Biosimilars Benefit Patients With Expanded Access, but Physicians Still Need Education

Patient access to treatment has improved in many countries since the advent of biosimilars, where access to biologic treatments is variable among nations and faces restrictions based on limitations to healthcare resources. During the Medicines for Europe 17th Biosimilar Medicines Conference, held March 28-29 in Amsterdam, the Netherlands, a panel of healthcare providers discussed this expanded access as well as other benefits that accrue to patients when biosimilars generate competition in the biologics market. They also considered lingering hurdles with provider education.

Fernando de Mora, PhD, MBA, professor of pharmacology and consultant on biosimilars, Universitat Autonoma de Barcelona, Spain, opened the panel with the observation that there has been a significant shift in attitudes toward biosimilars in the past few years, with recommendations to use biosimilars beginning to enter clinical guidelines, and with prescribers realizing that biosimilars are not meant to replace originator products but to provide expanded access to therapy.

Milan Lukáš, MD, PhD, a practicing gastroenterologist in the Czech Republic, said that waiting lists for biologics used to be the norm in his country; today, 100% more patients have access to biologic therapy than prior to biosimilar availability, and that number includes more than 6000 patients who receive biologics for inflammatory bowel disease (IBD).

“The mean duration of IBD before biologic therapy started was 8 or 10 years” prior to biosimilars, he said, but in early Crohn disease, biologics can significantly decrease complications like stricture or perforations. The potential to avert these complications, he said, has played a role in changing attitudes toward biosimilars, and the nation has now seen a 60% to 70% uptake of these products.

Peter van de Kherkof, MD, PhD, chief medical officer of the International Psoriasis Council, the Netherlands, also sees the potential for biosimilars to allow for early biologic intervention. Now that biosimilars are available, “the opportunity to treat more patient with moderate psoriasis is possible, and improving care is possible by more early access of biologics/biosimilars.”

Today, said van de Kherkof, physicians see a short duration of biologics early on in the course of psoriasis—rather than as long-term therapy in extreme cases—as a way to modify disease progression. “We’re talking about an intervention at an early stage to switch off the process,” he said, calling for patient registries to help track the benefits of early biosimilar intervention.

Anton Franken, MD, a practicing endocrinologist in the Netherlands, said that, while biosimilars have been bringing about some cost savings in his healthcare system, diabetes remains a challenging area. Currently, only 2 long-acting insulins are available in the Netherlands, so “competition will be less, price drop will also be less…so there is less use.” Biosimilars could play an important role in allowing more patients to gain access to long-acting options, but they could also serve another crucial role: mitigating shortages.

The Netherlands has experienced numerous drug shortages in recent years, said Franken, and the diabetes community is particularly concerned about any disruption in the supply of critical insulins. If more biosimilars become available, he said, the supply of insulin could be better ensured.

However, confidence in biosimilar insulins remains low in the Netherlands, largely because 80% of those prescribing these products, said Franken, are general practitioners (GPs). There is a clear need, then, to provide greater education to GPs who may have a particularly low awareness of biosimilars in general.

Finally, Rosa Giuliani, MD, a practicing oncologist in the United Kingdom, who authored a recent paper that examined low biosimilar use among prescribers in oncology, called on major medical societies to play a leading role in education about biosimilars.

It is now time, she said, to move beyond basic concepts like the extrapolation of indications and to go into greater detail for targeted audiences. Medical societies’ position statements, geared toward their individual memberships, will be crucial in building confidence, and will help colleagues to take an active role in educating one another.

Finally, she said, it is key to emphasize the fact that “switching is safe. We can discuss it, but switching is safe…this should be a firm position of societies, [and] at the national level.”