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There are many reasons why biosimilars are not utilized in gastroenterology, mainly patients present younger and treatments can lose efficacy over time.
Biosimilar use might be lagging in gastroenterology compared to other specialties.
Some potential reasons is that patients with gastrointestinal diseases like inflammatory bowel disease (IBD) might not be as comfortable switching to a medication when the originator is working, even if it results in a cost savings.
In an interview with HCPLive®, Jordan E. Axelrad, MD, MPH, NYU Langone, and David P. Hudesman, MD, Medical Director of the Inflammatory Bowel Disease Center at NYU Langone Health, discussed the history of using biosimilars in IBD.
“I think gastroenterologists probably came to the biosimilar conversation a bit later than our rheumatology colleagues where they have more therapeutics,” Axelrad said. “In gastroenterology we are obviously concerned about our patients who are particularly very sick and who require optimized dose escalation of these biosimilars and how that would translate if they were moved from an originator to a biosimilar.”
Hudesman said there is also a comfort factor in rheumatology that is not necessarily there in gastroenterology.
“As gastroenterologists, our patients with Crohn’s [disease] or ulcerative colitis have limited options, more than we used to,” Hudesman said. “A lot of these patients that initially do well can lose response over time and many of our patients are diagnosed at a younger age. So once we have them on a therapy that’s working, we don’t like to mess around, we don’t like to change.”