OBJECTIVES: Autoimmune disorders such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis have partially overlapping clinical manifestations that are most destructive to the joints. Given similarities in their clinical features, their therapies overlap significantly. These include conventional oral disease-modifying antirheumatic drugs (cDMARDs) and newer biologics (bDMARDs). Studies show that utilization of biologics is low in middle eastern countries; which could be attributed to biologics high cost. Biosimilars have comparable efficacy and safety to biologics yet with potential for lower acquisition cost; adalimumab-atto is the biosimilar of adalimumab, indicated for the management of several autoimmune diseases. With introduction of adalimumab-atto, healthcare utilization cost is expected to be reduced. This study estimated the budget impact (BI) of introducing adalimumab-atto for management of autoimmune diseases from Dubai Health Authority (DHA) perspective.

METHODS: BI model was developed to assess two scenarios — “with adalimumab-atto” and “without adalimumab-atto”, over a five-year time horizon. The key model inputs included estimated number of current and new patients with autoimmune diseases, market shares, drug acquisition cost, administration cost, monitoring cost, and adverse event cost. Inputs were retrieved from DHA claims data and secondary literature.

RESULTS: Over a five years’ time horizon, the total cost of autoimmune disease patients’ management using adalimumab was estimated to be AED 146,031,932. The gradual introduction of adalimumab-atto for the management of new patients was estimated to result in an overall savings of 13.5% (AED 19.6 million) compared to “without adalimumab-atto” scenario. The total replacement of adalimumab by adalimumab-atto for the management of new patients resulted in an estimated overall savings of 19.2% (AED 28.1 million). The savings are mainly attributed to the anticipated decrease in the drug cost.

CONCLUSIONS: The introduction of biosimilar adalimumab-atto has the potential to lead to substantial savings in the overall budget for the treatment of autoimmune disease patients from DHA payer perspective.