THU0634 PHYSICIAN PERCEPTIONS OF BIOLOGICS VERSUS THEIR BIOSIMILAR COUNTERPARTS IN RHEUMATOLOGY: A MULTICOUNTRY STUDY IN EUROPE
Authors: Casey Zhang, Denise Baldock, Elizabeth Baynton
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Following LOE for the originator brand of etanercept in 2016 and the subsequent launch of its first biosimilar version, several other biosimilars have arrived in the rheumatoid arthritis treatment space. Due to their potential for reducing healthcare spend and their supposed equivalence, biosimilars are expected to be of rising relevance and impact in the following years. 12 biosimilar brands of biologic originator treatments are now available in Europe to treat rheumatoid arthritis; it will be crucial to understand physician perceptions of biosimilars relative to branded products and the impact such views have on potential prescribing decisions. <h3>Objectives:</h3> The objective of the study was to assess perceptions of efficacy and safety for biosimilars relative to branded biologic originator products among treating Rheumatologists in the EU5 countries (United Kingdom (UK), France (FR), Italy (IT), Spain (SP) and Germany (DE)). <h3>Methods:</h3> A cross-sectional survey was conducted in Q3 2018 in the EU5 among national, regional and hospital physicians who had been practicing between 3-30 years. Respondents completed a Physician Perceptual Questionnaire online, which assessed the overall perception of biologic brands and anti-TNF biosimilars, important attributes for treatments, and specific barriers to prescribing them. Data were analyzed using descriptive statistics. <h3>Results:</h3> A total of 261 rheumatologists in the EU5 were recruited as part of the study (with almost equal numbers of rheumatologists representing each EU5 country). Treating rheumatologists were practicing for an average of 17.4 years, mainly in teaching hospitals (50.2%) and urban hospitals (20.7%)<sup>1</sup>. Physicians consistently expressed greater satisfaction for branded products, with 73.9% (range: 63.5% DE to 90.6% FR) of physicians having rated satisfaction with the originator brand of etanercept as a 6 or 7 (on a 7-point scale where 7 corresponded to highest satisfaction), compared to only 37.5% for biosimilar etanercept (range: 28.6% IT to 51.9% DE)<sup>1</sup>. When asked about specific attributes related to RA treatments, 64.4% of our sampled rheumatologists associated the originator brand of rituximab with 'Inhibition of radiographic progression' (range: 55.1% IT to 81.1% FR) – versus 47.5% association for biosimilar rituximab (range: 32.7% IT to 62.3% FR)<sup>1</sup>. 73.2% of physicians associated the originator brand of infliximab with 'helps maintain or improve physical function' (range: 55.8% DE to 87.0% ES) compared to 58.6% of biosimilar infliximab (range: 44.9% IT to 67.9% FR)<sup>1</sup>. For 'reduction in morning stiffness', 78.5% of our rheumatologists associated it with originator etanercept (range: 65.4% DE to 88.7% FR) versus only 66.7% for biosimilar etanercept (range: 55.1% IT to 81.1% FR)<sup>1</sup>. <h3>Conclusion:</h3> Biosimilars score lower on overall satisfaction and are less frequently associated with specific efficacy attributes relative to branded products. This is possibly due to their relatively short time in clinical practice, and the resulting lack of experience and supporting data compared to the older branded equivalents. Proof of concept may be essential to close the perceptual gap that still exists between branded products and biosimilars. <h3>References:</h3> [1] Ipsos RA Therapy Monitor (261 sampled rheumatologists reporting on RA patients in EU5 in Q32018) <h3>Disclosure of Interests:</h3> None declared