Build a Budget Impact Analysis Model

Individual case study: 4

Starting population: hypothetical 1,000,000 commercial health plan; population growth of 1.7% per year

Indication: Moderate-to-severe rheumatoid arthritis (RA) who had an inadequate response to or who are intolerant of methotrexate (MTX)

Intervention of interest: monotherapy XELJANZ® (Brand) 5 twice weekly

Comparators to include (Brands):

Market uptake expectations (proportional from comparators): Year 1: 10%, Year 2: 15%, Year 3: 20%

Inputs: Drug acquisition costs only (wholesale acquisition cost)

Analyses:

Test which input (using +/- 25%) influences the PMPM most: price of XELJANZ®, market share uptake of XELJANZ®, or eligible population

Test the impact of taking all market share from ENBREL® only

2

Current and Projected Treatment Mix (without XELJANZ®)	Year 1	Year 2	Year 3
ENBREL® 50 mg/ml once weekly	55%	57%	60%
HUMIRA® 40 mg/0.8 ml once weekly	45%	43%	40%

Objective: You are tasked with developing a budget impact analysis as an economic model and providing the total net budget impact per user per year, total net budget impact per member and the net per member per month (PMPM)