Insight into the Biosimilar Prescribing Habits of Rheumatologists

On May 31, the Generics and Biosimilar Initiative reported results from two GlobalData surveys, conducted in 2018 and 2020 on the biosimilar prescribing habits of high-prescribing rheumatologists from eight countries: France, Germany, Italy, Spain, the U.K., the U.S., Japan and Australia. The surveys focused on their biosimilar prescription patterns for patients with rheumatoid arthritis (RA).¹

Biosimilar Use Data

Overall, the results showed Japan had the largest increase in biosimilar prescriptions, with the percentage of Japanese rheumatologists prescribing biosimilars to at least 25% of their patients with RA jumping from 23% in 2018 to 78% in 2020. In the 2018 survey, almost half of Japanese rheumatologists (46%) said they preferred to prescribe originator biologic treatments, citing potential biosimilar manufacturing problems and doubts about the reliability of biosimilar agents. In the 2020 survey, only 6% of Japanese rheumatologists surveyed said they preferred to prescribe originator biologic agents—a significant decrease.

For European rheumatologists, 92% reported using biosimilars in at least 25% of their patients with RA in the 2020 survey, compared with only 70% in 2018. The increase in European use of biosimilars was due to more flexible interchangeability policies and government-mandated quotas for biosimilar prescriptions. In 2020, Europe experienced new biosimilar availability for such drugs as adalimumab, etanercept, infliximab and rituximab. With some treatments having multiple biosimilar products and lower prices, this availability is thought to have influenced the increased use by these European physicians.

According to the GlobalData surveyers, the slow increase in U.S. biosimilar use is most likely due to the lack of available biosimilar agents to treat RA. Only agents biosimilar to infliximab and rituximab are currently available in the U.S., and these agents are given by infusion rather than being self-administered. The U.S. Food & Drug Administration has approved agents biosimilar to adalimumab and etanercept. However, the launch of the adalimumab biosimilar has been delayed until 2023, and the etanercept biosimilar is undergoing litigation.² Another major reason for the slow increase in U.S. biosimilar use is the pharmaceutical industry’s aggressive tactics in blocking their approval and availability.³

Both the U.S. and Australia had similar biosimilar use from 2018 to 2020, with about 20–30% of surveyed rheumatologists reporting use of biosimilar agents in at least 25% of their patients with RA. Although having access to agents biosimilar to etanercept, infliximab and rituximab, about 30% of surveyed Australia rheumatologists prefer to prescribe the originator product over the biosimilar agent due to a higher degree of confidence in these agents, their inexperience with biosimilars and the lack of financial incentive to select biosimilars.

The competitive pricing of biosimilars in France, Germany, Italy, Spain, the U.K. and Japan is a vital reason for the increased use of biosimilars and success in these regions. GlobalData believes a clear financial incentive is needed to increase biosimilar use in the U.S. and Australia.

Michele B. Kaufman, PharmD, BCGP, is a freelance medical writer based in New York City and a pharmacist at New York Presbyterian Lower Manhattan Hospital.

References

1. Rheumatologists are prescribing more biosimilars. GaBI Online. 2021 May 31.
2. Approval and launch dates for U.S. biosimilars—2021 GaBI Online. 2021 May 7.
3. Lanfear D. How big pharma suppresses ‘biosimilars.’ The Wall Street Journal. 2019 Jun 23.