Patient attitudes about non-medical switching to biosimilars: results from an online patient survey in the United States

Abstract

Objective: To evaluate patient attitudes regarding non-medical switching (NMS) to biosimilars among patients with autoimmune disease currently receiving a biologic.

Methods: An online survey was conducted among patients meeting the following criteria: ≥18 years of age; residing in the US; diagnosis of rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis or psoriatic arthritis; currently taking a biologic; and consenting to participate. Patients answered questions about their attitudes and experiences related to NMS. Descriptive statistics were used to summarize responses.

Results: A total of 1696 patients completed the 20-min survey. Eighty-five per cent of patients were concerned that biosimilars wouldn’t treat their disease as well; 85% didn’t want to switch to a biosimilar if their current biologic was helping their disease; and 83% were concerned that switching may cause more side-effects. Twenty per cent of patients had previously received notification about a potential NMS to another biologic (that was not a biosimilar) from their insurance company. Of these, 79% took at least one action to avoid the NMS and 45% ultimately switched. Of these patients (n = 150), 67% indicated that their previous biologic worked well for them and 70% didn’t want to switch to another biologic. Most patients who switched (67%) did so to avoid paying a higher cost. More than half (56%) went without therapy for administrative reasons during the period of transition from the old biologic to the other treatment.

Conclusions: Patients reported multiple concerns about NMS that might impact treatment outcomes, and many of the patients who non-medically switched in this survey missed treatments. Future studies should be conducted on patient expectations and experiences with NMS to understand the impact on healthcare delivery, treatment persistency, and patient outcomes. The patient perspective and experience should be considered by decision-makers when developing coverage policies for biosimilar medications and associated communication strategies.

Keywords:

• Biosimilars
• Biologics
• Switching
• Patient
• Attitudes

Transparency

Declaration of funding

This research was sponsored by Janssen Scientific Affairs, LLC

Declaration of financial/other relationships

This research was sponsored by Janssen Scientific Affairs, LLC. The study sponsor was involved in decisions regarding study design, data analysis, interpretation of data, and writing of the report. AT and LE are employees and stockholders of Johnson and Johnson. Dr Curtis has received funding for research, fees for consulting, and/or honoraria from AbbVie, Amgen, BMS, CORRONA, Crescendo Bioscience, Janssen, Lilly, Myriad, Pfizer, Roche/Genentech, and UCB. LH and CR are employees of Benfield, retained by Janssen Scientific Affairs for assistance with this project. DW is a consultant for Benfield and provided assistance to Janssen Scientific Affairs for this project. A CMRO peer reviewer on this manuscript declares receipt of grants/research supports or participation in clinical trials (paid to Institution) from Abbvie, Almirall, Amgen, Boehringer Ingelheim, Janssen, Leo-Pharma, Lilly, Novartis, Pfizer, Regeneron, Roche, Sanofi, UCB; receipt of honoraria or consultation fees (paid to themselves) from Abbvie, Almirall, Amgen, Baxalta, Biogen, Boehringer Ingelheim, Celgene, Gebro, Janssen, Leo-Pharma, Lilly, Merck-Serono, MSD, Mylan, Novartis, Pfizer, Regeneron, Roche, Sandoz, Samsung-Bioepis, Sanofi, UCB; participation in a company sponsored speaker’s bureau for Celgene, Janssen, Lilly, MSD, Novartis, Pfizer. Other CMRO reviewers on this manuscript have no other financial/other relationships to disclose.

Previous presentations

Part of this research was presented at the American College of Rheumatology 2017 Annual Meeting, San Diego, CA, November 3–18, 2017.

Acknowledgments

The authors wish to acknowledge the following for research design and data analysis: David Rubin, MD, of the University of Chicago, and the late Jan Gollins of Delta Modelling. The authors also acknowledge Julie Vanderpoel, PharmD for providing medical writing support.