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Survey: Moderate Acceptance of Anti-TNF Biosimilars Among Patients With Immune-Mediated Conditions


Patients with and without experience with tumor necrosis factor (TNF)–blocker biologics have incomplete knowledge of biosimilars for these agents, according to findings presented at the Academy of Managed Care Pharmacy 2021 Nexus meeting.

Patients with immune-mediated conditions from Alabama, Mississippi, Nebraska and Puerto Rico (N = 500) were moderately inclined to accept anti–tumor necrosis factor (TNF) biosimilars, according to findings from a study presented at the Academy of Managed Care Pharmacy (AMCP) Nexus 2021 meeting.

The survey was conducted online from December 2020 to January 2021 and included patients receiving biologic therapy (44%; n = 221) or not currently receiving a biologic (56%; n = 279). Of the latter group, 16% had past biologic use and 40% were biologic naive.

Patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, and inflammatory bowel disease were included. A criterion for participation was that patients were not currently receiving an infliximab biosimilar.

“Most patients who completed the survey had not heard of biosimilars,” authors of the study wrote. “The majority of patients were receptive to biosimilar treatment and considered cost as part of the decision-making process.”

However, patients expressed particular concerns about adverse events that might arise during biosimilar use and how well these agents would treat their condition.

The authors concluded that through education, patients’ acceptance of biosimilars could improve.

Willingness to Switch

Patients under treatment with an originator biologic at the time of the survey were asked whether they would switch to biosimilar treatment if proposed by their provider. According to findings, 43% would accept the switch, 32% were unsure, and 26% were opposed to switching.

Patients not under treatment with a biologic were asked how they would feel if their insurance company required use of a biosimilar but their provider had prescribed a reference anti-TNF medicine. The survey indicated 49% would not accept the switch, 43% were unsure, and 8% were opposed to switching.

The findings suggested patient knowledge and experience with biosimilars were low: just 24% had heard of biosimilars, and among those who were current biologic users, 38% were familiar with biosimilars. Among past biologic users or the biologic naïve, just 12% indicated having heard of biosimilars.

Patients were shown the FDA definition of biosimilars, which is that biosimilars are as safe and efficacious as their reference drugs with no clinically meaningful differences in outcomes. They were then asked about their concerns.

Study authors said 37% of current biologic users were concerned they didn’t know enough about biosimilars vs 53% of past biologic users or biologic naïve patients. Other concerns for current vs past biologic/naïve patients, respectively, were as follows:

  • Long-term safety, 52% vs 49%
  • Adverse events, 58% vs 60%
  • The biosimilar might not work as well as the original biologic, 41% vs 25%
  • Patients responding that they had no worries about using biosimilars were 15% vs 15%, respectively.

Patient Characteristics

The mean age of patients completing the survey was 48.6 years; and 52% of patients were 35 to 54 years of age. The gender proportion of those participating was 61% female and 39% male. Equal proportions of patients had rheumatoid arthritis, psoriatic arthritis, or inflammatory bowel disease, which was per study design.

Among patients who were on a biologic at the time of the survey, 55% were receiving adalimumab; 26%, etanercept; and 9%, infliximab.

The study was funded by Boehringer Ingelheim. Some of the authors disclosed business relationships or stock ownership in AbbVie and other large pharmaceutical companies.


Ganguly S, Jacobson GM, Franklin AC, et al Attitudes about biosimilars among US patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, or inflammatory bowel disease: an online survey. Presented at AMCP Nexus 2021, October 18-21, 2021. Poster Z10.

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