Canadian physicians are becoming more familiar with biosimilars, according to a new survey by the U.S.-based Alliance for Safe Biologic Medicines.

The organization’s new survey, which polled more than 400 Canadian prescribers of biologics from 13 therapeutic specialties, found 83 per cent of respondents are either familiar or very familiar with biosimilars, compared to 58 per cent who said the same thing when the survey was last conducted in 2014. In 2017, only three per cent of respondents hadn’t heard of biosimilars versus 10 per cent in the previous survey.

Read: What to do about biosimilars?

While only a handful of biosimilars have entered the Canadian market so far, there are many more in the pipeline and this new category of drugs is expected to take off in the coming years as older biologics lose patent and data protection. Like the generic versus brand drug experience, biosimilars may offer significant savings to plan sponsors someday.

Currently, however, confusion and misconceptions abound regarding the role of biosimilars — also known as subsequent entry biologics — and their interchangeability with biologics. Unlike generics, which are considered identical to the brand, a biosimilar is similar to a biologic but not necessarily interchangeable.

“We’re seeing a lot of hesitancy and lack of understanding among physicians when it comes to using biosimilars,” says Michael Reilly, executive director of the Alliance for Safe Biologic Medicines. “There is still a lack of post-market data on biosimilars but we expect to accumulate more data as time goes on and that should make doctors more comfortable.”

Read: Cost, effectiveness of biosimilars touted

As physicians learn more about the role of biosimilars, plan sponsors may wonder what impact the new drugs could have on their group benefits costs. In theory, biosimilars should offer savings over higher-priced biologics but so far the discounts are less impressive than the typical savings ratio for generic versus brand-name drugs, according to Reilly.  “In Europe, discounts on the first few biosimilars were about 15 per cent” says Reilly. “Patient by patient, that isn’t a huge amount of money to switch from a biologic to a biosimilar. But from a payer’s perspective, the savings over the whole patient base could be significant.”

However, switching from a biologic to a biosimilar isn’t necessarily straightforward. “Biologics are typically used for far more complex health conditions such as psoriasis or rheumatoid arthritis,” says Reilly. “When a physician and a patient work together to stabilize a condition, there is reluctance when asked  to switch because of the cost.”

According to the survey, 67 per cent of respondents were comfortable switching a patient’s medicine for non-medical reasons such as cost or coverage, but only if they made the switch themselves. Only 34 per cent were comfortable with a third party, such as a pharmacist, switching a patient’s medicine for non-medical reasons.

Read: Debunking myths in drug plan management

The majority (83 per cent) of respondents considered it very important or critical that the prescribing physician decide the most suitable biologic for their patients and 78 per cent considered it very important or critical to be notified if a biosimilar is substituted at the pharmacy. A similar number (79 per cent) believe it’s very important or critical to have the authority to designate on a prescription for a biologic medicine “dispense as written” or “do not substitute.”

More studies demonstrating that biosimilars are interchangeable with biologics would make physicians more comfortable with switching, according to the survey. Some 82 per cent of respondents believe studies should be conducted to measure the effects of switching on patient safety and product efficacy prior to deciding whether automatic substitution should be allowed by a pharmacist or payer.

In the U.S., the Food and Drug Administration requires switching studies to be conducted before approving a biosimilar as interchangeable, says Reilly, noting that such studies are expensive and tend to drive up overall costs.

Read: Drug plan trends report: How drug plans are addressing skyrocketing costs

Copyright © 2018 Transcontinental Media G.P. Originally published on benefitscanada.com

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