More Research Finds Low Awareness of Biosimilars Among Oncology Providers

While a majority of survey respondents said that they were at least somewhat familiar with current developments in oncology biosimilars, analyses of open-ended definitions found that only 1 participant could fully define a biosimilar, according to researchers.

The need for improved biosimilar education among providers has been demonstrated, and with even more anticancer biosimilars gaining FDA approval, oncologists’ education on these products is a growing area of concern.

A newly published study sought to investigate oncology providers’ understanding of biosimilars and the information and data that they feel are important to assess before prescribing these products. The researchers found that understanding of biosimilars remains low among oncologists, pharmacists, and advanced practice providers.

The investigators contacted oncology providers at a single academic healthcare system in the United States between January 2018 and May 2018. They provided an online or paper-based survey to a total of 77 providers, of whom 52 were physicians, 16 were pharmacists, and 9 were advanced practice providers.

After 50 respondents had completed the survey, the team conducted in-depth interviews that centered on themes of cost, safety and efficacy, patient preference, and disease stage.

The investigators found that, while a majority of respondents said that they were at least somewhat familiar with current developments in oncology biosimilars, analyses of open-ended definitions found that only 1 participant could fully define a biosimilar. Only 28.4% of participants correctly identified at least 1 current indication for an approved biosimilar, though 62.3% correctly identified safety and efficacy as related to interchangeability requirements.

When asked about their likelihood of using a biosimilar in practice, 53.2% said they were likely or highly likely to prescribe one. Additionally, 94.8% said they would prescribe an interchangeable product. The most important factor was a biosimilar’s safety and efficacy, followed closely by cost differences.

Colleague and expert opinion were not as highly ranked by physicians as influencing prescribing behavior, though younger or less experienced providers considered colleague and expert opinion to be more important to their choice than older providers or those who had been practicing longer.

Providers were split on the importance of informing patients about whether they were given a biosimilar; 46.8% said that informing the patient was important or extremely important, while 42.9% said it was only somewhat or not at all important. This trend aligned with viewpoints on shared decision-making; 50.6% said that shared decision-making is important or extremely important, while 39.0% said it is only somewhat or not at all important.

In total, only 10 respondents said that pharmacists should be involved in the decision-making process. Seven providers said that pharmacists should not act outside of the prescriber’s approval.

“We found, as did previous studies, that oncologists require more education regarding biosimilars before they are extensively introduced into a clinical setting,” wrote the authors, adding that “our data also suggest that there is a disconnect between what the [FDA] and academic clinicians deem most important before a biosimilar is approved and used in a clinical setting.”


Cook JW, McGrath MK, Dixon MD, Switchenko JM, Harvey RD, Pentz RD. Academic oncology clinicians’ understanding of biosimilar and information needed before prescribing [published online January 6, 2019]. Ther Adv Med Oncol. doi: 10.1177/1758835918818335.

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