Background Tumour necrosis factor inhibitor class (anti-TNFs) represent the most widely prescribed biologic medications globally to manage chronic immunologic conditions. Biosimilars in this arena may provide an effective alternative to curtail looming economic burden associated with managing these conditions while alleviating patient burden. A survey of rheumatologists revealed moderate barriers to uptake of biosimilars, with 60% in key European countries (EU5: UK/France (FR)/German (DE)/Italy (IT)/Spain (ES)) reporting definitely or highly likely to prescribe a biosimilar when available. (Narayanan & Nag, 2015) Regional and national payer perceptions concerning biosimilar adoption is evolving.
Objectives To assess the perception of anti-TNF biosimilars among national, regional and hospital payers in the EU5.
Methods A cross-sectional survey was conducted in the EU5 among individuals meeting the following inclusion criteria: have a clinical background in immunology and play a role in influencing the approval of new drugs in that area, must have participated in a review of autoimmune diseases for reimbursement, funding, and/or formulary placement decisions within the last 24 months at national or regional level, and must be in a role that influences hospital formulary decisions for autoimmune diseases (within hospital payer category). A forty-minute online survey assessed the overall perception of anti-TNF biosimilars, specific barriers to prescribing them and factors (besides price) influencing the endorsement of biosimilars.
Results Eighty four payer stakeholders across EU5 (UK:15, FR:20, DE:15, IT:15, ES:19) participated; 61% (range: 20% (FR)–100% (UK)) reported highly or very favorable perception/opinion of biosimilars. Factors influencing their overall perception were: cost-benefit opportunities (23%), comfortability with biosimilar efficacy (23%), healthy market competition (13%) and saving opportunity and long-term sustainability (12%); 12% reported efficacy and safety concerns. On a scale of 1–7 (1: not at all important; 7: very important), rating of importance of place of manufacturing of anti-TNF biosimilars to be the same as the originator drug was 4.3 (range: 3.0 (DE)–5.6 (IT)); rating of level of comfort with extrapolation of clinical data permitting approval of a biosimilar for a therapeutic indication in which it has not been clinically evaluated, but for which an originator is approved was 4.8 (range: 4.3 (FR)–5.4 (ES)). 29% (range: 20% (UK/FR)–42% (ES)) reported the quality of clinical and economic data they have access to or would require to evaluate biosimilars to be very or extremely high. Top-5 factors influencing endorsement of biosimilar were availability of robust safety and efficacy data, comparable long-term clinical response, product quality and reliability of product supply. Majority (94%) expected biologically naïve patients to benefit the most from biosimilars.
Conclusions Payer stakeholders reported positive perceptions towards biosimilars, while expressing some concerns towards product attributes. Evidence generation and communication efforts addressing these payer perceptions may facilitate optimal access to biosimilars.
Narayanan S, Nag S. Likelihood of use and perception towards biosimilars in rheumatoid arthritis: A global survey of rheumatologists. Clinical and Experimental Rheumatology. 2015, July 6. CER8413.
Disclosure of Interest S. Narayanan Employee of: Ipsos Healthcare, Y. Lu Employee of: Ipsos Healthcare, R. Hutchings Employee of: Ipsos Healthcare, S. Mentzer Employee of: Ipsos Healthcare
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