Budget impact analysis of subcutaneous infliximab (CT-P13 SC) for treating autoimmune diseases in Jordan

Autoimmune diseases are increasingly prevalent, and their management in Jordan relies heavily on costly intravenous infliximab (IV IFX). Subcutaneous infliximab (IFX SC) may offer cost savings by reducing administration-related expenses. This study aims to investigate the financial impact of adding IFX SC to the currently available IV IFX, including originator and biosimilars, for the treatment of six autoimmune diseases: rheumatoid arthritis (RA), ulcerative colitis (UC), Crohn’s disease (CD), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and psoriasis (PS) in the Jordanian market from a payer perspective. A prevalence-based budget impact model was constructed to compare the current treatment environment without IFX SC (base case) with two future scenarios over a 5-year time horizon; 1st scenario: total adoption of IFX SC, 2nd scenario: gradual adoption of IFX SC. The numbers of patients eligible for IFX originator and its biosimilar, in addition to market share adoption, were obtained from official websites. Sensitivity analyses were conducted using Microsoft Excel ® to test the robustness of results to any variation of key input parameters. Over the 5-year horizon, the largest cost savings were observed in PS, PsA, and AS (–11.7 to − 13.3 million JD; − 16.5to − 18.7 million USD), while lower savings were seen in RA, UC, and CD (–2.0 to − 3.1 million JD; − 2.8 to − 4.4 million USD). Conversion to the more cost-saving scenario enabled expansion of treatment access, with the number of eligible patients increasing over time, particularly in highly prevalent conditions such as PS, PsA, and AS. The highest budget impact per patient was observed in UC and CD (approximately − 8,814.24 JD (–12,432.09 USD)), whereas the lowest was in RA (–2.810.92 JD ( − 3.074 USD)). In this study, there is a cost-saving potential with IFX SC use compared to IV IFX. These cost-savings, alongside the benefits of fewer hospital visits, additional eligible patients, and more efficient use of healthcare personnel time, support considerations of IFX SC reimbursement within the Jordanian healthcare system, while real-world evidence is needed to address uncertainties related to comparative effectiveness, patient tolerability and clinical acceptance.