Physicians hold a largely positive view of the uptake of biosimilars

Physicians who prescribe biological medicines hold a largely positive view of the uptake of biosimilars. However, biosimilars are not as commonly prescribed as could be expected based on the physicians’ positive view. According to study results, more independent information for health care professionals and patients in support of the promotion of the uptake of biosimilars is needed, as well as joint practices, procedures and technical solutions to secure rational prescription of medicines on the national, organisational and individual level.

This was the conclusion drawn in the study conducted by Fimea to investigate the attitudes of physicians who prescribe biological medicines and their views on the uptake of biosimilars, the factors that promote and prevent the uptake of biosimilars, and the sources of information about biological medicines that are used by physicians.

Perception mostly positive, prescribing not as common

The majority of the interviewed physicians considered reference medicines and biosimilars equal in value. However, biosimilars were not as commonly prescribed as could have been expected based on the physicians’ largely positive view: half of the physicians told that they start a biosimilar as the first biological pharmacotherapy and change the patient’s previous biological pharmacotherapy to a biosimilar. The physicians’ view of the generic substitution of biological medicines at pharmacies varied from approving to negative.

There are a number of factors promoting and preventing the uptake of biosimilars. The most typical promoting factors were cost benefit to society, shared operating culture between organisations, and putting medicine purchases out to open tender and cooperation in medicine purchases. The most typical preventive factors were the physicians’ personal opinions and desire for prescription autonomy, the patients’ desire to use the reference product, and the fact that the high cost of biosimilars reduces their use, even if they were less expensive than the reference products.

Pharmaceutical industry as the most typical source of information about biosimilars

All of the physicians except one told that the pharmaceutical industry was the most typical source of information about biosimilars. Physicians agreed on the relationship between the information provider and the quality of the information received: they felt that the reference medicine industry provides more extensive and comprehensive information about biological medicines. The majority of physicians told that the information disseminated by the pharmaceutical industry affects their prescription decisions. Examples of physicians’ other information sources included training events and conferences as well as scientific and professional publications.

Conduct of the study

The study focused on the treatment of dermatological, gastroenterological and rheumatoid diseases in specialised medical care and on the treatment of diabetes in specialised medical care and primary health care. The study was conducted in the form of semi-structured interviews and group discussions during January–September 2018. Physicians-in-charge of their respective operating units were selected as the subjects of semi-structured interviews, while specialists and physicians-in-charge who carry out clinical work were selected for group discussions from a total of 13 different locations. A total of 45 physicians participated in the semi-structured interviews. Nine group discussions were conducted, with 31 physicians participating in them. The results of the semi-structured interviews were corroborated by the group discussions

Why is the promotion of the uptake of biosimilars important?

The use of biological medicines has become increasingly common over the past decade in the treatment of many diseases, such as rheumatoid and inflammatory bowel diseases. The costs of biological medicines are typically high. In 2017, there were eight biological medicines among the ten best-selling medicinal products in Finland, measured in euros, with total wholesale value exceeding EUR 256 million.

A biosimilar is a biological medicine developed to be similar and comparable to a biological reference medicine. The development of biosimilars is partly based on the research data obtained from the development of the reference medicine, so they can be placed on the market with a price lower than that of the reference medicine. The uptake of biosimilars increases price competition to the benefit of both the user of the medicine and society.

Read more

Serial Publication Fimea Develops, Assesses and Informs 4/2019. Uptake of biosimilars in Finland – Physicians’ views (pdf, in Finnish)