COST MINIMIZATION ANALYSIS IN THE SWITCH OF INFLIXIMAB FOR ITS BIOSIMILAR IN THE BRAZILIAN PRIVATE HEALTHCARE SYSTEM

OBJECTIVES: To develop a cost minimization analysis in the switch of infliximab to it biosimilar, in the treatment of rheumatoid arthritis (RA) from the perspective of Brazilian private health system (BPHS). METHODS: A cost minimization analysis model was developed to measure the impact of treatment switch from Infliximab to its biosimilars. The analysis considered the perspective of the BPHS, and has included only direct costs of medicines (as regulated by the local Ministry of Health), in a cohort of 2 million lives (based on average of top 10 largest Brazilian Private Health Plans). The incidence rates for RA in the Brazilian population (0.46%; N= 9,200), followed by an estimate percentage of patients treated with Infliximab (34.15%; N=3,142), for the switch scenario were considered an increasingly switching rate from 30% with additional 5% early, up to 50% at the end of 5 years. The population was adjusted using a growth rate of 0.09% after first year. RESULTS: During first year, the "without switch" scenario costs were BRL 151,769 million, followed by BRL 151,905 million, BRL 152,042 million, BRL 152,178 million and BRL 152,315 million in the following years. For the "switch to biosimilar" scenario costs were BRL 136,088 million in the first year, followed by BRL 133,596 million, BRL 131,099 million, BRL 128,594 million and BRL 126,091 million in the following years. The difference between the scenarios generated an economy of BRL 15,6 million followed by BRL 18,3 million, BRL 20,9 million BRL 23,5 million and BRL 26,2 million in the following years resulting in a total economy of BRL 104,7 million. CONCLUSIONS: The switch to biosimilar could provide payers an option for expenditures reduction, being a viable alternative for physicians to provide the chosen treatment at a lower cost, increasing the access to the drug, and overall treatment availability.