Biosimilars: Bringing Patients into the Conversation

Sharing her ''Living With'' research results, new patient insights columnist Mariel Melcalfe discusses biosimilar awareness

There’s no doubt that the cheaper cost of biosimilars versus their originator biologic, even though not as substantial as generics, make them very attractive to healthcare markets. But so far, biosimilar manufacturers have dedicated most of their efforts to convincing payers of these cost benefits, seeing them as the primary gatekeeper of market access. However, by focusing just on payers, are they missing a trick? In the longer-term, manufacturers could benefit from educating and winning over a wider audience, and not just physicians, but also patients. Cheaper prices should lead to greater access to biologic therapy, especially at the early stages of disease.  The high cost of these drugs is one reason that patients often wait a significant amount of time before they can be considered for biologic treatment, during which time their disease has often irreversibly progressed. Raising awareness of biosimilar treatment amongst patients would likely result in more conversations between doctor and patient and could ultimately result in more demand for biosimilars as an equally efficacious yet more cost-effective option.

Findings from recent research conducted by Research Partnership among patients living with rheumatoid arthritis, reveals that awareness is currently very low. Only 18% of patients in the US and 11% of patients in the EU have even heard of biosimilars. Unsurprisingly, most of those who are aware are patients who are currently receiving a biologic; if patients are doing fine on the originator, then they should stay on that.

Our research amongst patients across a range of auto-immune diseases revealed that trust in their doctor is often the leading reason they are open to substitution.

Data collected from our online market tracking tool amongst physicians (Therapy Watch) was used to investigate the treatment protocol for RA. So far, biosimilars are primarily used as a 1st line option in patients who are eligible for the originator drug (70% are 1st line in RA, AS and PsA, 79% in IBD). However, there has been much debate regarding the substitution of originator products for biosimilars (currently only accounting for 18% of rheumatology patients vs. 15% in IBD) with our physicians expressing concerns about the automatic substitution of biologics for biosimilars.

The majority of patients in the EU (63%) said they would be open to the idea of substitution, mostly because they trust their doctor’s judgement and think the product would be effective. The picture isn’t quite as positive in the US, where only 48% said they would be willing to substitute to a biosimilar. The reasons stated for not wanting to substitute are concerns about safety, product effectiveness, and cost. In the US, where healthcare costs are largely met by insurance, concerns about whether a drug will be covered are certainly legitimate. Concerns about product effectiveness and safety however, demonstrate there is an opportunity for biosimilar manufacturers to improve the way they communicate with both physicians and patients. Communicating with physicians would help, in order to address any concerns they may have and ensure they are happy to recommend these drugs. This, in turn, will filter down to patients, the majority of whom trust their doctor’s  judgement. Our research amongst patients across a range of auto-immune diseases revealed that trust in their doctor is often the leading reason they are open to substitution. Communicating with patients would also help, in order to increase not just awareness but acceptance of biosimilars, particularly since many patients now report that their treatment decisions are made jointly by their physician and themselves. It would also help to allay their stated concerns regarding safety and product effectiveness, and to reassure them that the treatment decision is not being driven primarily by a desire to control cost.

Mariel Metcalfe is the Head of Living With and has 10 years healthcare research experience across a wide variety of qualitative and quantitative methodologies, including global tracker research and segmentation. She has managed projects for a range of therapy areas including infectious, autoimmune and rare diseases, as well as diabetes and oncology.  Mariel has particular expertise in market understanding, communications, patient and provider positioning research.  Contact Marielat  Research Partnership is one of the largest independent healthcare market research and consulting agencies in the world. Trusted partner to the global pharmaceutical industry, we use our expertise and experience to deliver intelligent, tailor-made solutions. We provide strategic recommendations that go beyond research, helping our clients to answer their fundamental business challenges. Find out more at

Sources: (1) Living with RA EU: Quantitative online study conducted with 500 biologic and non-biologic treated patients in France, Germany, Italy, Spain and the UK, Dec 2015-Jan 2016

(2) Living with RA US: Quantitative online study conducted with 498 biologic and non-biologic treated patients in the US, May 2016

(3) Therapy Watch RA: Quantitative online study conducted with a panel of 200 rheumatologists across France, Germany, Italy, Spain and the UK reporting monthly on approximately 1,400 RA, 400 AS, 400 PsA and 400 nr-axSpA patients they see and treat as part of their everyday practice, Aug 2016


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