In 2022, the Alliance for Safe Biologic Medicines and the International Federation on Ageing conducted a web-based quantitative survey of 41 participants practicing ophthalmology in Canada. Prescribers were asked for their views: on how products are identified; influence of the cost of biologicals and biosimilars when prescribing; prescribing biosimilars and switching to biosimilars; pharmacist-level switching to biosimilars and automatic substitution of biosimilars.

Overall, the survey revealed information about how the physicians record and identify biological/biosimilar drug products (product identification). It also demonstrates that ophthalmologists are confident in the Canadian pharmacovigilance system’s ability to accurately identify the specific product at the brand-name level that might be responsible for an adverse drug reaction. In addition, most physicians are not influenced by the cost when prescribing biologicals and they are confident prescribing biosimilars and switching patients to biosimilars where appropriate. The survey also highlights that prescribers hold patient education and support programmes in high regard.  

Regarding switching (by pharmacists or payers), physicians believe it is crucial for them to have the authority to designate a biological medicine as ‘DISPENSE AS WRITTEN’ or ‘DO NOT SUBSTITUTE’. They voiced the desire to be informed when pharmacists dispense biologicals that differ to those prescribed. Overall, 90% of practitioners said they think they should have the sole authority to decide what biological is dispensed to patients and over 80% said they are not comfortable with third-party switching for non-medical reasons. Most practitioners were in support of a system that would offer multiple products that are reimbursed, including innovator and biosimilars, they also supported biosimilars being encouraged for new patients and no automatic substitution.

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Reference
1. Reilly MS, Barratt J. Canadian prescribers' attitudes and perceptions about ophthalmic biosimilars. Generics and Biosimilars Initiative Journal (GaBI Journal). 2023;12(2):41-9. doi:10.5639/gabij.2023.1202.009

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