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ACR Survey Reveals Patient Knowledge Gaps on Biosimilars


Many patients with rheumatic diseases are unsure whether their prescriptions are biosimilars, suggesting more efforts in patient education are needed.

A national survey of individuals with rheumatic diseases found that 28.91% of patients weren’t sure whether they have been prescribed a biosimilar, indicating that there is a lack of knowledge about biosimilars and how they compare with reference products.

Additionally, about 35% of surveyed patients reported that they were prescribed a biosimilar medication.

The survey was conducted in June by Rheumatic Disease Awareness Month 2020 and the American College of Rheumatology (ACR) and its Simple Tasks public awareness campaign.

The survey builds on the ACR’s 2019 National Patient Survey and provides new insights into how issues regarding rheumatic diseases have changed over time, especially during the coronavirus disease 2019 (COVID-19) pandemic.

Trends in Prescription Medication

Prior authorization was required for nearly half (47.94%) of patients, according to the June survey. Previous reports have shown that prior authorization requirements can restrict access to lower-cost medications such as biosimilars and prolong a patient’s waiting period before receiving treatment.

Step therapy requirements affected 46.17% of surveyed patients. Step therapy, also known as fail first therapy, requires patients to begin treatment using therapies preferred by their insurance company—usually less expensive drugs, such as biosimilars and generics—prior to trying a more expensive reference product.

In general, annual median out-of-pocket expenses more than doubled over the past year, rising from $475 in 2019 to $1000 in 2020. Furthermore, in the June survey, 26.68% of patients reported spending more than $2000 in out-of-pocket costs.

COVID-19’s Impact on Treatment

Reported wait times to be seen by a rheumatologist have increased, with 17.13% of patients waiting between 61 to 90 days to get a first appointment with a rheumatologist following a referral, compared with 13.39% in 2019.

“These results could be attributed to factors such as the COVID-19 pandemic, an increase in the number of individuals without health insurance, and the growing nationwide shortage of rheumatology health professionals,” authors of the report wrote.

About 66% of patients reported that they had taken advantage of telehealth within the past year, with 52% of patients citing the pandemic preventing them from being seen in the office as the main reason.

Additionally, from 2019 to 2020 there was a 52% decline in the percentage of respondents who said they were currently being treated by a rheumatology provider. In 2020, 33.53% of patients surveyed said they were currently receiving treatment, compared with 57.41% of respondents in 2019 who said they were being treated by a rheumatology provider. Of those who reported that they were not being treated by a rheumatology provider, 38.23% said they used to be.

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