Academic oncology clinicians’ understanding of biosimilars and information needed before prescribing

• Type of Material: Article
• Authors: John W. Cook, Emory University; Megan K. McGrath, Emory University; Margie D. Dixon, Emory University; Jeffrey M. Switchenko, Emory University; R Donald Harvey, Emory University; Rebecca Pentz, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: SAGE Publications (UK and US): Open Access Titles
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s), 2019.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/1758835918818335
• Title of Journal or Parent Work: Therapeutic Advances in Medical Oncology
• ISSN: 1758-8340
• Volume: 11
• Start Page: 1758835918818335
• End Page: 1758835918818335
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI and the Winship Cancer Institute/Davidson College Impact Fellowship under award number P30CA138292.; This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
• Keywords: lung cancer; colorectal cancer; colon cancer; biosimilar; monoclonal antibody; breast cancer
• Research Categories: Health Sciences, Oncology

Abstract

Background: With increasing numbers of oncology biosimilars in the approval pipeline, it is important to investigate oncology clinicians’ understanding of biosimilars and what information they need prior to adoption. Methods: Between January and May 2018, 77 oncology clinicians (52 physicians, 16 pharmacists, and 9 advanced practice providers) completed a survey covering three domains: clinician understanding, prescription preferences, and patient involvement. An in-depth interview was designed based on themes identified in the first 50 surveys: cost, safety and efficacy, patient preference, and disease stage. Participants were chosen to participate in the interview based on outlying responses to survey questions. Results: When asked to define a biosimilar, 74% (57/77) of respondents could not give a satisfactory definition, and 40.3% (31/77) considered a biosimilar the same as a generic drug. The most important factor in biosimilar prescription was safety and efficacy (4.51 out of 5) followed closely by cost differences (4.34 out of 5). A 40% increase (53.2–94.8%) in clinicians’ prescribing likelihood was seen after a biosimilar is designated as interchangeable. Participants in this study were split regarding the importance of shared decision-making with patients [50.7% (39/77) important or extremely important, 39.0% (30/77) somewhat or not at all important]. Clinicians were also split concerning the role that pharmacists should play in the decision to prescribe or substitute biosimilars. Conclusion: Understanding of biosimilars is low, and educational needs are high. The information that clinicians deem important to assess, such as safety, efficacy and cost, will need to be provided before they are comfortable prescribing biosimilars.