US rheumatologists' beliefs and knowledge about biosimilars: a survey

Objectives We sought to evaluate perceptions of biosimilar products among US rheumatologists who prescribe TNF-alpha inhibitors, given that 10 TNF-alpha inhibitor biosimilars and two rituximab biosimilars have Food and Drug Administration (FDA) approval. Methods A 19-question self-administered online survey was conducted from 6 May to 1 June 2019, and fielded by WebMD, LLC. Rheumatologists (n = 9050) who were members of Medscape.com and its partner panels were invited to participate. Likert and other rating scales were used to collect responses, which were summarized descriptively. Results Responses were obtained from 320 board-certified US rheumatologists, 85% of whom were fellows of the ACR. Nearly all respondents were familiar with the FDA definition of a biosimilar product and were aware that an infliximab biosimilar was FDA approved; fewer realized that adalimumab, etanercept and rituximab biosimilars were also FDA approved. Most respondents (84%) were aware that an approved biosimilar was not automatically deemed interchangeable by the FDA. Rheumatologists were more likely to initiate biosimilar treatment for a biologic treatment-naive patient with RA (73%) than they were to switch to the biosimilar for a patient with RA doing well on the reference product (35%). Conclusions The results of this survey suggest that US rheumatologists have a good understanding and acceptance of biosimilar products, particularly for the initiation of treatment in biologic-naive individuals. They were hesitant to switch from a reference product to a biosimilar for a patient doing well on the reference product. Additional education on biosimilars is required to help inform treatment decisions by rheumatologists. of this article has been uploaded as supplementary material, available at Rheumatology online.

Automated summary

US rheumatologists generally have a good understanding and acceptance of biosimilar products, especially when initiating treatment in biologic-naive individuals. However, they are hesitant to switch patients who are responding well to reference products to biosimilars. Additional education on biosimilars is needed to better inform treatment decisions by rheumatologists.