Study Highlights Ongoing Need for Biosimilar Education Among Physicians, Pharmacists

Mohammed AL Qahtani, MSc, PhD

Credit: LinkedIn

A US-based online survey revealed varied attitudes among healthcare providers and pharmacists towards biosimilars, emphasizing the need for better organization in biosimilar guidelines, according to a study published in Innovations in Pharmacy.¹

Particularly, results highlighted the ongoing need for education on biosimilar manufacturing pathways among pharmacists and providers, which helps standardize legislation and supports the continued use of biosimilars.

The introduction of interchangeable biosimilars created an opportunity to increase patient access while the cutting costs associated with biologics. Despite this, many clinicians have voiced their hesitancy on prescribing or switching their patients to biosimilars, citing concerns about immunogenicity and efficacy.²

“Understanding the interchangeability process could improve the adoption of biosimilars,” wrote a team of investigators led by Mohammed AL Qahtani, MSc, PhD, associated with the Security Forces Hospital-Dammam in Saudi Arabia. “Previous studies on health professionals’ beliefs have examined their attitudes toward improving vaccination coverage among other topics. However, no prior study has utilized the theory of planned behavior (TPB) to comprehensively investigate healthcare beliefs and attitudes.”

To better understand the factors influencing US healthcare professionals’ prescription of biosimilars, as well as analyze any correlation between sociodemographic variables and intentions, investigators created 2 surveys (1 for providers and 1 for pharmacists) which were distributed in 4 counties in southern Florida.

The TPB was used to recognize which factors affected participants’ intentions. The approach encompasses 4 domains: behavior beliefs, normative beliefs, control beliefs, and intention. These variables were assessed using a 5-point Likert scale with 1 defined as “strongly disagree” and 5 as “strongly agree.” A logistic regression model evaluated the TPB constructs as intention predictors.

A total of 510 participants (279 providers and 231 pharmacists) responded to the survey. In the physician cohort, most were aged ≥ 61 years, 71% were male, and 46.2% were White. Most clinicians worked in the private sector (76.3%) and 17.9% worked in internal medicine.

Among clinicians, 142 providers had high intentions to prescribe or switch to a biosimilar and 137 exhibited low intentions. Attending physicians demonstrated the most consistent perceptions towards biosimilars, particularly for those in the private sector (76.3%). Awareness of the safety and efficacy of biosimilars was most highly correlated with the intentions variable (r = .471, P <.001; r = .511, P <.001).

The pharmacist cohort was predominantly female, most were aged between 31-41 years, and most were community pharmacists. A larger percentage of female pharmacists reported higher intentions to use biosimilars when compared with males (35.5% vs 28.1%). The associations between intentions and years of practice were deemed significant. Positive correlations were observed between beliefs and intentions, with the exception of normative beliefs.

Similar to providers, pharmacists who were aware of the safety and efficacy of biosimilars and understood there is no clinically meaningful difference between the reference product and the biosimilar were more likely to prescribe a biosimilar (r = .591, P <.001; r = .559, P <.001).

Investigators noted the small sample size as a limitation of the study. Additionally, generalizability was hindered as the survey only focused on 4 counties in South Florida.

“Educating healthcare professionals, especially across different specialties, is needed to understand the regulatory situation for biosimilars, which is essential for advocating policies that ensure efficient biosimilar approval and appropriate utilization,” investigators concluded. “Furthermore, future research should explore attitudes among nurses, physician’s assistants, physicians, pharmacists from other countries or US states, and patients for comprehensive insights.”

References

1. ^{Qahtani MA, Al-Jedai A, Wertheimer A. Factors that Influence Healthcare Professionals' Intentions towards Biosimilars. Innov Pharm. 2024;15(1):10.24926/iip.v15i1.5922. Published 2024 Mar 18. doi:10.24926/iip.v15i1.5922}
2. ^{Beck, M., Michel, B., Rybarczyk-Vigouret, M. C., Levêque, D., Sordet, C., Sibilia, J., & Velten, M. (2016). Rheumatologists’perceptions of biosimilar medicines prescription: Findings from a French web-based survey. Biodrugs, 30(6), 585–592. 10.1007/s40259-016-0202-5}