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Bruce Feinberg, DO, noted that although patients and providers ultimately understand that a biosimilar should theoretically be just as effective as a biologic, prescribers may still be wary of switching patients to a different product when they have historically experienced an excellent response to the original treatment.
Cardinal Health’s 2023 Biosimilars Report, published earlier this year, described the opinions of physicians across specialties, including rheumatology, dermatology, ophthalmology, and gastroenterology, regarding the experience of and level of comfortability associated with prescribing biosimilars.
Biologics are more expensive due to the extensive research required to prove their safety and efficacy. Although biosimilars undergo rigorous testing, they are not as rigorous as the original biologics. Bruce Feinberg, DO, Vice President and Chief Medical Officer at Cardinal Health, used adalimumab as an example, explaining that while the drug has 6 major disease indications, a biosimilar only has to prove itself in one indication, without a head-to-head comparison. In some cases, biosimilars may not have the same level of evidence in the disease state in which they are used, leading to reluctance among physicians with less experience or availability of biosimilars to prescribe them.
Despite this hesitancy, Feinberg believed the responses from providers, which showed that specialties with more biosimilar availability and exposure were more likely to recommend biosimilars to their patients, was predictable.
“I don't like to think that physicians in different specialties act differently. These are all medical specialties… It’s reassuring to me that as rheumatologists gained as much experience as oncologists had with this class of drug, their behaviors matched oncologists in terms of their willingness to prescribe in almost any clinical scenario.”
He noted that the one area that still poses a problem is the idea of switching to another treatment when a patient is having an excellent response to the reference drug. Even though biosimilars have been deemed equivalent to their reference products, prescribers may be wary of switching patients to a different product. Feinberg stated that this uncertainty is not unique to biosimilars and has also been seen with generics.
“[Patients and prescribers] know that there is no reason why it won't work the same,” Feinberg emphasized. “[However], we work both in our brain and our heart. When you're attached to a product because it's given you a dramatic improvement in quality of life or length of life, it’s hard to want to make a switch of any kind.”
Author Disclosures: Bruce Feinberg, DO, is the Vice President and Chief Medical Officer at Cardinal Health