Author Leonard and colleagues carried out a literature search using journal databases, including PubMed, Embase and the Cochrane Library, using terms related to biosimilars, survey questionnaires and education. Twenty healthcare provider surveys (3 US and 17 European) published between January 2014 and March 2018 met the inclusion criteria and were abstracted for data related to providers’ biosimilar prescribing habits, knowledge, safety and efficacy concerns, extrapolation and interchangeability viewpoints, and exposure to biosimilar educational activities.

The results of the review showed that most of the reviewed studies primarily surveyed gastroenterologists, rheumatologists and specialty physicians who routinely prescribed originator biologicals. It also showed that the percentage of biosimilar prescribing varied widely between countries and within similar practice fields.

The review noted that both US and European clinicians seemed to be unaware of the existence of biosimilars as alternative safe and effective treatment options for their patients. Most physicians perceived biosimilars as second- or third-line treatment options in patients requiring biological therapy and restricted use to biological treatment-naïve patients only. This was accompanied by concerns about biosimilar safety, efficacy, extrapolation and interchangeability.

The review also identified gaps in biosimilar knowledge and understanding among clinicians. The majority of surveyed physicians indicated having an incomplete or basic awareness of biosimilars, with familiarity higher among hospital-based rather than office-based practitioners.

Finally, detailed descriptions of biosimilar education programmes were lacking within the literature. Self-instruction and independent guideline and/or journal article review were the most common learning methods, followed by colleague discussion, continuing education, and consulting promotional manufacturer materials.

The authors concluded that ‘findings from this review indicate that US and European healthcare providers still approach biosimilar medicines with caution, citing limited biosimilar knowledge, low prescribing comfort, and safety and efficacy concerns as main deterrents for biosimilar use’. The authors say that ‘to realize the full cost-saving potential of biosimilar medicines, clinician-directed biosimilar education will be imperative to address gaps in biosimilar knowledge, facilitate prescribing changes, and ultimately increase biosimilar use’.

Conflict of interest
The authors of the research paper [1] declared that there was no conflict of interest.

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Reference
1. Leonard E, Wascovich M, Oskouei S, et at. Factors affecting health care provider knowledge and acceptance of biosimilar medicines: a systematic review. J Manag Care Spec Pharm. 2019;25(1):102-12.

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