Abstract
BackgroundWith the approval of biosimilars for subcutaneously administered products, such as adalimumab, etanercept and insulin, biosimilars become increasingly available in ambulatory care. Little is known about the knowledge and attitudes of healthcare providers who are in charge of dispensing and prescribing biosimilars in this context. This study aims to assess the knowledge and perception about biosimilars among community pharmacists and physicians.MethodsBelgian community pharmacists (n = 177) and physicians (n = 30) were surveyed on their knowledge, experience with dispensing/prescribing biologicals including biosimilars, perception regarding interchangeability, switching and substitution and informational and educational needs. Descriptive and statistical analyses were performed.ResultsOnly 32% of community pharmacists and 52% of physicians had yet dispensed/prescribed a biosimilar. Approximately 35% of community pharmacists felt insufficiently trained to counsel patients with biosimilar therapy, which was significantly higher compared to their self-assessed competence to counsel patients with biological therapy in general (p = 0.023). Community pharmacists experienced questions about similarity between reference products and biosimilars (47%) and their interchangeability (42%). Over 40% of physicians found patient uncertainty about efficacy and safety challenging when prescribing biosimilars. A similar proportion of physicians would only prescribe a biosimilar in indications for which the biosimilar has been tested clinically. The majority of pharmacists (58%) was in favor of substitution of biologicals, on the condition that the prescriber would be contacted. Also over 40% of physicians was open to this approach in case of substitution. Educational support, budget for additional staff and transparency about savings were considered suitable stimuli to incentivize biosimilar use. The need for information about biologicals including biosimilars was nearly unanimous among community pharmacists. Also 67% of physicians requested more information. Both community pharmacists and physicians preferred to be informed by their respective professional associations.ConclusionsThis study showed a substantial need for targeted educational measures to increase the knowledge and confidence about both biological medicines in general and biosimilars in particular among Belgian community pharmacists and physicians. The results may inform educational and policy measures to stimulate biosimilar use in ambulatory care.
Highlights
With the approval of biosimilars for subcutaneously administered products, such as adalimumab, etanercept and insulin, biosimilars become increasingly available in ambulatory care
To contextualize the results regarding the knowledge and perception of healthcare providers about prescribing or dispensing biosimilars, the surveys enquired about their knowledge and perception regarding biological medicines in general
Almost all had experience with dispensing Tumor Necrosis Factor (TNF)-alpha inhibitors (95%, n = 119/125) and hormones such as insulin, growth hormone, and follitropin-alpha (94%, n = 118/125), as both product classes are dispensed in the community pharmacy in Belgium (Additional file 2: Table S1)
Summary
With the approval of biosimilars for subcutaneously administered products, such as adalimumab, etanercept and insulin, biosimilars become increasingly available in ambulatory care. Little is known about the knowledge and attitudes of healthcare providers who are in charge of dispensing and prescribing biosimilars in this context. The use and success of biological medicines comes, at a considerable cost because of their generally high prices. The arrival of expensive innovative medicines increasingly challenges healthcare systems to find avenues to optimize spending while ensuring access to these therapies for their patients [1]. Following the expiry of exclusivity of a reference biological medicine, biosimilar alternatives can become available and introduce price competition in the market. Competition created by biosimilar entry has shown to result in decreased treatment costs and in some cases to facilitate patient access to biological therapies [3]. Savings derived from biosimilar competition may contribute to the financing of expensive innovative therapies [4]
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