PSY15 - BUDGET IMPACT ANALYSIS OF THE INCORPORATION OF GOLIMUMAB AS AN ADDITIONAL TREATMENT OPTION FOR NAÏVE PATIENTS WITH PSORIATIC ARTHRITIS IN THE BRAZILIAN PUBLIC HEALTH SYSTEM

Abstract

Clinical guidelines are available at a national level for the treatment of patients with psoriatic arthritis (PsA) in the Brazilian public health system (SUS). The present research aims to estimate the budget impact of the incorporation of golimumab (GOL) as an additional biological treatment option in these guidelines. A budget impact analysis (BIA) was developed using a two health states Markov model (new/first line and discontinued) with annual cycle length. The budget impact of GOL incorporation was compared to the current scenario, from SUS perspective. Target population was defined as patients naïve to biological treatment and estimated based on DATASUS database. A 5-year time horizon was employed, considering population growth according to IBGE statistics. GOL adoption rate was assumed as 40% at the end of 5 years, with annual discontinuation rate of 25%. Once discontinued, it was assumed patients remain in this state until the end of the analysis. Only drug acquisition costs were considered and prices were gathered from the official government website. Annual treatment costs were calculated following doses/intervals defined in the guidelines. Deterministic sensitivity analysis (DSA) was carried to determine the impact of the assumptions on results. 3,010 naïve patients were eligible to start treatment with biological drugs in the first year. Due to its lower annual treatment cost, the BIA estimated that GOL incorporation would bring a saving of R$633,000 in the first year of incorporation, reaching a total of R$17.7 million savings in 5 years. DSA confirmed the robustness of model and, regardless of the parameter altered, GOL would bring savings to the government budget, ranging from R$13.2 million to R$28.2 million in 5 years. Introduction of GOL in SUS as an option for patients with PsA shows potential to bring significant savings to government budget. The higher incorporation rate, the greater the economy.