Clinicians in the US and Europe are often cautious about biosimilar use and do not support the use of biosimilars as safe and effective treatment options in patients already receiving bio-originator therapy.
Biosimilar agents have the potential to offer significant cost-savings to the health care system by mitigating the rising costs of drugs and expanding patient access to care for important biologic therapies. However, uptake of these agents is largely dependent on health care provider willingness to promote, prescribe, and use biosimilars in clinical practice.
Emily Leonard, University of North Carolina at Chapel Hill, and colleagues conducted a systematic review to evaluate the current US and European health care provider knowledge, perceptions, and prescribing behaviors of biosimilar agents to assess the need for clinician-directed biosimilar education. Data from 20 surveys published between 2014 and 2017 were used in the study, of which three originated from the US and 17 originated from multiple European countries. Hospital specialists, gastroenterologists, and rheumatologists were among the most frequently surveyed practitioners.
Results of the review were published in the Journal of Managed Care & Specialty Pharmacy (January 2019;25:102-112).
Researchers found that the percentage of biosimilar prescribing varied substantially between countries and within similar practice fields. When utilized, biosimilars were most prescribed in biologic treatment-naïve patients.
While providers reported that self-study and available literature were the most trusted sources of biosimilar information, an overall lack of awareness about biosimilars persists in both the US and Europe. Only 22.9% of physicians and 38.8% of pharmacists reported “complete” or “good” knowledge of biosimilars in a 2016 survey.
Similarly, providers reported concerns with interchangeability and pharmacy-level substitution. In 2016, 89.9% of surveyed clinicians disagreed with pharmacy-level substitution of a biosimilar. Another 2016 survey found that 80% of respondents were unaware that an interchangeability designation could result in automatic substitution.
“Biosimilar-specific education remains a relatively neglected are of emphasis in the published literature,” authors of the study concluded. “To realize the full cost-saving potential of biosimilar medicines, clinician-directed biosimilar education will be imperative to address gaps in biosimilar knowledge, facilitate prescribing changes, and ultimately increase biosimilar use.”—Zachary Bessette