Background Treatment with Tumour Necrosis Factor (TNF-α) antagonists in patients with Rheumatoid Arthritis (RA) is expensive for the National Health Service.

Purpose To analyse the financial impact of this group of drugs and identify discrepancies between the theoretical cost and the actual cost.

Material and methods A retrospective, descriptive study of all patients with RA treated with adalimumab, etanercept or infliximab for the last three years in a tertiary hospital. The variables studied were: number of patients, number of units dispensed and cost per patient per year for each drug. Financial calculations used the official price of drugs plus VAT and took discounts into account.

Results The total cost generated of etanercept, adalimumab and infliximab was €4,053,861 in the study period. 92 patients were treated with adalimumab: 3,717 units were dispensed (mean 13.46 units/patient/year), mean cost €8,333/patient/year. 69 patients were treated with etanercept: 5,239 units were dispensed (mean 25.3 units/patient/year), mean cost €6,837/patient/year. 59 patients were treated with infliximab: the number of administrations was 1,050 (mean 5.9 administrations/patient/year), mean cost €8,431/patient/year. Theoretical cost calculated per (70 kg)/patient/year was €6,977 for infliximab (3 mg/kg), €11,254 for etanercept (50 mg/week) and €12,120 for adalimumab (40 mg/2 weeks). The underspend was €4,417/patient/year and €3,787/patient/year for etanercept and adalimumab respectively, whereas the actual cost of infliximab represented an increase of €1.454/patient/year compared to the theoretical cost.

Conclusion The actual cost of treatment with adalimumab and etanercept per patient/year was less than theoretically calculated, unlike infliximab, where the true cost per patient/year was greater than the theoretical cost.

References and/or Acknowledgements No conflict of interest.