Rheumatic disease patients express dissatisfaction following the mandatory switch to biosimilars.
A study published in ACR Open Rheumatology found that patient satisfaction rates with a forced nationwide switch in New Zealand from reference adalimumab (Humira) to a biosimilar were low. The study discovered that the availability of care supplies, the caliber of patient support programs, biosimilar device training, and assistance and knowledge from patient support groups all had an effect on satisfaction.
An estimated 3000 rheumatologist patients on reference adalimumab began a required switch to a biosimilar from March to September of 2022. The mandated changeover was implemented with the intention of saving costs and enhancing access for more patients.
“Knowing how patients feel about the switch to adalimumab is especially crucial because the biologic is self-administered at home,” the authors said.
To find out how satisfied patients with rheumatic conditions were, they used a survey. Twenty respondents were disqualified from the poll because they completed less than half of it out of a total of 137 respondents. In the end, 117 people with rheumatic disorders provided responses.
The majority of responders (68%) were female and between the ages of 51 and 60 (33%). Rheumatoid arthritis was diagnosed in nearly half (48%) of the cases. Prior to the modification, 35 percent of respondents had used the reference product for two to four years.
85% of people were continued using the biosimilar after the transition period. Of those who had stopped using the biosimilar, 12% were on a completely other medication and 88% had switched back to the original. 75% of patients stopped using the biosimilar due to a lack of illness control or efficacy, and 25% did so due to safety concerns about potential drug interactions and additional adverse effects.
The possibilities for the satisfaction response were 0 (not at all satisfied) to 10 (very satisfied). The transition was deemed satisfactory overall with a mean (SD) of 6.2 (3.2).
The following categories had the lowest mean satisfaction scores:
Organizations that assist patients: 3.4 (3.5)
Data gathered from patient advocacy groups: 3.5 (3.2)
Biosimilar device training: 4.9 (3.8)
Areas that received the highest mean satisfaction scores were
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.”
Following the changeover, the respondents expressed dissatisfaction with the manufacturer’s patient support program and the availability of supplies like alcohol wipes and sharps bins. Before and after the shift, there was no discernible difference in how satisfied people were with getting authorization and prescriptions.
Over 50% of the participants reported that the biosimilar caused less pain during injections and that the device was user-friendly. They added that both the originator and the biosimilar managed their illness. Some participants did, however, feel that the biosimilar was less successful in managing their joint pain and flare-ups of arthritis.
Certain patients reported that they were fully informed about the change, while others only learned about it when they picked up their prescription.
The following were some of the participants’ top suggestions for upcoming adjustments:
Prior to the change, improve communication
Give more details, including the cause of the change, the price, and the materials used.
Offer a similar patient assistance program.
Permit patients to continue taking the original medication if their illness is under control.
Make sure there are options to switch back.
A primary constraint of the research was the potential for selection bias and the inclusion of fewer than 5% of patients with rheumatic diseases affected by the modification. The study’s design also required participants to recall prior encounters. Lastly, because the adalimumab biosimilar is taken at home, it’s possible that the survey’s findings cannot be applied to drugs taken at different healthcare facilities.
The authors came to the conclusion that, in the end, patient experiences ought to come first when implementing biosimilar transitions.
