Uncertainty about biosimilars and lack of motivation among healthcare providers and patients to use them may have been curbing biosimilar use. Guidance on how to implement biosimilars in clinical practice and how to incentivize stakeholders to use biosimilars may help to realize the benefits offered by biosimilars for healthcare systems and patients.
A study by Barbier et al. aimed to propose actionable recommendations that can facilitate the use of biosimilars both on a clinical and practical level. The authors report results based on the insights from 44 expert interviews with healthcare professionals (physicians, hospital pharmacists, nurses), patient(s) (representatives) and regulators across Europe .
The study outlines the considerations of various stakeholders on how to implement biosimilar switching and design incentives to stimulate biosimilar use and translates them into practical, overarching and strategic recommendations.
Initially, there was strong desire for the adoption of a structured and collaborative approach to implement a switch. Detailed proposals are given in the paper on how this can be approached and communicated to the patient. To further increase trust in the use of biosimilars in clinical practice, it was deemed valuable to disseminate evidence from and experience with (multiple) switching to healthcare providers and provide them with clear, one-voice regulatory guidance about the interchangeability of biosimilars and their reference products. Further, it was believed important to apply a pragmatic approach when taking switch decisions; and to avoid mandated switching. Allowing stakeholder communication and alignment when implementing biosimilars was deemed to be an essential factor of a successful implementation strategy.
Several approaches to improve stakeholder motivation to use biosimilars emerged from the interviews. Generally, incentives to offset the effort of healthcare professionals associated with a switch were believed necessary. Incentive schemes should be tailored to the level of effort required and could involve a combination of non-financial and financial incentives. Non-financial incentives include, for example, transparent reporting about biosimilar-related savings and their allocation. In terms of tangible incentives, gainsharing agreements emerged as the preferred way to reward stakeholders, as savings could partially serve to optimize local clinical care.
The results and recommendations outlined in this study may support healthcare professionals and policymakers when planning to improve the use of biosimilars in healthcare systems.
Conflict of interest
Several of the authors of the research paper  reported conflict of interest, including being involved in consulting, advisory work and speaking engagements, stakeholder roundtables, participating in advisory board meetings and contributing to studies on biologicals and biosimilars for pharmaceutical companies.
For full details of the authors’ conflict of interest, see the research paper .
Abstracted by Liese Barbier, PhD Researcher, Regulatory Evaluation and Market Access Biosimilars, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium.
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Sustainable biosimilar policies in Europe
International policies for interchangeability, switching and substitution of biosimilars
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1. Barbier L, Simoens S, Vulto AG, et al. European stakeholder learnings regarding biosimilars: Part II—improving biosimilar use in clinical practice. BioDrugs 2020;34(6):797-808.
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