Vivian Bykerk, MD: Switching Patients to Biosimilars

Vivian Bykerk, MD, associate attending rheumatologist at the Hospital for Special Surgery, associate professor of medicine at Weill Cornell Medical College, discusses switching patients to biosimilars.


How are your patients responding to the idea of switching to a biosimilar from a reference biologic?

So, I think a person who’s barely controlled…I wouldn’t switch them, because I don’t know what’s going to happen. A person who is incredibly well controlled, I suspect there will be no problem. A person who’s on methotrexate and well controlled, where I suspect methotrexate is doing half the work, again, I don’t have any concern.

But, there are people who can’t use methotrexate, who are sort of hovering at the low disease activity mark and sometimes flare, but mostly they’re doing quite well. I wouldn’t switch those people, I wouldn’t touch them. So, I think that everyone needs to have some consensus about where it’s okay, where it’s possible, and where you just don’t change anything.

I think that, at this point, I know the insurance companies and the pharmacy benefit managers believe they are making good decisions for our patients, but they need to include the patient’s rheumatologist in the decision.

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