TP2 COMMUNITY RHEUMATOLOGISTS' EXPERIENCE AND VIEWS ON NON-MEDICAL SWITCHING TO BIOSIMILARS

Abstract

Chronic disease management requires sequential drug treatments, as toxicities develop and responses wane. Non-medical switching (NMS) is described as a change in drug therapy for non-clinical reasons, such as payer formulary, economic, or patient preference. This study aimed to assess community rheumatologists’ experience with and perceptions of NMS between originator biologics and their biosimilars in routine clinical practice. We surveyed US-based rheumatologists from various geographic locations and practice types in October and November 2018 to understand NMS of originator to biosimilars for rheumatoid arthritis (RA). Physician characteristics and responses were summarized using descriptive statistics. Among 54 participating rheumatologists, 45% practiced in suburban areas and 7% rural; 24% were solo practitioners, and 38% were from a small, medium, or large private community practice. Mean years in practice were 19 years (range 3-40). Biosimilars were used among 33 (61%) participating rheumatologists to treat patients with RA. Over one-third of rheumatologists reported increased use of biosimilars. Most common concerns for prescribing biosimilars were efficacy (43%), safety (41%), and patient’s insurance policy constraint (31%). Of 25 rheumatologists who switched at least one RA patient from Remicade (originator) to Inflectra (biosimilar) in the past year, 56% reported that NMS comprised >75% of these switches. Approximately one-third (35%) reported that prescribing biosimilars provided cost-savings to their practice and/or patients, one-third reported that they were not cost-saving, and the remaining 31% were not aware of the cost. The use of biosimilars for RA patients is increasing among US rheumatologists. The majority of the switching appears to be for non-medical reasons, and a minority of rheumatologists report cost-savings related to biosimilars. Further research is needed to assess the cost-effectiveness and comparative effectiveness of biosimilars versus originator biologics in RA.