s): The total cost of tofacitinib treatment is lower than the mean total cost of treatment with biological DMARDs, with an approximate reduction of 25.22%. Considering the assessed time horizon and the estimated diffusion rate for tofacitinib in relation to the biological therapy for SS beneficiaries in 2015, tofacitinib may yield savings of approximately 2% in 2015, 3% in 2016, 4% in 2017, 5% in 2018, 6% in 2019, adding up an accrued of approximately 20% in the first five years of its standardization in the SS. Conclusion(s): The use of tofacitinib may decrease the total treatment costs in the Brazilian private healthcare system for patients with moderate to severe RA.