Can Physician Prescribing of Biosimilars Be Influenced by Price?

To this point, information about clinicians’ interest in prescribing biosimilars was largely limited to their comfort levels with the safety and efficacy of these agents compared with that of the originator products. They’ve shown a reasonable reluctance to prescribe biosimilars in patients whose disease activity has been stable with the use of an originator biologic, but have been more open to using them in patients who had not received biologics before. A new study in a small sample of physicians implies that the cost factor could be a bigger influence in their prescribing habits than suspected before.

A “microsurvey” from InCrowd of 150 physicians (30 dermatologists, endocrinologists, gastroenterologists, oncologists, and rheumatologists) was conducted in September 2016. Eighty-four percent are convinced that they will be prescribing biosimilars within 3 years.

Interestingly, the survey demonstrated that clinicians, too, are influenced by the cost savings biosimilars may bring—an area that was considered of interest mostly to payers. In their study, physicians would increasingly consider prescribing biosimilars as the cost difference with the originator product increased, from 28% with a 5% discount, 59% with a 15% discount, and 77% with a 25% discount. This may signal clinicians’ concern with the rising cost of biologics. The study authors did not specify whether these prescriptions would occur in a treatment-naïve or a switching scenario. However, three-quarters did admit that cost is important to their prescribing decision, but they would be unlikely to know what the patient’s cost share may be at the time of prescription.

Physician wariness of the biosimilars is still evident, according to InCrowd President and Co-founder Diane Hayes, who said, "Data reflect that during this time when biosimilars are of strong interest to insurers and health care systems for cost control, physicians are not rushing to issue a blank check for their substitution, and are keenly aware of their need to thoughtfully consider any such use." The survey did find that 67% would prohibit, at least in some cases, pharmacist-substitution of a prescribed originator product.