The mode of delivery and content of communication strategies used in mandatory and non-mandatory biosimilar transitions: a systematic review with meta-analysis

ABSTRACT

Effective patient-provider communication is crucial to promote shared decision-making. However, it is unclear how to explain treatment changes to ensure patient acceptance, such as when transitioning from a bio-originator to a biosimilar. This review investigates communication strategies used to educate patients on transitioning to biosimilars and explores whether the willingness to transition and treatment persistence differs for the delivery (verbal or written) and the amount of information provided. MEDLINE, Embase, Scopus, and relevant conference databases were systematically searched. Communication strategies from 33 studies (88% observational cohort studies) published from 2012 to 2020 were synthesized and willingness to transition, persistence, and subjective adverse events explored. Patients only received information verbally in 11 studies. The remaining 22 studies also provided written information. Cost-saving was the main reason provided for the transition. Patients were most willing to transition when receiving written and verbal information (χ² = 5.83, p = .02) or written information that only addressed a few (3–5) concerns (χ² = 16.08, p < .001). There was no significant difference for persistence or subjective adverse events (p’s > .05). Few randomized controlled trials have been conducted. Available data shows more willingness to transition when patients received written and verbal information. Initial documents should contain basic information and consultations or telephone calls used to address concerns.

KEYWORDS:

• Biosimilars
• biologics
• follow-on biologics
• patient acceptance of healthcare
• communication
• patient education

Acknowledgements

We would like to thank the authors of the included studies for their research in this area, and in particular, those who provided us with supplementary information and kindly shared their resources. We would also like to thank the subject librarian, Anne Wilson, for the help with developing the search strategy.

Disclosure statement

One of the reviewed studies (Gasteiger et al., 2019) was conducted by three of the authors (Chiara Gasteiger, Nicola Dalbeth and Keith Petrie). Alfons den Broeder was involved in two other studies included in the review (Tweehuysen, Huiskes, et al., 2018; Tweehuysen, van den Bemt, et al., 2018). Nicola Dalbeth has received consulting fees from Abbvie, Janssen, and Horizon, and research funding from Amgen, outside the submitted work. No other authors have conflicts or funding to declare.