AB0471 Biosimilar medicine is acceptable to patients if recommended by a rheumatologist in an australian tertiary ra cohort
Authors: T. Kovitwanichkanont, D. Wang, S. Raghunath, L. Kyi, N. Walpola, S. Pignataro, S. Morton, E. Morand, M. Leech
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Advancement in biological disease-modifying antirheumatic drugs (bDMARDs) has greatly improved the prognosis of patients with rheumatoid arthritis. Their high costs, however, pose a significant health-economic challenge. Biosimilars are being adopted in Australia and worldwide to improve affordability and access to treatment. While the predominant focus of current literature has been on physicians' awareness and confidence of biosimilars, an effective introduction of biosimilars requires an understanding of patient acceptance of these products. <h3>Objectives</h3> To investigate patient awareness and attitudes to biosimilar medicine in a tertiary hospital RA clinic. <h3>Methods</h3> A cross-sectional study of 127 patients with rheumatoid arthritis was performed in Melbourne, Australia. A brief education on biosimilars was provided. Patients rated concerns regarding biosimilar efficacy, side-effect profile, operation of the medication, and general attitude towards the new medication on a ten-point scale. <h3>Results</h3> 45.2% of our cohort have received biological DMARDs. Although only 5.6% have some knowledge of biosimilars, 75.4% would accept biosimilars if their rheumatologist recommends it, with only 5.6% refusing to switch. 19% of patients were unsure. Of those refusing biosimilars, the main concerns related to efficacy and general concerns about change. In our RA cohort, 61.9% took generic medicines regularly and 84.6% of these they would also be comfortable taking biosimilars. In those refusing generic medicines (27%), 61.8% would be still comfortable taking biosimilars. 15.9% and 12.7% of patients had great concerns about the efficacy and safety profile of biosimilars, respectively. 26.2% were significantly worried that their physician may be unaware if they were receiving the biosimilar or reference product. <h3>Conclusions</h3> Despite being unfamiliar with biosimilars, most patients in our cohort would be comfortable taking biosimilars if recommended by their rheumatologist, highlighting the role of trust in doctor-patient relationships. Of patients usually refusing generic medicines, nearly two-thirds would still accept biosimilars. Almost a quarter of the patients were unsure about the use of biosimilars and many patients indicated that they would like more information regarding these products. This patient group offered the opportunities to improve the uptake rate of biosimilars by allaying their concerns through information-education strategies. The current legislation in Australia allows pharmacists to substitute biological DMARDs in consultation with the patient without informing the prescriber. This concerns nearly all (89%) prescribers in Australia. The majority of patients in our study were not concerned, whilst approximately one quarter were worried about unrecognised switching. A successful introduction of biological DMARDs is likely to improve patient access to effective biological therapy and to ensure sustainability of the healthcare budgets. <h3>Reference</h3> [1] Reilly M, Murby S. A survey of Australian prescribers' views on the naming and substitution of biologicals. Generics and Biosimilars Initiative Journal 2017;6(3):107–13. <h3>Disclosure of Interest</h3> None declared