Background/Purpose: Biosimilars intend to be as effective and safe as the originator product and would increase patients’ access to biological agents. The decision for switching to a biosimilar is not always promoted by the physicians and, although there is emerging evidence from randomized controlled trials concerning this issue, data from real world clinical practice is still lacking.

Our objective was to learn about physicians’ and patients’ perspectives concerning biosimilars in the context of non-medical switch.

Methods: A standardized questionnaire was conducted aimed at physicians´ perspectives and to patients who experienced a switch to a biosimilar.

Results: The survey was applied to 51 physicians (39% male), both residents and specialists of rheumatology (public and private practice). All of them considered theirselves to be at least reasonably informed about the concept of biosimilar and more than half (n=31; 61%) were reasonably familiar with its prescription. Among the factors influencing biosimilars prescription, efficacy was considered the most relevant (reduction of symptoms n=16, 31%; disease progression n=9, 18%), followed by safety (n=16, 31%) and cost (n=12; 24%). Even though the large majority believes that prescription of these therapies will increase in the near future (especially in RA, PsA and AS), they would prescribe them as first, second or third line therapy in only 22, 24 and 29%, respectively. Almost half the physicians (n=25; 49%) had only a mild to moderate degree of confidence in the switching process. Globally, economic reasons were assumed to have determined the switching process (costs n=17, 33%; savings n=16, 31%).

Regarding the 22 patients who answered the telephone survey, most of them (n=15; 68.2%) claimed to have been at least ‘reasonably’ informed about biosimilars. Several health care providers were involved in this process. The patients´ main worries about switching were safety (n=11; 50%) and efficacy (n=6; 27.3%). Most patients were at least moderately confident about biosimilars’ efficacy and safety (50% and 36.4%, respectively). Nearly half of the patients (n=10) accepted the switch without apprehension while the other half (n=11) believed they had no other choice, and 50% (n=11) considered that the switch was made by economic reasons. Globally, most patients didn’t change the degree of satisfaction after switching to the biosimilar.

Conclusion: In this case-study, physicians seem to still be cautious about biosimilar prescription, worrying particularly about their efficacy. On the other hand, patients do not seem to have changed their satisfaction with biological agents (before and after the switch), yet still worry mostly about the safety of biosimilars. Economic issues were the main reason to justify the switching process in both physicians’ and patients’ perspectives. However, switching should remain a case-by-case clinical decision made primarily by the physician and patient on an individual basis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/non-medical-switch-to-biosimilars-what-have-we-learned/