Treatment journey in rheumatoid arthritis with biosimilars: from better access to good disease control through cost savings and prevention of nocebo effects

Abstract

Early diagnosis and treatment of rheumatoid arthritis (RA) are of critical importance to halt the progression of the disease. Optimal use of advanced imaging techniques or biomarkers may facilitate early diagnosis of RA. Even though many disease-modifying anti-rheumatic drugs (DMARDs) are available for RA treatment, biological DMARDs (bDMARDs) offer expanding therapeutic options and good outcomes in patients with RA who do not have a sufficient response to conventional synthetic DMARDs. However, high costs of bDMARDs have limited patient access to optimised disease management and increased the cost burden for healthcare systems. The advent of biosimilars led to significant cost savings driven by price competition among the reference products, which could be beneficial for healthcare systems. Healthcare provider (HCP)–patient communication and informed shared decision-making are crucial to prevent the occurrence of a nocebo effect, which results from negative perceptions that patients may have and could lead to less effective outcomes. Research has demonstrated that effective communication between HCPs and patients utilising positive framing can improve acceptance by patients to be initiated on or switched to a biosimilar and can help to integrate biosimilars into routine clinical practice to maximise benefits for patients with RA.

Hypothalamic‐Pituitary‐Adrenal Activity in Adverse Events Reporting After Placebo Administration

“…Their better understanding could be crucial to control and avoid poor compliance and dropouts. A recent example is represented by biosimilars, namely biologic medical products that are an almost identical copy of an original product that is manufactured by a different company 25,26 . Indeed, the biosimilar infliximab for the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis has resulted in lack of efficacy and increased discontinuation mostly attributable to subjective complaints, with large and robust nocebo effects 27 .…”

“…A recent example is represented by biosimilars, namely biologic medical products that are an almost identical copy of an original product that is manufactured by a different company. 25,26 Indeed, the biosimilar infliximab for the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis has resulted in lack of efficacy and increased discontinuation mostly attributable to subjective complaints, with large and robust nocebo effects. 27 As biosimilars represent an alternative treatment option to the more renowned biologics, patients are likely to believe that they would not work as effectively as the originator biologics.…”

Switching from One Biosimilar to Another Biosimilar of the Same Reference Biologic: A Systematic Review of Studies

“…Currently, clinical experience with biosimilars exceeds 2 billion patientdays, indicating an increase in global biosimilar adoption [7,10]. A biosimilar is commonly less expensive than the reference biologic, and therefore may increase patient access to effective treatments [10][11][12]. By substituting biosimilars for reference biologics, the cost of high-priced medications used to treat diseases, such as cancer and rheumatoid arthritis (RA), might be reduced by $38.4 billion, or 5.9% of instead to use the term 'biosimilar-to-biosimilar switching' as it is unambiguous and precisely describes the nature of the switch.…”

Safety and Efficacy of Mesenchymal Stromal Cells and Other Cellular Therapeutics in Rheumatic Diseases in 2022: A Review of What We Know So Far

“…A number of therapeutic agents were recently approved for treating autoimmune diseases, including biologics and immunosuppressive agents (1). Even with the availability of these new drugs, a number of patients do not adequately respond, or experience significant side effects from the medications.…”