Perceptions and Policies Still Holding Back Biosimilars in Europe

While the European experience with biosimilars is often pointed to as a model for the United States to follow in adopting and reaping the rewards of biosimilars, Europe still has room to improve with respect to these cost-saving products. This week, during the International Society for Pharmacoeconomics and Outcomes Research 2019 meeting being held in Copenhagen, Denmark, 3 teams of researchers presented findings that show that, despite the fact that Europe’s biosimilars market is far more mature than that of the United States, the region still sees setbacks from stakeholder perceptions of biosimilars and from policies that do not adequately incentivize biosimilar use.

First, researchers from the University of Birmingham, in Birmingham, United Kingdom, presented results of a systematic literature review of articles on the perceptions of biosimilars among European stakeholders that were published between 2006 and 2018.¹ In total, they reviewed 17 articles, and found that “The level of knowledge, familiarity, and understanding of what biosimilars actually are seems to be quite satisfactory. However, there are still several misconceptions regarding biosimilars and their degree of similarity compared to the reference products.”

While most healthcare providers and patients recognized that biosimilars could reduce costs, “benefits such as opportunities for more treatment options have not been highlighted by demand-side stakeholders to such an extent,” and reluctance to select a biosimilar instead of a reference drug still persists.

A second team also found that perceptions of biosimilars continue to be a barrier for biosimilars. The researchers, from Ipsos Healthcare in the United Kingdom, presented results from a cross-sectional survey conducted in the third quarter of 2018 in the United Kingdom, France, Italy, Spain, and Germany (EU5).²

The survey assessed overall perception of brand-name biologics and biosimilars among 261 rheumatologists, most of whom practiced in teaching hospitals or urban hospitals.

In total, 73.9% of physicians said they had greater satisfaction with originator etanercept than with biosimilars, and when asked about specific attributes of rheumatoid arthritis treatment, 64.4% of rheumatologists said that brand-name rituximab was associated with inhibiting radiographic progression, but only 47.5% said that a biosimilar was associated with the same benefit.

According to the researchers, these results may be due to biosimilars’ relatively short period of availability in clinical practice.

Finally, a team from Lifescience Dynamics in London, United Kingdom, reported on an analysis of policies that impact uptake in the EU5 nations.³ The researchers interviewed 20 payers who influence policy related to biologics at a local, regional, or national level, and conducted an advisory board comprising 30 healthcare providers from oncology, gastroenterology, and rheumatology practices to assess their perceptions of biosimilars.

Among payers and physicians, there was a consensus that biosimilars are equivalent to originators, and price was a main driver for adoption of these agents. However, despite large discounts for some products, market penetration has not kept pace with anticipated uptake.

Most physicians said they did not have prescribing obligations—such as financial targets or incentivization policies—in place, and the researchers note that such policies may be needed to drive greater market penetration of biosimilars across the EU5.

References

1. Braoudaki E, Barton P. Resistance to or support of biosimilars’ market penetration? A systematic review of European stakeholders’ behaviors. Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PBI58.

2. Baldock D, Baynton E, Zhang C. Physician perceptions of biologics versus their biosimilar counterparts in rheumatology—a multi-country study. Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PBI92.

3. Gaffney A, Cadi-Tazi A, Ribeiro A. Payer and physician dynamics surrounding biosimilar access in the EU. Presented at: ISPOR Europe 2019; November 2-6, 2019; Copenhagen, Denmark. Abstract PBI57.