Comparative Cost Efficiency of the Originator Drug of Infliximab and its Biosimilar for the Treatment of Rheumatoid Arthritis in the MENA Region

Objectives: To study and assess the comparative cost efficiency of Infliximab’s originator (Remicade®) and its biosimilar (Remsima®) in the treatment of Rheumatoid Arthritis (RA) across seven Middle Eastern and Northern African countries including Saudi Arabia, Jordan, Morocco, UAE, Tunisia, Algeria and Iraq. Methods: Direct costs incurred by one patient for the treatment of moderate to severe RA according to clinical practice were calculated with a treatment regimen consisting of the recommended initial dose of infliximab which is 3 mg/kg every 8 weeks after taking initial loading doses at weeks 0, 2 and 6. The budget impact analysis also depended on two different scenarios. The first scenario disallows the interchangeability between Remicade® and Remsima® during the treatment duration, while the second scenario assumes interchangeability after 6 months of treatment from the infliximab’s originator to its biosimilar. Results: The cumulative cost for treatment with the originator infliximab (Remicade®) and its biosimilar Remsima® for the three-year period was 27054.00 $ and 21384.00 $, respectively and according to the first treatment scenario. For the second scenario which assumes interchangeability, the total 3 year cost for both Remicade® and Remsima® was 27054.00 $ and 22335.30 $, respectively. The overall cost savings over three years ranged between 17.4–21% for the two simulated scenarios. Conclusion: Our study displayed that employing Infliximab’s biosimilar (Remsima®) for the treatment of RA makes a significant decrease in the overall cost of treatment incurred by the patient (or the payer). Our results clearly highlight that employing Infliximab’s biosimilar, Remsima®, for the treatment of RA in the MENA regions would provide significant savings both for the patient or the institutional health care organizations responsible for covering the cost of therapy.