U.S. physicians start to embrace prescribing of biosimilars


Physicians are beginning to understand the value of biosimilars, particularly those who are high prescribers of biologics and therefore familiar with biosimilars.

Nearly half (44%) of U.S. physicians expect to prescribe more biosimilars over the next three years, according to a recent survey of doctors across five specialty areas. In addition, 17% of respondents felt that biosimilars would become the norm or replace biologics over the next three years as more biosimilars become available, according to InCrowd's MicroSyndicated survey.

 “We believe the data show that physicians are beginning to understand the value of biosimilars, particularly those who are high prescribers of biologics and therefore familiar with biosimilars,” Diane Hayes, PhD, president and co-founder of InCrowd, told Drug Topics.

See also: Biosimilars offer hope of lower-cost treatment of autoimmune diseases

Efficacy and price

Expected lower costs for patients are the primary reason doctors will prescribe biosimilars. In fact, assuming they had the choice between an FDA-approved biosimilar and its originator biologic, 83% of doctors would prescribe a biosimilar if it were 25% cheaper, while 33% would prescribe the biosimilar if it were 5% cheaper.

"Biosimilars will be cheaper. If the efficacy is there and the price is better, then why not?" said an oncologist. InCrowd's MicroSyndicated survey captured data in early February from 150 U.S.-based board-certified physicians in specialties where biologics prescribing is significant - including 30 practitioners each in the disciplines of dermatology, endocrinology, gastroenterology, oncology, and rheumatology.

However, one in four doctors said that payers and insurance firms ultimately will determine - if not mandate - their level of biosimilar prescribing over the next three years. 

"As the healthcare industry grapples with the best strategies to lower drug costs, the MicroSyndicated survey shows that while understandably prioritizing efficacy and safety first, physicians are on board with their use," Hayes said. "The key will lie in how payers decide to reimburse for biosimilars and their biologic counterparts."

Microsyndicated infographic courtesy of Incrowd


Pharmacy-level substitution

However, 20% of doctors said they were likely to strictly prohibit pharmacy-level substitution of the originator biologic with biosimilars. Conversely, 30% of respondents said they would “never” prohibit substitutions, and 40% will treat substitutions on a case-by-case basis.

“We’re not sure why, but certain specialties feel strongly about substituting a biosimilar. It may have something to do with what various physician specialties believe are standard of care for different disorders,” Hayes said.

For example, oncology is an ever-changing field with new treatments coming to market often, so oncologists need to be open to new data  on the efficacy and safety of new treatments, according to Hayes.

“In contrast, dermatologists have only recently been able to prescribe biologics for stubborn diseases that were previously poorly treated. This may reflect less flexibility on their part, due to lack of alternatives historically.”

Other key findings of the survey include:

  • Efficacy (89%) and safety (81%) outranked patient costs (71%) among the top factors in determining whether healthcare professionals would prescribe biosimilars.

  • Physicians expect to prescribe biosimilars to a greater proportion of their treatment-naïve patients (49%) than to patients currently or previously treated with the originator biologics (30% and 38%, respectively).
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