PP01-16: European Physician Perspectives on Biosimilars
Philip James Schneider
Chair, Advisory Board
Alliance for Safe Biologic Medicines United States
Authors measure perspectives on biosimilars of European prescribers from 6 countries across 10 specialties, on topics including: prescribing to new patients, switching stable patients, prescriber autonomy, and importance of availability of multiple products. Results are compared with a 2013 survey.
Authors commissioned 15-minute web-based surveys of biologic prescribers in France, Germany, Italy, Spain, Switzerland, and UK from 10 practice areas: Dermatology, Endocrinology, Gastroenterology, Hematology-Oncology, Immunology, Nephrology, Neurology, Oncology, Ophthalmology, and Rheumatology.
579 responses were received. Biosimilar familiarity was high, increasing from 76% to 90% from the 2013 survey. Confidence in biosimilars was high, with 80% of respondents comfortable prescribing to new patients, and only 17% uncomfortable doing so. Physicians were more divided over switching stable patients: 60% were comfortable, 40% uncomfortable. Physician autonomy in treatment decision was highly and increasingly important: The percentage of physicians who felt sole treatment decision authority was very important or critical had increased from 72% to 82%. Similarly, regarding the importance of retaining authority to prevent a substitution, the percentage considering it “very important or critical” increased from 74% in 2013 to 84% in 2019. 58% of physicians were uncomfortable switching patients to biosimilars for non-medical (cost) reasons. When the non-medical switch was initiated by a third party, 73% of physicians were uncomfortable.
Physician confidence in biosimilars has increased since the previous survey was conducted in 2013, as has the importance of maintaining physician autonomy in treatment decisions. Europe is the world leader both in biosimilar approvals (~60) and in biosimilar usage (with approximately 60% of the global market. Biosimilars have achieved market shares as high as 91% for older biosimilars (pre-2013) and 43% for newer biosimilars such as monoclonal antibodies. The physicians who comprised the survey's respondents are among the most experienced with biosimilars in the world today and after 13 years, have very high confidence in these products. Nevertheless, physician autonomy in treatment authority remains highly important and physicians remain uncomfortable when switching stable patients for non-medical (e.g., cost) reasons. They are highly uncomfortable with the switching of stable patients initiated by third parties for non-medical reasons. As countries worldwide look to duplicate Europe's success, the results of this survey can be used as a guide to policymakers on how to adopt biosimilar substitution policies which achieve high physician confidence and avoid policies which undermine physician confidence in biosimilars- these policies would include those which overrule medical treatment decisions, require non-medical switching of stable patients, or permit such switching to be initiated by third party payers.