Knowledge, perceptions, attitude, barriers and facilitators of biosimilars use across specialty physicians and hospital pharmacists: A national survey.

Objective: To analyze knowledge, perceptions, attitude, barriers and facilitators of biosimilars uptake across physicians managing immune diseases and hospital pharmacists.

Method: Two structured and closed anonymous online surveys were designed and sent to 41 physicians (rheumatologists, dermatologists, gastroenterologists) and 32 hospital pharmacists.  Sociodemographic and clinical practice related variables were collected. We also gathered information about biosimilars knowledge and importance,  access, attitude in clinical practice and perceptions, barriers and facilitators to biosimilars uptake. A descriptive analysis was performed.

Results: Surveys response rate was 100% (hospital pharmacists) and 96% (physicians). We found certain lack of biosimilars knowledge  about key aspects including switching, extrapolation, interchangeability or  substitution. There was a great variability in the types and brands of  biosimilars depending on the hospital. We observed several organization  preferences, policies, and practices regarding biosimilars. General  perception and attitude to biosimilars was positive. If used, biosimilars  were predominantly prescribed in biologic treatment-naive patients (this  indication was considered adequate and participants felt comfortable with  it). Reluctance to switch in clinical practice was common. The main  barriers to biosimilars uptake were the lack of confidence and knowledge.  The main facilitators were the development of recommendations from  professional associations and societies and the demonstration of  interchangeability efficacy. We gathered concerns about biosimilar long  term efficacy and safety, lack of real-life data, lack of biosimilars  traceability or the risk of biologic reference medicines stock shortages.

Conclusions: Biosimilar education and more evidence filling current gaps  might help increase prescriber knowledge, comfort and use of biosimilars.