Effects of Message Framing on Patients’ Perceptions and Willingness to Change to a Biosimilar in a Hypothetical Drug Switch

Abstract

Objective Patients often hold negative perceptions toward biosimilars that can create barriers to their uptake. Physicians also report uncertainty in how best to explain biosimilars. The aim of this study was to measure the effect of differently framed explanations on patients’ perceptions of and willingness to change to a biosimilar in a hypothetical drug switch. Methods Ninety‐six patients with rheumatic diseases taking an originator biologic were randomized to receive 1 of 4 biosimilar explanations: positive framing with and without an analogy, and negative framing with and without an analogy. Willingness to switch to a biosimilar, perceptions about biosimilars, and the effectiveness of the explanation were measured after the information delivery. Results Positive framing led to more participants being willing to switch (67%) than negative framing (46%). Framing significantly predicted willingness to switch to a biosimilar, with participants in the positive framing group being 2.36 times more willing to switch (P = 0.041). The positive framing group also reported significantly greater perceived efficacy of biosimilars (P = 0.046) and thought the explanation was more convincing (P = 0.030). The analogy did not enhance willingness to switch or increase understanding (P > 0.05). Conclusion Positive framing can improve perceptions of and willingness to switch to a biosimilar in patients currently taking biologic treatments.

Who is afraid of biosimilars? Openness to biosimilars in an Australian cohort of patients with rheumatoid arthritis

“…We found that the patients likely to refuse biosimilars tended to be older and more likely to refuse generic medicines, mirroring the findings of the French cohort . It could be particularly valuable to provide these patients with reassuring and positive framing about biosimilars, as this has been demonstrated to increase patient acceptance of these medicines and to reduce the nocebo effect . Although there are distinct differences between generics and biosimilars, it is likely that some patients extrapolate their negative perception of generic medicines to the biosimilar.…”

“…5 It could be particularly valuable to provide these patients with reassuring and positive framing about biosimilars, as this has been demonstrated to increase patient acceptance of these medicines and to reduce the nocebo effect. 9,10 Although there are distinct differences between generics and biosimilars, it is likely that some patients extrapolate their negative perception of generic medicines to the biosimilar. The commonest reason for biosimilar nonacceptance was concern regarding loss of efficacy, suggesting patients may feel apprehensive when switching from a bio-originator to a biosimilar.…”

Informing Patients about Biosimilar Medicines: The Role of European Patient Associations

“…Several studies have already shown that it is crucial to positively formulate the message about biosimilars towards patients. An empathic and positive communication (including positive framing) or attitude increase the acceptance to switch and reduce the development of nocebo effects after transitioning to a biosimilar [54][55][56][57][58]. An open and positive communication, emphasizing the equalities and not the differences between the reference product and its biosimilar, should be the norm when talking to patients.…”

The Importance of Countering Biosimilar Disparagement and Misinformation

“…As cited previously, one example is that biosimilars are highly similar but not identical to their reference products, which can be understood as implying a difference of some sort. The impact of message framing on biosimilar use was evaluated in a recent study that compared patient responses to a hypothetical switch from a reference biologic to a biosimilar that was accompanied with either positive or negative framing [ 40 ]. The authors found a greater patient willingness to switch to a biosimilar if the switch was explained to them by physicians (1) who emphasized the similarities between reference product and biosimilar and (2) who used positive body language and verbal cues to promote a positive interaction.…”