NHL and rituximab biosimilar: How have prescribing behaviours changed in EU5 in 15 months?

Abstract

e19054 Background: 15 months after EMA approval of the first rituximab biosimilar to treat NHL – and 12 months on from our presentation on its initial impact at the Biosimilars Special Clinical Symposium of ASCO 2018 – this study tracks the real world impact of official endorsement on prescribing behaviour and biosimilar adoption for NHL. Methods: The Ipsos Global Oncology Monitor – an online multi-country, multi-centre medical chart review of NHL patients, where 138 geographically representative physicians provided de-identified data on 3,239 patients treated with anti-cancer drugs in France (565), Germany (379), Italy (622), Spain (684) and UK (989) from July 2017 to Sept 2018. Physicians provided diagnosis date, current and historic treatment and reasons for prescribing treatment. Data on patients treated with and without a rituximab biosimilar were compared using descriptive statistics. Results: While prescribing of the rituximab molecule was stable over the study period, prescribing of rituximab biosimilars significantly increased – from 7% to 35% (p < 0.01), most notably in Germany and UK. By Q3 2018, for those patients treated with a rituximab-including regimen (N = 483), prescribing of any EMA-approved rituximab biosimilar was 72% in Germany and 63% in UK; France, Italy and Spain reported 47%, 32% and 30%, respectively. Physicians were significantly more likely to state “Well tolerated” and “Proven efficacy” as reasons for prescribing rituximab biosimilars in Q3 2018 vs Q3 2017 (p < 0.01). Prescribing of branded rituximab in the SC formulation significantly increased, from 21% to 33% (p < 0.01). Rituxan prescribing may be partially driven by availability of the SC mode of administration (MoA) not available for biosimilars. Conclusions: Over time, prescribing of rituximab biosimilars has significantly increased in the EU5, mainly in Germany and UK. Growth is less evident in Italy and Spain, perhaps as Southern physicians are historically more averse to ‘generic’ versions. Physicians’ ongoing experience of mAb biosimilars has resulted in higher associations with “Well tolerated” and “Proven efficacy”. The rise in prescribing Rituxan with the SC MoA has likely contained an even higher prescribing of rituximab biosimilars.