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Although most clinicians surveyed are unopposed to prescribing adalimumab biosimilars, hesitancies surrounding prescribing practices and an uncertainty of cost savings remains.
Spherix Global Insights, a leading provider of market research, conducted a survey using a sample of 81 rheumatologists, 83 gastroenterologists, and 80 dermatologists to evaluate adoption rates, experiences, concerns, and future expectations of biosimilars.
Findings revealed the adalimumab (Humira) is steadily losing its popularity as the biosimilar market continues to expand, according to the third quarter update of Spherix Global Insights’ Special Topix™: Biosimilars Today and Tomorrow.1
However, the embracement of biosimilars varied among different specialties, with dermatologists demonstrating the highest resistance to change. Approximately half of dermatologists surveyed said they were unlikely to prescribe a biosimilar option outright over the reference adalimumab. However, rheumatologists and gastroenterologists were less resistant to the change.
Although adalimumab-adbm (Cyltezo), the first adalimumab biosimilar granted interchangeability by the US Food and Drug Administration (FDA), had a slight edge among recent adalimumab biosimilar launches, adalimumab-atto (Amjevita) was the most recognizable adalimumab biosimilar among the surveyed group. These results are unsurprising as adalimumab-atto was the first FDA-approved adalimumab biosimilar.2 Despite a broad understanding of current biosimilars, many specialists expressed they did not know how to differentiate between the recently available biosimilar options.
In a previous interview with HCPLive, Stephen Pagnotta, executive director and biosimilar commercial lead at Boehringer Ingelheim, explained the significance of an interchangeable designation.
“A biosimilar with an interchangeable designation can be auto-substituted for the reference product by a pharmacist,” Pagnotta said. “Pharmacist-mediated auto-substitution could mean fewer administrative hurdles, which can potentially help patients get their medications faster than they would get non-interchangeable biosimilars.”3
The gastroenterologists and dermatologists surveyed expressed an increase in asking for an adalimumab biosimilar, of which a growing majority were willing to prescribe the biosimilar option; indicating a decrease in those willing to argue for the reference product.
Dermatologists surveyed were largely neutral towards biosimilars (58%), although 38% reported being uncomfortable with initiating a non-medical switch from the branded drug to a biosimilar. They also reported patient concern as the main reason why an adalimumab biosimilar may be deemed inappropriate.
Gastroenterologists were overall unopposed to prescribing biosimilars, with 24% reporting being significantly more confident prescribing biosimilars vs the reference adalimumab and 55% stating they would be extremely comfortable initiating a biologic naïve patient on a biosimilar. This trend continued to be demonstrated with their comfort of biosimilar approvals, with 92% reporting being either strongly in favor or neutral to the clinical evidence required for approvals.
Four out of 10 rheumatologists believed patients stable on current treatment are inappropriate candidates for a switch to an adalimumab biosimilar. However, the vast majority (94%) of rheumatologists were comfortable with the biosimilar approval process. While most (53%) believed biosimilars would not provide savings to their practice, 92% believed they would deliver savings to the overall health system.
Although more biosimilar options continue to become available to the US market, specialists surveyed stated their overall use of the reference product has remained generally consistent over the past year. Despite this, the adalimumab share has declined 10% since adalimumab-atto and other competitors have entered the market.
“Going forward, efficacy is top of mind as prescribers’ leading concern when it comes to the adoption of the adalimumab biosimilars, followed by safety concerns, and an overall lack of cost savings,” the Spherix Global Insights statement concluded.