Attitudes towards subsequent entry biologics/biosimilars: A survey of Canadian rheumatologists

Abstract

Globally, patents on several well established biologic agents used to treat rheumatic diseases have already or will expire over the next few years, allowing for the availability of subsequent entry biologics (SEBs or biosimilars). The objective of this study was to identify gaps in knowledge and attitudes towards SEBs among Canadian rheumatologists. Eighty-one rheumatologists completed the survey and were included in the analysis (22 % of the 369 who were contacted). We found that one third of physicians (31 %) were familiar with SEBs and that physicians with greater than 20 years of practice were significantly more likely to be familiar or very familiar with SEBs compared to respondents with less than 10 years or 10-20 years of experience (OR 11.1, 95 % CI: 2.1-55.5, p = 0.004 and OR 4.5, 95 % CI: 1.2-16.2, p = 0.023, respectively). A third (32 %) of physicians agreed or strongly agreed that they would be comfortable with indication extrapolation. Most respondents (88 %) would feel concerned or very concerned if a pharmacist had the ability to substitute a biologic drug for an SEB without the physician's approval. This survey was the first study that evaluated the position of rheumatologists on key areas surrounding SEBs from a nationwide Canadian perspective. Current physician attitudes and perceptions of SEBs can inform future educational initiatives and highlight important issues for payers, policy makers, and other stakeholders.

Treatment preferences of originator versus biosimilar drugs in Crohn’s disease; discrete choice experiment among gastroenterologists

“…According to their results, less than 10% of clinicians would replace the originator with a biosimilar for a patient already under treatment, while 25% would consider interchangeability only for new prescriptions. Another, Canadian survey with 81 rheumatologists explored physicians' attitudes toward biosimilars and found that about one-third of the clinicians were unlikely or very unlikely to offer a biosimilar treatment to a biological-naïve patient as initial therapy, even though evidence from RCTs are available in this field [10]. These studies presented only descriptive results, and did not analyze benefits which might compensate for the risks of using biosimilar treatments.…”

“…Although the penetration of biosimilars to clinical practice, and consequently potential benefits related to their use, might strongly depend on these preferences. Previous studies examined clinicians' attitudes to biosimilars did not consider these trade-offs, and did not connect the risks with potential benefits [9,10].…”

Supply-Side and Demand-Side Policies for Biosimilars: An Overview in 10 European Member States

“…Meanwhile, several studies have shown that physicians' familiarity with biosimilars is not satisfactory and that prescribers perceive the information on biosimilars provided as not sufficient and even not trustworthy [6,[127][128][129][130][131]. HTA may create the opportunity to satisfy the need for physicians' education through guidance publication, which is shown to be crucial for the acceptance of biosimilars, where concerns regarding efficacy and safety may exist among healthcare professionals and patients [6,132].…”

Biosimilars in inflammatory bowel disease

“…However, only 24% considered 'extrapolation' to all indications correct, and a surprising 61% 'felt little or no confidence in using biosimilars in their everyday clinical practice'. These types of concern were found to be also very common in a recent survey of Canadian rheumatologists [38]. Perhaps even more interesting is reviewing the statements of scientific societies in recently available 'position statements'.…”