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Study: Gender, Internet Habits Influence Biosimilar Acceptance


Patient characteristics are predictive of whether a switch to a biosimilar is likely to be accepted, investigators found.

Patients’ demographics and physiological characteristics influence whether they will accept a switch from an originator drug to a biosimilar, according to findings from a New Zealand study.

For example, being a woman was a strong predictor of concern about a biosimilar switch (P < .001), they said. “Gender was significantly correlated with perceptions of a biosimilar's safety. Female patients were more concerned about switching from a bio-originator to a biosimilar [P < .001].”

Patients who perceived they are highly sensitive to medicines were less likely to accept a biosimilar switch (P = .001), and those with a habit of looking health information up on the internet were more likely to be concerned about switching (P = .001), the investigators said.

In addition, patients who had strong emotional responses to their health condition were less likely to perceive biosimilars as safe or to consider switching from originator drugs, although these findings were not statistically significant.

Investigators enrolled 96 patients taking originator drugs for rheumatic diseases. Patients were asked to watch a video tutorial explaining biosimilars and their equivalence to originator drugs and then given a survey to gauge their receptiveness to biosimilars.

The average patient was aged 54 years and college educated (64%); most were women (69%). The most common originator therapy was rituximab (35%), and the most frequent condition rheumatoid arthritis (65%).

A strong negative association for biosimilar safety was observed among those who had taken the originator product for only a short time (P = .002).

The investigators said their findings were consistent with previous studies. “Interestingly, the study findings show that concerns about switching to a biosimilar are exacerbated in patients who have stronger emotional responses to their condition. This is an important finding as negative affective responses, such as anger or fear, are common in patients with arthritis but can bias treatment decision-making and risk perceptions.”

They added that the finding about strong emotions and biosimilar rejection suggests that efforts to improve patient coping skills and resilience may pay off.

Past studies also have shown that patients with high levels of health anxiety and perceived sensitivity to medicines tend to search for information online. One concern is patients may access incorrect information. Providers should step in after a switching discussion with “credible material” to help support the switch, the authors said.

A patient’s experience with the originator product, in terms of effectiveness and adverse events, is also a factor in biosimilar acceptance. Providers need to “assess and reassure patients who have had unfavorable experiences with biosimilars,” the investigators said.

The study was important because biosimilars are equivalent to originators in terms of safety and efficacy, and they have the potential to bring down the costs of health care. Knowing which patients are less likely to be accepting of a switch to a biosimilar can allow for interventions, the investigators said.


Gasteiger C, Lobo M, Dalbeth N, Petrie KJ. Patients’ beliefs and behaviors are associated with perceptions of safety and concerns in a hypothetical biosimilar switch. Rheumatol Int. Published online April 16, 2020. doi:10.1007/s00296-020-04576-7

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