Perceptions of Biosimilars among Medical Specialists

Abstract

Biosimilars are a new pharmaceutical development engineered as a cost-effective alternative to biologics. Prescribing biosimilars will facilitate savings for the healthcare system and improve patient access to expensive biological medicines. Biosimilars are highly similar to their reference biologic, however, the active ingredient in a biosimilar is not identical to the reference biologic. For this reason, there may be reluctance on the part of prescribers to use biosimilars. Due to the substantial benefits biosimilars offer it is important to establish how prescribing specialists perceive them, and whether they will want to prescribe biosimilars. The benefits of biosimilars will not be realised unless specialists prescribe them. Therefore, the aim of the current research was to investigate specialists’ perceptions of biosimilars and the factors associated with acceptance of biosimilars. An online questionnaire was constructed to measure perceptions of biosimilars across ten domains. A total of 327 specialists working in the areas of rheumatology, dermatology, gastroenterology, oncology and haematology, throughout New Zealand, were invited to complete the questionnaire. This generated 110 complete questionnaire responses. Analysis of the results showed that specialists held predominantly positive views of biosimilars. Approximately 50% to 74% were confident in the efficacy, safety, manufacturing and pharmacovigilance of biosimilars, as well as the use of indication extrapolation, and perceived biosimilars to be comparable to their reference biologics. Negative perceptions were reported by between 9% and 32% of specialists, and between 13% and 36% were undecided regarding these biosimilar issues. Eight factors were found to be associated with biosimilar acceptance: familiarity with biosimilars (p = .003), type of practice (p = .040), trust in Medsafe (p < .001), trust in Pharmac (p < .001), confidence in biosimilar pharmacovigilance (p < .001), confidence in indication extrapolation (p < .001), intentions to prescribe biosimilars for monetary savings (p < .001), and perceived length of time to explain biosimilars to patients (p < .001). In terms of prescribing biosimilars, specialists were again predominantly positive (72% to 79%). However, around 28% of specialists were not confident in switching a patient from a biologic to a biosimilar for the reason that it may be less effective. This research has contributed a number of unique findings to the literature. Firstly, it has shown that, in general, specialists are confident in biosimilars, and confident prescribing them to their patients. This is reassuring because it suggests that specialists are likely to use biosimilars which will generate cost savings for the healthcare system and improve patient access to these medicines. Secondly, the current study has identified several factors associated with the acceptance of biosimilars which provides multiple avenues for improving specialists’ perceptions of biosimilars where required. Thirdly, it has identified specialists would like greater information about biosimilars and would also like material designed to inform patients about biosimilars. Finally, it has provided a sound basis for further research in the area of biosimilars. This should focus on the assessment of patient perceptions of biosimilars and investigation of the effects of biosimilar explanations on patient outcomes.