In a paper published last week in ACR Open Rheumatology, researchers reported that although patients had some concerns about safety and efficacy, overall, they were satisfied with the switch to a biosimilar.
While reports of patient attitudes toward switching from reference infliximab to biosimilars are growing in number in the European context, fewer reports are available about US patients’ experiences with and attitudes toward nonmedical switching. In a paper published last week in ACR Open Rheumatology, researchers reported that although patients had some concerns about safety and efficacy, overall, they were satisfied with the switch to a biosimilar.
The researchers conducted a cross-sectional survey of adults treated for rheumatologic diseases in the Kaiser Permanente Colorado health system, which implemented a switch to biosimilar infliximab, Inflectra, from the reference Remicade in 2017 for patients with rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis.
In total, 108 patients qualitied for the switch, and 52 consented to be surveyed by telephone. Overall, the patients surveyed tended to be older, female, white, diagnosed with RA, enrolled in a Medicare plan, and experiencing moderate disease burden. At the time of the survey, 76.9% of patients reported that their current therapy was the biosimilar, whereas 23.1% reported that they were receiving the reference infliximab.
Overall, in both those who had and had not switched, patients had been receiving biologic therapy for a mean of 9.3 years, and 84.6% of patients said that they were satisfied with their current treatment in terms of disease control; 80% of patients who switched reported being satisfied, and 100% of patients who did not switch reported the same.
Although approximately one-third (32.7%) of patients said that they had heard of the biosimilar previously, 35.8% said they did not know enough about the safety and efficacy of the biosimilar before the switch. Some were worried that the biosimilar would be too expensive (13.5%), could have side effects (38.5%), or might result in loss of disease control after the switch (38.5%). Among patients who did not switch, 58.3% said that they were not confident that there was enough information available to undertake the switch.
According to the paper’s authors, this survey identified that, in general, patients who switched and those who did not were satisfied with their current therapy, though they had some concerns about switching. “Patient involvement in the switching decision‐making process may allay concerns and enhance [biosimilar] uptake,” write the authors.
Finally, the authors acknowledge that the relatively small sample size and the fact that the survey was conducted in one healthcare system limit the generalizability of these findings.
Chau J, Delate T, Ota T, Bhardwaja B. Patient perspectives on switching from infliximab to infliximab-dyyb in patients with rheumatologic diseases in the United States [published online March 15, 2019]. ACR Open Rheumatology.