CHICAGO, April 6, 2021 — Physicians and patients alike see biosimilars as safe and effective, but key policy changes are necessary to make prescribing biosimilars more widespread, according to new research from NORC at the University of Chicago.

The research—which included surveys of patients and physicians, as well as focus groups and interviews with insurers and physicians—examines the physician and patient attitudes around biosimilars, as well as physician biosimilar prescribing behaviors. The researchers also offer policy solutions that, if adopted, could increase biosimilar prescribing.

Biosimilars are similar to brand name drugs, also known as biologics, and have no meaningful differences in clinical effectiveness compared to their brand name counterparts. Biosimilars are also cheaper than their biologic counterparts—currently, available biosimilars are between 3 percent and 24 percent cheaper than the corresponding biologic.

Despite the clinical effectiveness, cheaper prices, and positive physician and patient perceptions, prescribing of biosimilars has been slow to get off the ground over the last decade. Just one biosimilar has more than half the market share compared to the corresponding biologic.

“The goal of biosimilars was that they would come in and create instant competition with the brand biologic and in doing so drive down costs to the system and to the patient,” said Caroline Pearson, senior vice president at NORC at the University of Chicago. “While we see higher rates of Food and Drug Administration approvals of biosimilars and an upward trend in physicians prescribing them, biosimilars still lag far behind biologics in usage.”

According to survey findings and interviews with physicians, they see biosimilars as equally safe (78 percent of physicians surveyed) and effective (75 percent of physicians surveyed) as the corresponding biologic and are comfortable prescribing them. Physicians, however, are hesitant to prescribe them to patients already taking the brand biologic. Concerns around side effects from switching treatments midstream and patient hesitancy around switching from a treatment that works for them are obstacles physicians perceive in moving a patient from a biologic to a biosimilar.

Patients, for their part, express confidence in biosimilars if their physician prescribes them, and 71 percent of patients surveyed report they would be fully confident and accept a biosimilar if their physician prescribed it.

“There is a clear willingness from patients to try biosimilars, but it needs to be recommended by their trusted physician, who serves as a gatekeeper to their treatment,” said Pearson. “As doctors gain experience with biosimilars and more products are on the market, we expect more patients to be started on these products, and some may even switch from a brand to a biosimilar.”

Costs and coverage under a patient’s drug benefit also contribute to the uptake of biosimilars. Both patients and physicians believe that biosimilar out-of-pocket costs are less than biologics, but many drug discount programs mitigate the difference in real costs to the patient. Furthermore, despite the fact that biosimilars drive down costs to patients and insurers, biologics often maintain preferred coverage. For both physicians and patients, transparency around the total costs of prescribing a biosimilar versus a biologic would be an important factor in their decision-making.

According to experts at NORC at the University of Chicago, three policy changes could increase the uptake of biosimilars. First, the experts call for more Food and Drug Administration guidance and real-world data on the effectiveness and safety of biologics versus biosimilars. Second, the experts recommend limiting incentives that hide the real cost differences between biologics and biosimilars, ensuring that both the patient and the system benefit from the lower total costs of biosimilars. Finally, the experts recommend additional transparency requirements to both physicians and patients regarding the actual price of the drugs, so they can weigh the difference equally, along with safety and effectiveness.

Methodology
NORC at the University of Chicago (NORC) conducted quantitative and qualitative research on provider, patient, and payer perceptions of biosimilars to understand how stakeholders’ actions may affect uptake of biosimilars in the future.