OP0070-HPR Is patients’ satisfaction with being switched to a biosimilar medication associated with their level of health literacy? results from a norwegian user survey
Authors: M. Cvancarova Småstuen, M. Brandvold, R. Andenæs
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Economically motivated switching to biosimilar medication has been practiced in Norway since March 2016. There are several studies comparing the efficacy, safety and immunogenicity of biosimilars, however no studies have yet described patients' experiences and attitudes towards economically motivated switching. <h3>Objectives</h3> The aim of this study was to describe patients' experiences regarding being switched to an alternative medication (the switch) and further to investigate possible associations between such switching and health literacy. <h3>Methods</h3> Potential users of Etanercept or Infliximab were asked to participate using three patients' interest associations. Data from this convenience sample was collected using a web-survey in January 2017. Attitudes and experiences with a possible switch to an alternative medications were assessed using several questionnaires. In addition, data on gender, age and marital status were collected. Patients' experiences, attitudes and satisfaction were assessed using a self-developed questionnaire. In addition, health related literacy was measured using The Health Literacy Questionnaire<sup><sup>1</sup></sup> a multi-dimensional validated questionnaire. We used three domains covering patients' ability to actively engage with health care providers (Scale 6), ability find good health information (Scale 8) and understanding health information well enough to know what to do (Scale 9). Data were analysed using multiple logistic regression and the results expressed as odds for being satisfied with the switch. <h3>Results</h3> Of all included responders (n=290), 155 reported being switched to a biosimiar medication in 2016. Median age was 51 years, range 20–74. The majority of responders were females, 61% (n=176) and more than half (51%) completed higher education. Over 80% of those who were switched (economically motivated switch to a biosimilar drug) were neutral or satisfied with their new medication. Patients who were dissatisfied with being switched had lower levels of health related literacy compared to patients who were satisfied. Further, older patients reported more often being satisfied compared to younger patients. Only 14% reported that they were involved when a decision to being switched was made, male patients significantly more often compared to female patients (p=0.02). Self-assessed good health was strongly associated with higher probability of being satisfied with the switch, only 9/74 patients who reported bad health also reported being satisfied. When adjusted for age and self-assessment of one's own health, scales 6 and 8 but not scale 9, were significantly associated with higher odds for being satisfied with being switched (OR=2.5, 95% CI: [1.2 to 5.2] and OR=2.7, 95% CI: [1.2 to 5.9], for scale 6 and 8, respectively). <h3>Conclusions</h3> A great majority of patients reported being satisfied with being switched to a cheaper biosimilar medication, however, almost one in five (19%) reported being dissatisfied. Our findings suggest that patients' attitudes and level of satisfaction are associated with being given sufficient and necessary information concerning their health. <h3>Acknowledgements</h3> We would like to thank Pfizer for providing us with unrestricted grant to finantially support this project. <h3>Disclosure of Interest</h3> M. Cvancarova Småstuen Grant/research support from: Grant from Pfizer, M. Brandvold: None declared, R. Andenæs: None declared