A study of patients taking biological drugs in New Zealand identifies a number of attributes associated with negative perceptions of biosimilars, including being female, seeking information online, and preferring innovator drugs .
One of the major barriers to widespread uptake of biosimilars is negative perceptions among patients. Although several educational campaigns  have been launched to try to improve understanding of biosimilars, precisely what drives negative beliefs about biosimilar drugs remains incompletely understood.
A new study  investigated which patient characteristics are associated with negative perceptions of biosimilars. Although it has previously been shown that patient characteristics can influence preferences towards switching to generic drugs, no previous studies have looked at the effect of patient characteristics on acceptance of biosimilars.
The study investigated the demographic and psychological characteristics associated with negative perceptions of biosimilars and concerns about switching to a biosimilar. It included 96 people in New Zealand who were taking an originator biological for a rheumatoid condition (for rheumatoid arthritis in the majority of cases).
Patients completed a series of questionnaires and provided demographic and clinical information. All participants also watched a video explanation discussing switching from an originator to a biosimilar, which included information about manufacturing, safety and the cost savings made by biosimilars. Concerns about switching were measured with questions such as ‘How concerned would you be about taking a biosimilar?’.
The analysis showed that being female was independently associated with having negative safety perceptions of biosimilars. Negative safety perceptions were also associated with taking an originator drug for a short time, seeking health-related information on the internet, having a high perceived sensitivity to medicines, and negative beliefs about medicines in general (although none of these factors were independently associated).
Concerns about switching were independently associated with seeking information on the Internet, having stronger emotional responses to illness, or having a preference for branded medicines.
Concerns about switching were also associated with timeline beliefs (beliefs about the duration of the illness), emotional responses, being female, perceiving oneself to be sensitive to medicines, engaging in information-seeking behaviours and having a preference for branded medicines (although none were independently associated).
The authors say the finding that patients who are more emotionally affected by their illness have greater concerns about switching suggests a need to enhance coping and resilience. They also say that patients should be directed to reliable information about switching, as those who look for information online were found to be more concerned.
The findings also showed that a patient’s experience with their originator drug also influenced their perceptions of biosimilars; for example, those who perceived their current originator drug to be more effective were more likely to prefer originator therapy over a biosimilar.
Based on their findings, the authors make several recommendations:
- Healthcare professionals should guide patients to credible information on biosimilars, reducing the risk of them finding incorrect information online.
- Providers should reassure patients who have had negative experiences with originator biologicals, as this can also influence their perceptions of biosimilars.
- Healthcare professionals should assess patient preference for branded medicines. This can help them to provide educational materials to combat misconceptions about biosimilars.
Overall, the authors conclude that educational programmes on biosimilars should focus on patients who are taking originator biologicals, are female, seek health information on the Internet, have strong emotional responses to their condition, and prefer branded medicines.
Conflict of interest
One of the authors of the study  received speaker fees, consulting fees, or grants from pharmaceutical companies.
Readers interested to learn more about perceptions of generic and biosimilar drugs are invited to visit www.gabi-journal.net to view the following manuscripts published in GaBI Journal:
Generics perceptions in patients, pharmacists and doctors
Perceptions of the effectiveness and quality of generics
Tell me the whole story: the role of product labelling in building user confidence in biosimilars in Europe
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1. Gasteiger, C., Lobo, M., Dalbeth, N. and Petrie, K.J. (2020). Patients’ beliefs and behaviours are associated with perceptions of safety and concerns in a hypothetical biosimilar switch. Rheumatology International, 41(1), pp.163–171.
2. GaBI Online - Generics and Biosimilars Initiative. Education for biosimilars in Europe and the US [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2021 Jul 23]. Available from: www.gabionline.net/Reports/Education-for-biosimilars-in-Europe-and-the-US
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