OBJECTIVES: This study seeks to evaluate the financial impact arising from the substitution of Adalimumab, Infliximab, and Etanercept reference products with their biosimilar counterparts among patients diagnosed with rheumatoid arthritis (RA) within a Brazilian private health insurer catering to 100,000 beneficiaries.

METHODS: The impact analysis draws upon medication values outlined by the Chamber of Market Regulation of Medicines (CMED), a regulatory benchmark for drug pricing in Brazil. The RA patient population is estimated based on a national study, indicating an approximate 0.5% prevalence, of which 25% may experience a moderate or severe condition justifying the use of this medication class. The analysis exclusively focuses on medication costs for patients in the maintenance phase, projecting three scenarios for each medication across the entire eligible population over a one-year.

RESULTS: Prevalence data reveals the portfolio comprises around 500 RA beneficiaries, with 125 having an indication for biologic therapy. An individualized analysis for each agent, considering recommended dosages, estimates the impact of substitution for therapy-indicated patients: Adalimumab (3,000 doses/year) – reference cost $5,287,755.10 versus biosimilar cost $1,436,493.47, resulting in a saving of $3,851,261.63; Infliximab (patients ≅70kg – 1,500 doses/year) – reference cost $1,322,888.78 versus biosimilar cost $499,591.84, resulting in a saving of $823,296.94; and Etanercept (6,500 doses/year) – reference cost $10,458,144.49 versus biosimilar cost $3,400,664.29, resulting in a saving of $7,057,480.20. Implementing the switch among 125 beneficiaries diagnosed with moderate or severe RA yields significant savings of approximately 72%, 62%, and 67%, respectively.

CONCLUSIONS: Prescribing biosimilar agents in Brazil's private healthcare sector remains challenging. Economic studies play a crucial role in raising awareness within the medical community amid a progressively resource-scarce landscape. The imperative for resource optimization is evident in RA management, where studies affirm no efficacy differences between agents, enabling prescribers to choose agents with an optimal cost-effectiveness ratio.