EULAR Report: Physicians Increasingly Pass on Biosimilars


Rheumatologists still lack confidence in prescribing biosimilars, shows study presented at EULAR.

Despite good knowledge of biosimilars, some rheumatologists do not switch to these agents due to lack of confidence, according to results from French study presented at the European Congress of Rheumatology (EULAR) annual meeting.

While biosimilars for subcutaneous tumor necrosis factor (TNF) inhibitors have been available in France since 2015, French health agencies do not legally oblige rheumatologists to first prescribe or switch to biosimilars.Elisabeth Gervais, of Poitiers University Hospital in France, and colleagues assessed the knowledge and beliefs of French rheumatologists about biosimilars via a questionnaire that also looked at demographic data, professional practice and confidence.

Of the 101 respondents, 53.2 percent always prescribed a biosimilar when prescribing a subcutaneous TNF inhibitor for the first time, and 78.5 percent did so in 90 percent of cases. However, 30.6 percent of the respondents never switched to a biosimilar. Those who did switch, did so in more than 75 percent of cases. The majority of the participants agreed that biosimilars are as efficient, as safe and have the same immunogenicity profile as the originator.

Of the rheumatologists who did and did not initially prescribe a biosimilar in more than 90 percent of cases, 77.4 percent and 31.2 percent, respectively, disagreed that biosimilars and the originator have to be compared in a phase 3 study for every indication for which the originator obtained marketing approval. Meanwhile, 25.4 percent of rheumatologists who switched to a biosimilar in more than 75 percent of cases and 57.7 percent of rheumatologists who did not meet this switch rate agreed that there are not enough experiences with biosimilars.

“The initial biosimilars prescription is associated with a better knowledge about biosimilars,” Gervais said. “The switch to a biosimilar is associated with the beliefs and confidence.”

Meanwhile, a U.K. study, which was also presented at the EULAR meeting, found that switching to an adalimumab biosimilar resulted in no major differences in disease outcomes and no reported issues. Muhammad Khurram Nisar, M.B.B.S., of Luton and Dunstable University Hospital in the U.K., and colleagues studied 198 patients established on adalimumab who had switched to Imraldi. All patients were happy to switch and substantial annual cost savings were projected. However, around 10 percent of patients returned to the originator within three months of switching due to a loss of efficacy and confidence in the drug.

“We support the routine switching from originator to biosimilar adalimumab however close monitoring is required certainly in the first few weeks of dose administration,” Dr. Nisar said.


AB1162 (2020)Anti-TNF Biosimilars: How Knowledge And Belief Influence Prescription. Elisabeth Gervais. 2020 EULAR E-Congress

THU0552 (2020)Switch To Biosimilar Adalimumab - Is It Cost Effective? Muhammad Khurram Nisar, M.B.B.S. 2020 EULAR E-Congress

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