PSY21 - BUDGET IMPACT ANALYSIS OF THE INCORPORATION OF GOLIMUMAB AS AN ADDITIONAL TREATMENT OPTION FOR PATIENTS WITH PSORIATIC ARTHRITIS IN THE BRAZILIAN PUBLIC HEALTH SYSTEM

Abstract

Clinical guidelines are available at 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 drug (biological) in these guidelines. A budget impact analysis (BIA) was developed using a three health states Markov model (new/first line, second 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 patients either naïve to biological or receiving the first biological, estimated based on DATASUS database. A 5-year time horizon was employed and GOL adoption rate was assumed as 40% in naïve patients at the end of 5 years and 33,3% of patients switching the first biological. Patients discontinuing the second biological remained in ‘discontinued 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, 7,767 were receiving the first biological and 886 the second one. The BIA estimated that GOL incorporation would bring a saving of R$2.4 million in the first year of incorporation, reaching a total of R$39.2 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$24.4 million to R$61.9 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.