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Survey Finds Asian Gastroenterologists Report Less Confidence in Biosimilars


Just 6% of the Asian doctors said they felt confident using biosimilars in clinical practice. A survey of European doctors found a similar confidence level in 2013, but that level had climbed to 28.8% by 2015.

Compared with their European colleagues, Asian gastroenterologists have less confidence in biosimilars, according to survey results reported in the Korean Journal of Gastroenterology.

The report discussed results of a 17-question survey sent to members of the Asian Organization of Crohn’s and Colitis (AOCC). Initially, 320 members were randomly selected to participate, and 151 doctors from 8 Asian countries responded. The survey was done by email from February 24, 2017, to March 26, 2017. Nearly all respondents were gastroenterologists (96.6%), and 77.5% had cared for patients with inflammatory bowel disease (IBD) for at least 5 years.

Notably, just 6% of the Asian doctors said they felt confident using biosimilars in clinical practice. The finding was comparable with a 2013 survey of members of the European Crohn’s and Colitis Organization (ECCO), which found just 5% felt confident using biosimilars in practice; by 2015, however, that share had increased to 28.8%.

Other survey results showed:

  • 66.2% were aware that a biosimilar is “similar but not equivalent” to the reference drug
  • 77.5% said cost savings are the main advantage of using biosimilars
  • 38.4% were concerned about a different immunogenicity from the originator
  • 19.2% of respondents considered biosimilars and the originator drug to be interchangeable

The 2015 ECCO survey had found that European doctors were more impressed with the cost savings and less concerned about a different immunogenicity than the Asian respondents. The ECCO results found:

  • In 2013, 89.5% said cost savings were the biggest advantage of using biosimilars; by 2015, the percentage had increased to 92.4%
  • In 2015, 16.9% said biosimilars work differently from their originator, down from 43% in 2013. In the AOCC survey, 19.9% said biosimilars work differently from the originator.
  • The 2015 ECCO survey found 27.1% of respondents were concerned about the immunogenicity of the biosimilar compared with the originator.

In the AOCC survey, 86.7% disagreed that pharmacists should automatically substitute biosimilars for originators, which was similar to the ECCO findings (85% in 2013 and 89.8% in 2015). When asked when substitution was appropriate, 62.3% of Korean physicians disagreed with automatic substitution in any case, compared with 38.8% of Japanese doctors and 11.8% of Chinese doctors.

The authors note that the first infliximab biosimilar, CT-P13 (Remsima, Celltrion) was manufactured by a Korean biopharmaceutical company and licensed in Korea in 2012. By 2017, 74.2% of the participants were from countries where this biosimilar was available, and the doctors were generally well-informed about what biosimilars are.

The share of physicians who prescribed biosimilars for more than 2 years was 41.5% in Korea, 20.6% in China, and less than 5% in other Asian countries. The authors noted that there is a relatively small price difference between biosimilars and originators in Asian markets compared with ECCO countries, which could explain the lack of uptake in some countries.

“Compared to ECCO members in 2015, Asian gastroenterologists had more concerns and less confidence about the use of biosimilars in clinical practice,” the authors concluded. “Thus, IBD-specific data on a comparison of the efficacy, safety, and immunogenicity in Asian patients will be needed.”


Park SK, Moon W, Kim ES, Park SH, Park D. Knowledge and viewpoints on biosimilar monoclonal antibodies among Asian physicians: comparison with European physicians. Korean J Gastroentrol. 2010;74(6):333-340.

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