Specialists Lack Confidence in Biosimilars

Physicians wonder about the efficacy of biosimilars and worry about the fine print in drug substitution laws, according to a survey by Quantia, an online discussion platform for about 225,000 doctors.

The survey of 300 primary care physicians (PCPs) and specialists finds that while 94% of all physicians appreciate the value of biosimilars, only 17% of specialists who treat patients with biologics would be willing to use biosimilars, citing a general lack of awareness about the drugs even among specialists who currently prescribed biologics. Only 12% of specialists are confident that biosimilars are as safe as the original biologic; 22% are “not at all confident” that that is the case, according to the survey, which was conducted in March.

In addition, “prescribing specialists’ main questions and concerns about biosimilars are related to regulations for prescription drug substitution (24%) and understanding best practices for evaluating when to prescribe a biosimilar vs. branded therapy (21%),” the survey states.

It was an easier path for generics vs. brand-name small-molecule drugs, the authors argue. Biosimilars are more chemically complex and more vulnerable to microbial contamination.

Also in play: A changing employment model thanks to provider consolidation that makes physicians harder to reach and restricts their decision making. Researchers say that 70% of physicians “now practice within an organized system,” citing an October 2014 report that Quanita did with Capgemini Consulting.

Pharmaceutical sales representatives have a more difficult time tracking down these doctors. Communication between the leaders of the hospital or practice and the physicians in the trenches might not go as smoothly as when doctors owned their own practices.

Still, the survey reinforces the notion that specialists should be the first to give biosimilars a close inspection, because “they are 120% more likely to already prescribe biologics than PCPs and 47% more aware of biosimilars, and therefore likely to represent the majority of biosimilar early adopters….”

Educational efforts should also focus on nurse practitioners and physician assistants who may not prescribe biosimilar  “but who will nevertheless be a core part of the care team treating patients taking these therapies,” according to the survey.