When it comes to switching from a biologic to a biosimilar drug, patient choice and engagement is extremely important, according to Durhane Wong-Rieger, president and chief executive officer of the Canadian Organization for Rare Disorders. 

“While a patient’s on a drug, they need to be continuously monitoring,” she said during a session at Benefits Canada’s 2019 Calgary Drug Trends Summit on Oct. 24. “In order to do that, though, patients need to be truly engaged. They have to believe that the drug they’re taking works well for them and [understand that], if they don’t take it as required, it’s not going to be effective.”

Biosimilars are biologic drugs made on the basis of the originator’s patent expiration, explained Wong-Rieger. She noted these have been approved as being similar but aren’t identical to the biologic equivalent. Further, biosimilars aren’t generic biologics. “They aren’t called biogenerics and people who call them that are actually using a wrong term.”

Read: Personalizing biologic treatment in the age of biosimilars

According to Health Canada, physicians can’t give a biosimilar to a patient who’s been prescribed an original biologic and assume it’s going to be exactly the same; they’re not interchangeable, said Wong-Rieger. 

“We’ve had patients who have told us it’s taken six months to get the dosing right. We don’t want to take patients who are stable on biologic therapies and switch them. It isn’t worth the risk, in many cases, to disrupt a patient who actually might be very sensitive.”

Based on Canadian surveys, 95 per cent of patients said they don’t want to be switched from a biologic to a biosimilar drug if they’re stable, said Wong-Rieger. “People call it a nocebo effect, but it’s much more than that. We know what it means for patients to believe in what they’re getting and the relationship they have with their clinician in order for it to work.”

Read: Is nudging biologic patients towards biosimilars a good choice?

The surveys also revealed 50 to 75 per cent of patients said they understand biosimilars, but they also believe the drugs have different effects, she noted. “They do believe they’re different when it comes to adverse effects — and they’re not entirely wrong. They recognize they’re not generic. Patients believe that; they aren’t ill-informed.”

In terms of switching, two things would help a patient feel comfortable, according to Wong-Rieger. The first is monitoring, so they know whether the biosimilar is working and is safe, and the second is the discussion around switching. “When we ask patients whether they’d be willing to pay extra to stay on the original and not have to switch, they say yes, with both private and public plans.”

Read more coverage from the 2019 Calgary Drug Trends Summit.

Copyright © 2020 Transcontinental Media G.P. Originally published on benefitscanada.com

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