Influence of information provided prior to switching from Humira to biosimilar adalimumab on UK patients’ satisfaction: a cross-sectional survey by patient organisations

Abstract

ObjectivesTo investigate the perceptions and experiences of people with specific immune-mediated inflammatory diseases during the process of switching from Humira to biosimilar adalimumab.DesignCross-sectional survey.SettingAn anonymised, self-administered, web-based survey.ParticipantsThe participants were drawn from members and non-members of either the National Rheumatoid Arthritis Society, the National Axial Spondyloarthritis Society, Crohn’s and Colitis UK, or Psoriasis Association. Birdshot Uveitis Society and Olivia’s Vision also signposted to the survey links.ResultsA total of 899 people living with various immune mediated inflammatory diseases participated in this survey. Thirty-four per cent of respondents reported poor overall satisfaction with their biosimilar adalimumab after the switch, associated with complaints related to the switching process including lack of shared decision making, scarcity of information provided by or signposted to by the department instigating the switch as well as lack of training with the new injection device. Where training with the new device had been provided, there were significantly reduced reports of pain when injecting the new biosimilar (OR 0.20, 95% CI 0.07 to 0.55), side effects (OR 0.17, 95% CI 0.06 to 0.47) and difficulty in using the new injection device (OR 0.25, 95% CI 0.15 to 0.41). Self-reported side effects were reduced by (OR 0.13, 95% CI 0.05 to 0.38) when written information was provided by healthcare professionals and by (OR 0.15, 95% CI 0.05 to 0.42) with provision of verbal information. Difficulty in using the new injection device was also reduced by provision of satisfactory information such as written documents (OR 0.38, 95% CI 0.23 to 0.63) or by verbal communication with healthcare professionals (OR 0.45, 95% CI 0.27 to 0.73). Finally, provision of satisfactory written or verbal information was associated with a reduction in any negative perception regarding symptom control with the new biosimilar by (OR 0.05, 95% CI 0.004 to 0.57) and by (OR 0.15, 95% CI 0.03 to 0.84), respectively.ConclusionsPatient reported experiences of the process of switching from originator to biosimilar emphasise the importance of clear communication, training and information in order to optimise perception and maximise achievable outcomes with the new treatment.

Outcomes Following Adalimumab Bio-originator to Biosimilar Switch—A Comparison Using Real-world Patient- and Physician-Reported Data in European Countries

“…Switching treatment and nocebo response to biosimilar therapy may negatively impact medication adherence and lead to poorer clinical outcomes [ 12 , 32 ]. Mitigating the nocebo effect requires increased awareness among prescribers and patients of the strict regulatory evaluation, similar safety and efficacy of biosimilars to their reference product [ 12 ], and enhanced prescriber–patient communications [ 17 ].…”

“…However, some unsuccessful switches have been attributed to patients’ perceptions (the “nocebo” effect [ 16 ]), and reduced efficacy and safety [ 14 ]. Furthermore, the manner and content of communications to patients about the reasons for non-medical switching may greatly influence the outcome [ 17 ]. The lower biosimilar retention rates in open-label switch studies compared to double-blind switch trials suggests that the nocebo effect might also play a role in biosimilar retention rates [ 18 ].…”

Rheumatology Patients’ Experiences of a Mandatory Nationwide Transition to an Adalimumab Biosimilar

“…In other studies, patients have reported suboptimal communication during a biosimilar transition, including wanting more notice, not being satisfied with the verbal or written information, or not having their concerns satisfactorily dealt with (5, 12). Our participants reported receiving enough notice before the transition occurred, but some also experienced a lack of information and resources.…”

“…However, only a few studies have explored patients’ experiences with the transitioning process, when considering how frequently patients are transitioned to biosimilars. A recent study surveyed 899 patients in the United Kingdom with immune‐mediated inflammatory diseases (e.g., arthritis, skin psoriasis and Crohn's disease) on shared decision‐making and the information they received during the transition to an adalimumab biosimilar ( 5 ). The survey demonstrated that transitioning was often done with suboptimal communication.…”

Pharmacists' confidence in explaining biosimilars to patients before a nationwide medicine change: A cross-sectional study

“…Educating pharmacists is important as some patients transitioning to Amgevita in the United Kingdom reported dissatisfaction with the information, and this was associated with more side effects, difficulty in using the new device, and negative perceptions about symptom control. 39 The results also pose an important question of where the responsibility falls to ensure pharmacists are sufficiently informed. A coordinated approach to sharing information is essential before a medicine brand changes to ensure pharmacists and other healthcare providers obtain up-to-date and balanced information on newly funded pharmaceuticals.…”