In March 2019, the Alliance for Safe Biologic Medicines (ASBM) asked European prescribers for their views on the prescribing, adverse drug reaction (ADR) reporting, automatic substitution and switching of biologicals and biosimilars. This was a follow-up survey, replicating that carried out by the organization in 2013 [2]. In total, 579 prescribers in France, Germany, Italy, Spain, Switzerland and the UK were asked for their views on various aforementioned aspects related to biosimilars and also questions related to their familiarity with, knowledge of, attitudes to, and beliefs in, biosimilars.

Since the 2013 European prescriber study, the percentage of respondents considering themselves highly familiar with biosimilar medicines has increased from 76% to 90%.

Key results relating to ADRs include:

• Four out of five prescribers said they are legally required to report ADRs that are brought to their attention
• Over half of prescribers are most likely to report an ADR to the National Competent Authority
• Two-thirds of prescribers said they spend 10 to 20 minutes filing reports
• Overall, prescribers said they file detailed reports; however, this level of detail deters 55% of prescribers from reporting minor events
• More than half of prescribers said the reporting infrastructure was the biggest barrier to accurate reporting; another 20% said no barriers exist
• Frequency of including batch number is mixed; not having the number available at time of reporting was selected by more than half of prescribers who said sometimes, rarely, or never

Key results relating to control over prescribing and dispensing include:

• Four out of five prescribers feel very strongly about having control over what is prescribed and dispensed to their patients
• More than 40% of prescribers said they rarely or never prescribe biological products by non-proprietary name only
• More than one-third said confidence would be lacking in knowing exactly what was dispensed to patient if they prescribed a product using non-proprietary name
• Four out of five prescribers said it would be critical or very important to be notified by pharmacist that patient received a biological medication other than the one they prescribed
• Almost 60% of prescribers said it would be acceptable for a pharmacist to determine which biological to dispense on initiation of treatment, but would require clinician agreement in advance

Key results relating to switching include:

• Prescriber comfort levels decrease when asked about switching a stable patient to a biosimilar versus prescribing a biosimilar to a naïve patient
• Approximately 20% of prescribers are uncomfortable in prescribing a biosimilar to a naïve patient
• Approximately 40% are uncomfortable with switching a stable patient from an originator to a biosimilar
• In France, Switzerland and the UK, prescribers are most comfortable with prescribing a biosimilar to a naïve patient, while Spanish prescribers are the least comfortable with switching a stable patient to a biosimilar

Key results relating to prescriber switch versus third-party switch:

• Prescriber comfort levels decrease when asked about switching a patient to a biosimilar for non-medical reasons
• More than half of prescribers (58%) are uncomfortable with switching their patients to a biosimilar for non-medical reasons
• Just over 70% of prescribers are uncomfortable when asked about a third party initiating such a switch (this figure has increased sharply since the 2013 survey)
• In France and the UK, prescribers are most comfortable with switching their patients, while in Spain, prescribers are the least comfortable with having a third party make the switch

Overall, the survey highlights that prescribers think governments should make multiple therapeutic choices available in tenders. They also believe these tenders should consider factors besides price.

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References
1. Feldman MA, Reilly MS. European prescribers’ attitudes and beliefs on biologicals prescribing and automatic substitution. Generics and Biosimilars Initiative Journal (GaBI Journal). 2020;9(3):116-24. doi:10.5639/gabij.2020.0903.020
1. Dolinar, RO, Reilly MS. Biosimilars naming, label transparency and authority of choice – survey findings among European physicians. Generics and Biosimilars Initiative Journal (GaBI Journal). 2014;3(2):58-62. doi:10.5639/gabij. 2014.0302.018

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