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Switching to a Biosimilar

A mandatory nationwide transition from reference adalimumab to a biosimilar was implemented in New Zealand, and patient satisfaction was low, according to the study “Rheumatology Patients’ Experiences of a Mandatory Nationwide Transition to an Adalimumab Biosimilar” (11/23/2023;  American College of Rheumatology Journal).

The research indicates that satisfaction was impacted by provision of care supplies, quality of patient support programs, training on the biosimilar device, and support and information from patient support organizations – arguably, solvable problems.

From March to September 2022, some 3,000 rheumatology patients receiving reference adalimumab (Humira) initiated a mandatory transition to a biosimilar. The objective of the mandatory switch was to save money and improve access for additional patients.

A survey with 137 participants responding was made up mostly of women (68%) between the ages of 51 and 60 years (33%). Nearly half (48%) had a diagnosis of rheumatoid arthritis. Thirty-five percent had 2 to 4 years of experience with the reference product before the change.

Following the transition period, 85% were still taking the biosimilar. Of those no longer taking the biosimilar, 88% had changed back to the original medication and 12% were taking an entirely new treatment. Reasons for discontinuing use of the biosimilar included loss of disease control/efficacy (75%) and safety concerns, such as possible drug reactions and new side effects (25%).

Areas that received the lowest mean satisfaction scores included–

  • Support from patient support organizations
  • Information from patient support organizations
  • Training for biosimilar device

Areas that received the highest mean satisfaction scores  included–

  • Supply of the biosimilar
  • Support from pharmacists
  • Information before the change occurred

The authors noted the high satisfaction with communication from pharmacists, highlighting that pharmacists seemed to take on additional educational responsibilities and “were a major source of information for patients during the brand change.”

After the transition, respondents indicated that they were less satisfied with the provision of supplies such as sharps bins and alcohol wipes, as well as the patient support program provided by the manufacturer. There was no significant difference in satisfaction with obtaining prescriptions and authorization before and after the transition.

More than half of participants mentioned that there was less injection pain with the biosimilar and that the device was easy to use. In addition, they said the biosimilar controlled their disease as well as the originator. Some participants did perceive the biosimilar was less effective at controlling their arthritis flares and joint pain.

The study put forth five recommendations–

  1. Improve communication before the change
  2. Provide more information, such as reason for the change, cost, and supplies provided
  3. Provide a comparable patient support program
  4. Allow for patients to stay on the originator if their disease is well controlled
  5. Ensure options to change back.