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Considering high prices of biologic drugs, using a cost-effective option for treatment of patients with rheumatoid arthritis who did not respond well to first biologic drug would have highly beneficial impact on health insurance budget. The aim of this study was to explore impact on budget of Republic Fund for Health Insurance (RFHI) caused by replacing etanercept with rituximab for treatment of rheumatoid arthritis patients who failed to respond to the firstline biologic drug. A Markov model with 5 states was constructed, having eight 6-months cycles. The perspective of the RFHI was used in the model, and annual savings in Serbia caused by using rituximab instead of etanercept were calculated. Using rituximab instead of etanercept for treatment of 20% of rheumatoid arthritis patients who failed to respond to the first-line biologic drug in would lead to absolute annual savings of 144,115,218.09 ± 431,906,009.46 RSD. The annual drug budget of RFHI would be decreased for 0.24 ± 0.73 %, while total annual budget of RFHI would drop for 0.07 ± 0.21 %. Based on the results of our study, using rituximab instead of etanercept for treatment of rheumatoid arthritis patients who failed to respond to the first-line biologic drug is a costeffective option in Serbia, which would bring significant savings to RFHI

racionalna terapija

Rituximab for the treatment of rheumatiod arthritis patients with failure to the first biologic drug: Impact on Republic fund for health insurance in Serbia