Most patients are relatively familiar with traditional oral drug therapy, but there are still many questions regarding the use of biologics. For example: “Biologics are so effective, give me direct access to biologics” “There are so many kinds of biologics, which one is more effective?” ”Is it true that imported biological agents must be better than domestic ones?” ”I don’t care about the money, it’s too much trouble for me to take medication.” As we introduced before, after decades of widespread use of anti-rheumatic drugs to improve the condition, the emergence of biologics can be said to be a big jump in the field of rheumatism, which opened a new chapter in the treatment of rheumatism. Generally speaking, biological agents have the following characteristics: (1) highly targeted, fast-acting and effective; (2) expensive. Therefore, when formulating treatment plans, we must consider the issue of cost effectiveness of drugs, such as “what conditions to use biological agents”, “how long to use”, “whether the treatment effect is good” All of these issues should be evaluated according to the patient’s condition and financial ability. First of all, biologics are not suitable for everyone and cannot be used whenever you want. Because biologics are expensive and cost tens of thousands of dollars to use, we do not recommend that all patients with rheumatoid arthritis use biologics. However, for some patients with severe disease, rapid disease progression, and ineffectiveness of common anti-rheumatic drugs, biologics are a better choice. It is also important to mention that biologics can suppress certain immune responses in the body, so they should not be used when the patient is in active infection status (e.g., active hepatitis B, active tuberculosis, etc.), has low autoimmunity (e.g., tumor patients), or during pregnancy or lactation. This explains why doctors have to conduct a series of tests on patients before using biologics, especially screening for hepatitis B, tuberculosis and other related conditions in accordance with China’s national conditions, with the aim of excluding the above conditions. Secondly, biological agents are not the more expensive the better, and their selection should be based on the principle of “individualization”. There are many different biologics that are effective in more than 70% of patients, including many who do not respond to methotrexate and/or leflunomide, but there are also some patients who do not improve significantly with biologics. Overall, imported biologics are slightly more effective than domestic ones, but they are also more expensive. Of course, there are cases in which domestic agents are superior to imports or in which all kinds of biologics are ineffective in treatment. Therefore, whether to use biologics and which biologics to choose, patients can fully communicate with their primary care physicians and choose the most suitable treatment plan by integrating the progress of their disease and their personal financial ability.