Most Pediatric Gastroenterologists Comfortable With Prescribing Infliximab Biosimilar

Results of a cross-sectional survey indicated that 87% of gastroenterologists reported being comfortable prescribing an infliximab biosimilar and 69% were accepting of a one-time switch to the biosimilar for patients in clinical remission, according to a study published in Journal of Pediatric Gastroenterology and Nutrition.¹ Furthermore, respondents who practiced at an ImproveCareNow (ICN) center, which combines the perspectives of patients, clinicians, researchers, and parents to improve the health of children with Crohn’s disease and ulcerative colitis, as well as physicians who cared for a higher number of patients with inflammatory bowel disease (IBD), were more likely to be more comfortable with prescribing biosimilars.

Ross Maltz, MD

Credit: NationwideChildrens.org

“Biosimilars are biological agents that have been demonstrated to have similar safety and efficacy profiles as the originator,” wrote lead investigator Ross Maltz, MD, associated with the Department of Pediatrics at the Ohio State Wexner Medical Center, and colleagues. “The objective of this study was to evaluate the perspectives of pediatric gastroenterologists in the United States (US) toward biosimilar use and to explore factors that impact their comfort level with prescribing infliximab biosimilars.”

The survey was distributed to gastroenterologists living in the US using the Pediatric gastroenterology Bulletin Board listserv. Information such as the demographics of physicians were collected. The participant’s perceptions towards biosimilars, including switching from the biologic to the biosimilar and factors that impacted comfort levels, were assessed using a 6-point Likert scale. Fischer exact tests determined statistically significant differences in responses.

In total, 139 pediatric gastroenterologists participated in the survey. Of those who responded, most (87%) were comfortable prescribing an infliximab biosimilar to patients who were tumor necrosis factor (TNF)-naïve and 69% were fine with a one-time switch for patients experiencing clinical remission. Physicians who were currently managing less than 50 patients with IBD were less likely to be comfortable prescribing the biosimilar, as well as those who practiced at ICN.

These results mirror the recent Cardinal Health 2023 Biosimilars Report, which surveyed more than 350 specialty providers including gastroenterologists, rheumatologists, dermatologists, and ophthalmologists to analyze their perspectives on prescribing biosimilars to their patients.²

“The advent of biologic therapy (TNF inhibitors) has transformed the management of patients with IBD over the last 2 decades,” stated Vivek Kaul, MD, FACG, professor of medicine at the University of Rochester, in the report. “The introduction of biosimilars in this realm presents an opportunity to provide comparable products to patients at a lower cost.”

According to the Cardinal Health survey, all gastroenterologists were at least somewhat comfortable with prescribing biosimilars to their patients, with most (86%) stating that they were very comfortable. Participants noted that biosimilars were most commonly prescribed for new patients (36%) or for existing patients for whom payers have required a biosimilar (49%). However, Kaul stated that this may change as new biosimilar options become available.

In an interview with HCPLive, Bruce Feinberg, DO, Vice President and Chief Medical Officer at Cardinal Health, stated that different specialties, including gastroenterology, have different levels of comfortably regarding the adoption of biosimilars.³

“It seems that those levels are directly related to the amount of experience those physicians have had with the products that were available and the number of products available, not just the individual biosimilar but how many types of reference brands have biosimilars,” he explained.

Results demonstrated that physicians who have more experience with biosimilars and a greater variety of reference brands with biosimilars available tended to have higher levels of acceptance and adoption. The field of gastroenterology, which has had less exposure to biosimilars when compared with other specialties such as rheumatology and oncology, had lower adoption rates. However, the overwhelmingly positive perception of prescribing an infliximab biosimilar for pediatric patients, along with the increasing number of available biosimilars may bode well for the future of biosimilar uptake among this specialty group.

References

1. ^{Maltz RM, McClinchie MG, Boyle BM, et al. Biosimilars for Pediatric Patients With Inflammatory Bowel Disease: Pediatric Gastroenterology Clinical Practice Survey. J Pediatr Gastroenterol Nutr. 2023;76(5):616-621. doi:10.1097/MPG.0000000000003750}
2. ^{Cardinal Health. (2023, February 22). 2023 Biosimilars Report: Tracking market expansion and sustainability amidst a shifting industry. Retrieved April 24, 2023, from https://www.cardinalhealth.com/content/dam/corp/web/documents/Report/cardinal-health-biosimilars-report-2023.pdf}
3. ^{Pine, L. (2023, March 20). Bruce Feinberg, do: Differences among specialties in biosimilar uptake. HCP Live. Retrieved April 24, 2023, from https://www.hcplive.com/view/bruce-feinberg-do-differences-among-specialties-in-biosimilar-uptake}