Background/Purpose: Transitioning patients with rheumatic diseases to biosimilars has become common to reduce healthcare costs and improve patient access to biologic therapies. However, it is unclear how the transition process impacts healthcare providers at the frontline of the brand change. This study explores providers’ experiences of a nationwide mandatory brand change to an adalimumab biosimilar.

Methods: A nationwide online survey was conducted in Aotearoa New Zealand with rheumatologists, rheumatology nurses, and pharmacists. The transition was the first large-scale nationwide brand change for biosimilars and was anticipated to benefit >700 patients in the first year and reduce administrative burdens by extending authorization renewal durations. The transition occurred between March and September 2022, with data collected between November 2022 and February 2023. Survey items assessed satisfaction with logistics and supply, information and education, support, and administrative workload, on a 0-10 scale, with 10 indicating high satisfaction. Open-ended questions explored changes to workload and what did and did not go well during the transition.

Results: The sample (N = 164) consisted of rheumatologists (n = 39), rheumatology nurses (n = 16), and pharmacists (n = 109), yielding a response rate of 61%, 62%, and 3% for each practicing workforce. The mean [SD] overall satisfaction score with the transition was 5.7 [2.6]. Providers were the least satisfied with training for the biosimilar device (mean [SD] 3.7 [2.8]), information from government agencies (4.4 [2.7]), and administrative workload (4.6 [2.9]) during the transition. Satisfaction with adalimumab safety, efficacy, quality of the device, and the provision of sharps bins, alcohol wipes, and patient support was lower following the transition (p < .05 for all). Satisfaction with administrative workload (B = .37, p < .001) and training for the device (B = .20, p = .020) predicted overall satisfaction. Providers’ workload increased during the transition period due to additional patient counseling needs, navigating the initial authorization process, and sourcing resources and information. Participants reported that the transition was complicated by poorly implemented initial authorization processes and loss of the bio-originator patient support program. The citrate-free preservative and longer authorization duration after the transition were viewed positively.

Conclusion: Providers reported increased workload during the transition and less satisfaction with the biosimilar following the adalimumab transition. Provider experiences may be improved by ensuring training for the biosimilar device, maintaining a high-quality patient support program, and ensuring authorization processes function well throughout the transition period.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/healthcare-providers-experiences-of-a-mandatory-nationwide-transition-to-an-adalimumab-biosimilar/