September 30, 2019 – Barcelona, Spain – The Alliance for Safe Biologic Medicines (ASBM) this week shared preliminary findings from a survey of 575 biologic prescribers in six Western European countries, covering several key policy issues including biosimilar substitution practices, adverse event reporting, and government tendering criteria. Since 2010, the group has routinely surveyed physicians in 13 countries to gather empirical data that can serve as a guide to policymakers on how to increase physician confidence in biosimilars.

The results were presented in a poster and discussion session at the 2019 Congress of the European Society of Medical Oncology (ESMO 2019). Survey respondents were drawn in equal proportion from France, Germany, Italy, Spain, Switzerland, and the United Kingdom. They came from 10 practice areas: Dermatology, Endocrinology, Gastroenterology, Hematology Oncology, Immunology, Nephrology, Neurology, Oncology, Ophthalmology, and Rheumatology. The survey is a follow-up to the group’s 2013 survey of 479 European prescribers.
One policy issue examined in the survey is physician control over biologic treatment decisions, including automatic  substitution and non-medical-switching. As governments worldwide seek to control health costs, use of lower cost biosimilars can be an effective tool. Yet unlike generics, biosimilars are not identical copies of the originator product. For this reason, automatic substitution of biologics is rare, and indeed banned in the majority of European Union countries.
“With 13 years of experience prescribing biosimilars, Europe’s physicians have become most knowledgeable and familiar with biosimilars in the world,” said Michael Reilly, executive director of ASBM and poster co-author. While 76% of physicians considered themselves familiar with biosimilars in the 2013 survey, that figure has risen to 90% in 2019.

Mr. Reilly presented the poster at ESMO with fellow co-author Andrew Spiegel, executive director of the Global Colon Cancer Association. “Countries looking to duplicate Europe’s success with biosimilars may look to these results for guidance. Note that the importance of maintaining physician and patient control of treatment decisions – including the decision to switch a stable patient to a biosimilar – has also increased since they were last surveyed six years ago,” said Mr. Reilly.

A strong majority of respondents (82%) considered it “Very Important” or “Critical” to decide which biologic medicine is dispensed to their patients, an increase from 72% in the 2013 survey. In addition, 84% consider the authority to prevent a substitution either “Very Important” or “Critical”, an increase from 74% in the 2013 survey.

While 84% of physicians were comfortable prescribing biosimilars to new patients, the comfort level drops to 60% when switching stable patients to a biosimilar. 58% of physicians were uncomfortable switching patients to a biosimilar for economic rather than health reasons. If the decision to do so were made by a third party, 73% would be uncomfortable.

The ability to choose between several different medicines was also highly important to prescribers: With regard to the awarding of government tenders, a majority of respondents (63%) feel that it is either “Very Important” or “Critical” that tenders to be awarded to multiple suppliers. 83% feel that it is either “Very Important” or “Critical” for national tender offers to consider factors besides price.

“While comfortable with prescribing biosimilars, Europe’s physicians want to have multiple options to choose from, so they can make the best medical decision for their patients – whether that’s the originator product, or one of its biosimilars,” emphasized Mr. Spiegel.
ASBM will be sharing the full results of the survey in a series of meetings with regulators throughout Europe this fall. This will include sharing country-specific data with several national health ministries, as was done with ASBM’s 2013 survey.

View the ESMO poster here.