Asian Gastroenterologists Are Less Confident in Biosimilars Than Their European Peers

Results of a recent survey demonstrate that Asian physicians are less confident in using biosimilars than their European peers are.

The European Crohn’s and Colitis Organisation (ECCO) has surveyed its members in 2013 and 2015 concerning their knowledge of and views on biosimilars, and in 2017, researchers from Asia adopted the same survey questions to gather information on the views of members of the Asian Organization of Crohn’s and Colitis (AOCC). Results of the survey, published in Intestinal Research, demonstrate that Asian physicians are less confident in using biosimilars than their European peers are.

The 17-question, multiple-choice, anonymous web survey gathered responses from 151 physicians from Korea, Japan, China, Hong Kong, Malaysia, Taiwan, Singapore, and India. Most participants were gastroenterologists (96.6%), and most (77.5%) had cared for patients with inflammatory bowel disease (IBD) for more than 5 years.

The survey found that 49.6% of respondents had access to biosimilars and had already prescribed them, while 26.4% had access to biosimilars but had not prescribed them, and 19% had no access to biosimilars (in 2015, the corresponding percentages among ECCO members were 60%, 22%, and 18%, respectively).

In terms of provider education, most respondents (66.2%) were aware that a biosimilar is not identical to the originator. Some (8%) thought that a biosimilar was a different agent altogether (comparable to the difference between adalimumab and infliximab). Furthermore, 19.9% believed that biosimilars have different activities than the originator, while 38.4% thought that biosimilars would have different immunogenicity than the originator. While these patterns of education are similar to ECCO members’ responses, a lower percentage of AOCC respondents (77.5%) than ECCO members (92.4% in 2015) considered cost savings as a main advantage of biosimilars.

Like ECCO members (85% in 2015), most AOCC respondents (87.8%) disagreed with automatic substitution of a biosimilar by a pharmacist, but unlike ECCO members (44.4% in 2015), only 19.2% of AOCC respondents believed that biosimilars could be used interchangeably with their references. Similarly, fewer AOCC respondents (39.1%) than ECCO members (50.8% in 2015) were comfortable with the extrapolation of indications.

Finally, only 6.0% of the survey respondents said they would be confident prescribing a biosimilar, compared with 28.8% of ECCO members in the 2015 survey.

“Asian gastroenterologists are generally well informed about biosimilars,” write the paper’s authors. “However, compared with ECCO members in 2015, Asian gastroenterologists had more concerns and less confidence about the use of biosimilars clinical practice. Thus, IBD-specific data on comparison of efficacy, safety, and immunogenicity in Asian patients are needed.”


Park SK, Hisamatsu T, Ran Z, Wei SC, Park DI. Knowledge and viewpoints on biosimilar monoclonal antibodies from members of the Asian Organization of Crohn’s and Colitis: comparison with European Crohn’s and Colitis members [published online November 12, 2018]. Intest Res. doi: 10.5217/ir.2018.00084.

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