The Alliance for Safe Biologic Medicines conducts regular surveys to better understand physicians’ perspectives on originator biologics and biosimilars. The organization recently released its 2017 Canadian Prescriber Survey. The survey reveals Canadian physicians’ attitudes on a number of critical policy issues surrounding the approval and use of originator biologics and biosimilars.


83 per cent of Canadian doctors considered it “very important” or “critical” that the prescribing physician decide the most suitable biologic for their patients, according to the survey of 403 Canadian prescribers of biologics.


Canadian doctors also believe that biologics and biosimilars should have distinct names. Of physicians surveyed, 68 percent were in favor of Health Canada granting distinct nonproprietary names for biologics and biosimilars.


These results come at a time when policy discussions about these medicines are taking place, and could have clinical implications for years to come.


As the name implies, biosimilars are similar but not identical to originator biologics. These important medications treat a variety of complex diseases, like rheumatoid arthritis, Crohn’s disease, diabetes, psoriasis and others.


We caught up with Michael Reilly, executive director of ASBM, to discuss the what the results revealed, and what they could mean for Canadian health care professionals and patients.


The Alliance for Safe Biologic Medicines (ASBM) recently published data from a study of Canadian physicians. What were the objectives of the survey?


Michael Reilly: This is a follow-up to the survey we first conducted in 2014 to gain a better understanding of Canadian physicians’ perspectives around biosimilars. The overall objectives were to capture these positions and share them with stakeholders, regulators and Health Canada.


One theme from the study was the topic of non-medical switching and substitution of innovator biologic medicines and biosimilars. What did you learn from the study, and why is this a topic of interest to Canadians?


Michael Reilly: Canadian physicians have serious concerns about the possible switching of a patient’s medicine for non-medical reasons, such as cost. They think it is bad policy, and more importantly, problematic for patients to be switched from one medication to another without physician involvement.


This is important for Canadians because the provinces are making decisions about whether or not automatic substitution occurs. We think it’s important for the provinces to understand that physicians are overwhelmingly opposed to automatic substitution for non-medical reasons.


What is the significance of these findings in the context of the Canadian health care landscape?

Michael Reilly: The findings make it clear that provinces should be cautious before they move to a system of automatic substitution. Canadian doctors have serious concerns about this, and patients ultimately want physicians involved in decision-making.

In fact, Health Canada recommends that a decision to switch a patient being treated with an innovator biologic drug to a biosimilar should be made by the treating physician in consultation with the patient and taking into account available clinical evidence. But ultimately, decisions around automatic substitution are up to the provinces.

What is ASBM’s position on the findings? What does ASBM hope will come out of this research?

Michael Reilly: We advise moving slowly in terms of an automatic substitution policy.

And we hope provincial governments will use this information and reach out to ASBM and others as they consider how to proceed. ASBM’s goal is to see forward-thinking, sustainable biosimilars policies that offer benefits for patients and physicians, balanced with lowering cost and providing access to treatments.


Another theme in the research was the naming of originator biologics and biosimilars. What did the data reveal and why is that important?

Michael Reilly: As we’ve seen with numerous surveys in other countries as well as the 2014 survey in Canada, the data revealed overwhelming support for distinguishable naming of biologics and biosimilars by the physician community. Canadian doctors believe that distinguishable, non-proprietary names are important to better ensure clear communication throughout the treatment process, and to improve tracking of safety and efficacy.


Why is this significant to Canadians? What does ASBM hope will come out of this research?


Michael Reilly: Health Canada and global leaders including the World Health Organization are trying to determine what naming policy should be implemented at the country level and globally. By better understanding the physicians’ perspectives on the need for distinguishable naming and the benefits from a pharmacovigilance standpoint, Health Canada can decide what the policy should look like.

Our position, which is informed by the physician data, is that Health Canada should take a leadership role, working with the WHO and FDA. Collectively, they have the credibility to move toward a unified solution to this global naming problem.