Knowledge, perceptions, attitude, barriers and facilitators of biosimilars use across specialty physicians and hospital pharmacists: A national survey

Objective: To analyze knowledge, perceptions, attitude, barriers and facilitators of biosimilars uptake across physicians managing immune diseases and hospital pharmacists. Method: Two structured and closed anonymous online surveys were designed and sent to 41 physicians (rheumatologists, dermatologists, gustroenterologists) and 32 hospital pharmacists. Sociodemographic and clinical practice related variables were collected. We also gathered information about biosimilars knowledge and importance, access, attitude in clinical practice and perceptions, barriers and facilitators to biosimilars uptake. A descriptive analysis was performed. Results: Surveys response rate was 100% (hospital pharmacists) and 96% (physicians). We found certain lack of biosimilars knowledge about key aspects including switching, extrapolation, interchangeability or substitution. There was a great variability in the types and brands of biosimilars depending on the hospital. We observed several organization preferences, policies, and practices regarding biosimilars. General perception and attitude to biosimilars was positive. If used, biosimilars were predominantly prescribed in biologic treatment-naive patients (this indication was considered adequate and participants felt comfortable with it). Reluctance to switch in clinical practice was common. The main barriers to iosimilars uptake were the lack of confidence and knowledge. The main facilitators were the development of recommendations from professional associations and societies and the demonstration of interchangeability efficacy. We gathered concerns about biosimilar long term efficacy and safety, lack of real- life data, lack of biosimilars traceability or the risk of biologic reference medicines stock shortages. Conclusions: Biosimilar education and more evidence filling current gaps might help increase prescriber knowledge, comfort and use of biosimilars.

Automated summary

The study found a lack of knowledge among some physicians and hospital pharmacists regarding key aspects of biosimilars, with a wide variety in types and brands depending on the hospital. There were different preferences, policies, and practices regarding biosimilars among the organizations. Overall, there was a positive attitude towards biosimilars, but there was some reluctance to switch in clinical practice.