Background Prescribing physicians play an important role in the adoption of biosimilars in rheumatic diseases. Assessing physician perception of patients (pts) they consider as biosimilar-suitable may provide insights into eventual biosimilar adoption in clinical practice settings as well as any physician educational needs.
Objectives To assess clinical characteristics of pts with Rheumatoid Arthritis (RA) considered biosimilar-infliximab-suitable (when it becomes available) by their physicians, in comparison to those who were not considered infliximab-biosimilar-suitable in Europe (EU).
Methods A medical chart-review study of RA pts was conducted among physicians (primarily rheumatologists) in hospitals/private practices in UK/France/Germany/Italy/Spain (5EU) to collect de-identified data on pt diagnosis, treatment patterns/dynamics and pt symptomatology/disease status; physicians identified whether pt was biosimilar-infliximab-suitable (yes/no), and if yes, rated how likely would they prescribe biosimilar-infliximab to them when the product becomes available. Physicians were screened for practice-duration and pt-volume and recruited from a large panel to be geographically representative. Consecutive pts currently on (or discontinued within past-3mo) biologic visiting each center during screening period were selected for chart abstraction; analysis compared biosimilar-infliximab-suitable to those who were not (per physician judgment), excluding those who previously failed infliximab.
Results 1204 pts (UK: 239/France: 233/Germany: 229/Italy: 252/Spain: 251) were included in the analysis. 425 (35%; UK: 46%/France: 27%/Germany: 36%/Italy: 41%/Spain: 27%) were identified by physicians as biosimilar-infliximab-suitable; of these, 55% & 26% were rated ≥5 & 4 (scale: 7 (extremely likely)–1 (not at all likely)) respectively regarding likelihood of being prescribed biosimilar-infliximab. For biosimilar-infliximab-suitable Yes/No groups, mean age: 50.2/51.6 yrs; female: 73% (both-groups); time since diagnosis: 67.1/85.3mo; mean # of lines of past biologic/oral-DMARD use: 1.2/1.4, score of ≥5 on pt involvement in treatment decisions: 64%/56% (scale: 7 (very much involved)–1 (not at all involved)). Current treatments included (biosimilar-infliximab-suitable: Yes/No): biological-DMARD: 95%/94%, non-biological-DMARD: 63%/60%, steroids: 20%/27%, NSAIDs: 23%/18%, analgesics: 21%/13%, physical therapy: 11%/5%. Percentage pts with moderate/severe disease (per physician judgment; biosimilar-infliximab-suitable: Yes/No): 46%/40%. Among those with available data, recent lab/disease measures were (biosimilar-infliximab-suitable: Yes/No): ESR (23.4/21.2mm/h) and CRP (12.6/8.1mg/dl); VAS (0-10 scale; 3.7/3.4), Swollen Joint Count (2.6/1.9) and Tender Joint Count (4.4/3.1).
Conclusions RA pts considered infliximab-biosimilar-suitable (per clinical judgment) had been in care for relatively shorter period, had higher disease severity and were more involved in treatment decisions. Physicians were also not readily prepared to prescribe the biosimilar to all infliximab-biosimilar-suitable RA pts. Further scrutiny is warranted to understand the drivers behind physician perception of biosimilar-infliximab-suitability of RA pts.
Disclosure of Interest None declared