Physicians’ perceptions of the uptake of biosimilars: a systematic review

Abstract

ObjectivesTo examine physicians’ perceptions of the uptake of biosimilars.DesignSystematic review.Data sourcesMedLine Ovid and Scopus databases at the end of 2018.Eligibility criteriaOriginal scientific studies written in English that addressed physicians’ perceptions of the uptake of biosimilars.Data extraction and synthesisThe search resulted in altogether 451 studies and 331 after removing duplicates. Two researchers examined these based on the title, abstract and entire text, resulting in 20 studies. The references in these 20 studies were screened and three further studies were included. The data of these 23 studies were extracted. All the publications were quality assessed by two researchers.ResultsMost of the selected studies were conducted in Europe and commonly used short surveys. Physicians’ familiarity with biosimilars varied: 49%–76% were familiar with biosimilars while 2%–25% did not know what biosimilars were, the percentages varying from study to study. Their measured knowledge was generally more limited compared with their self-assessed knowledge. Physicians’ perceptions of biosimilars also varied: 54%–94% were confident prescribing biosimilars, while 65%–67% had concerns regarding these medicines. Physicians seemed to prefer originator products to biosimilars and prescribed biosimilars mainly for biologic-naive patients. They considered cost savings and the lower price compared with the originator biologic medicine as the main advantages of biosimilars, while their doubts were often related to safety, efficacy and immunogenicity. 64%–95% of physicians had negative perceptions of pharmacist-led substitution of biologic medicines.ConclusionsPhysicians’ knowledge of and attitudes towards biosimilars vary. Although physicians had positive attitudes towards biosimilars, prescribing was limited, especially for patients already being treated with biologic medicines. Perceptions of pharmacist-led substitution of biologic medicines were often negative. Education and national recommendations for switching and substitution of biologic medicines are needed to support the uptake of biosimilars.

Clinical and Regulatory Concerns of Biosimilars: A Review of Literature

“…After screening for eligibility, we included 16 studies in the analysis ( Table 2 ) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The included studies were from Europe, UK, United States, Australia, Asia, and Africa [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The targeted healthcare professionals were: clinicians, GPs, pharmacists, nurses, consultants, care managers, and specialists in clinical settings where biologics are more involved such as oncology, rheumatology, endocrinology, gastroenterology, dermatology, nephrology, and hematology.…”

“…After receiving printed educational material, the survey of Ismailov and Khasanova found that over 90% of oncology/hematology nurses, nurse practitioners, medical assistants, and patient navigators identified correct answers about the definition, regulation, interchangeability and safety of biosimilars [ 31 ]. Sarnola et al found that 49%–76% of healthcare professionals were familiar with biosimilars, while 2%–25% did not know what biosimilars were [ 35 ].…”

“…In the Polish study, 88% of hospital pharmacists reported concerns that biosimilars are not identical with the originators, 48% with concerns about their immunogenicity and 44% with concerns about other pharmacokinetic properties [ 33 ]. In the systematic review of Sarnola et al, 64%–95% of physicians were against the substitution of biosimilars at the pharmacy level [ 35 ]. Meanwhile, the Bangladesh study reports that 74% of academicians, 41% of clinicians and 61% of industry experts are positive about interchangeability [ 36 ].…”

Health technology assessment of biosimilars worldwide: a scoping review

“…Despite this, the use of biosimilars, the costsavings achieved and their market share vary considerably between biosimilar drugs, therapeutic areas, countries and even within the same country [6,12,13]. Those differences can be linked to an overall lack of biosimilar familiarity worldwide accompanied by concerns about biosimilars efficacy, safety, immunogenicity, extrapolation, switching and interchangeability [8,[14][15][16].…”

Equivalence and switching between biosimilars and reference molecules in rheumatoid arthritis: protocol for two systematic reviews and meta-analyses

“…In this regard, it is believed that biosimilars can accelerate the rheumatic disorders drug market competition, positively impacting the global health-care system though improved health-care affordability and increased patients' access to effective and safe drugs (13,15) However, despite the cost-savings potential of biosimilar drugs, there is still uncertainty as to whether currently marketed biosimilar drugs are equivalent to reference molecules in terms of e cacy, safety, and immunogenicity. Besides, the switching and interchangeability between biologics and biosimilars drugs are still topics of great debate in the treatment of RA (16)(17)(18)(19)(20).…”