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French Rheumatologists Lack Confidence in Biosimilars, Study Says


A study presented at the European League Against Rheumatism conference suggested that French rheumatologists have good knowledge of biosimilars but lack the confidence to use them.

A survey of rheumatologists in France concluded that they generally have a good understanding of biosimilars but lack the confidence to use them, according to data presented at the EULAR 2020 Congress, the virtual meeting of the European League Against Rheumatism.

The study concerned the use of subcutaneously applied tumor necrosis factor inhibitor (SC TNFi) biosimilars, which have been available in France since 2015 at lower cost than reference products. There is no requirement in France that rheumatologists prescribe biosimilars or switch patients to them.

The findings mirror the results of a similar US-based study reported last year in which rheumatologists expressed hesitancy about switching to biosimilars and extrapolating to uses beyond those the biosimilars were approved for.

Survey Details

French investigators surveyed 101 rheumatologists, 47.1% of whom were younger than 40 years and 92% of whom had authorization to prescribe TNFi.

According to the findings, 53.2% always prescribe biosimilars when prescribing TNFi for the first time, and 78.5% prescribe TNFi biosimilars 90% of the time.

Investigators said 30.6% of French rheumatologists never switch patients from originator drugs to biosimilars. Those who switch patients to biosimilars do it more than 75% of the time.

In the survey, 96.5%, 87.1%, and 91.8% agreed that biosimilars are as efficient, are as safe, and have the same immunogenicity profile as originator products, respectively.

Among rheumatologists who prescribe biosimilars in more than 90% of cases, 77.4% correctly answered no to the question “biosimilars and originators have to be compared in phase III studies for each indication for which the originators received marketing approval.”

Among those who prescribe biosimilars less than 90% of the time, just 31.2% answered this question correctly, indicating to the investigators that those who prescribe biosimilars as initial treatments tend to be equipped with better knowledge of biosimilars. Investigators said this finding was significant (P < .001).

Rheumatologists were also asked whether there is enough experience with biosimilars. Most rheumatologists who switch to biosimilars more than 75% of the time answered this question in the affirmative, and just 25.4% in this group said there isn’t enough experience with biosimilars.

The same question was asked of those who switch to biosimilars less than 75% of the time. Investigators said a majority of them (57.7%) answered that there isn’t enough experience with biosimilars. This finding also was significant (P < .003).


De Chateaubriant A, Ingrand P, Gervais E. Anti-TNF biosimilars: how knowledge and belief influence prescription. Presented at: EULAR 2020 Congress; June 3-August 31, 2020. Abstract AB1162.

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