PHP184 - PATIENT INFLUENCE ON BIOSIMILAR UPTAKE: THE NOCEBO EFFECT

Abstract

Both regulators and payers recognise the potential financial benefits of biosimilars however, negative patient perceptions can hinder uptake. The nocebo effect is defined as unexplained detrimental therapeutic effects of a medicine. The aim of this study was to understand whether the nocebo effect impacts biosimilar uptake. The OVID search engine was used to conduct a structured literature review across multiple databases. Searches were limited to English language studies published between May 2008 and May 2018 and included only studies on nocebo effect with biosimilar and generic drugs. Additional grey literature searches were conducted. There was a paucity of data regarding the nocebo effect in biosimilars, with only eight publications identified. These publications concluded that increased discontinuation and switch-back rates for patients transitioning from biologic therapies to biosimilars were associated with a nocebo effect. Strategies proposed to minimise the nocebo effect with biosimilars were varied and included enhanced physician/patient communication (n=5) or training and education (n=3). In contrast, a wealth of data on the nocebo effect and strategies to minimise this effect were available for generic drugs. These strategies included improving patients’ perception through increased communication and education by re-framing conversations around medicine use to focus on positive outcomes. Similarly, patient learning through information specifically detailing clinical improvements and side effects was effective in minimising the nocebo effect. Such strategies may be applicable to biosimilars. There are a lack of data on the nocebo effect with biosimilars; however, there is a consensus in the literature that it can negatively affect uptake. Managing patient concerns through communication and education will be key in patients successfully transitioning to biosimilars.