In the US, a legal framework for approving biosimilars was established via the Biologics Price Competition and Innovation Act of 2009 (BPCI Act). At the time of writing of this report, 37 biosimilars have been approved. Some biosimilars in the US can be designated as ‘interchangeable’, which means they can be automatically substituted at the pharmacy level.

In September 2021, the ASBM conducted a web-based quantitative survey with 401 participants practicing medicine in the US. Prescribers were asked for their views on substitution of, as well as their familiarity with, knowledge of, attitudes to, and beliefs in, biosimilars.

Overall, the survey revealed that most physicians are comfortable prescribing biosimilars and comfortable switching stable patients to biosimilar product. Over half of physicians are more likely to prescribe biosimilars with interchangeable status and they are comfortable with pharmacy-level substitution of these products. However, the majority want to keep the authority to prevent pharmacy-level substitution if they specify so. When it came to switching patients to a biosimilar for non-medical reasons, the majority were comfortable doing this but fewer than half were comfortable with third-party switching. In addition, most physicians favoured a scenario where multiple products, including innovator and biosimilars are reimbursed, and biosimilars may be encouraged for new patients with no automatic substitution permitted. 

In general, physicians in the US are confident when it comes to prescribing biosimilars. The survey also sheds light on how they feel about the interchangeable designation, indicating a confidence in them. It also reveals how they feel about biological drugs switching choices made by them, pharmacists and payers. 

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Reference
1. McKibbin RD, Reilly MS. US prescribers' attitudes and perceptions about biosimilars. Generics and Biosimilars Initiative Journal (GaBI Journal). 2022;11(3):96-103. doi:10.5639/gabij.2022.1103.016

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