Also familiar with biosimilar medicines (62%). Have confidence prescribing biosimilar medicines (49%). biosimilar medicines (37%). 5.3.2 Familiarity with biosimilar medicines As with biologics, familiarity with biosimilars was highest among specialists and lowest among GPs. Two in three specialists (66%) were familiar with biosimilar medicines (either ‘very familiar’ or ‘familiar’), compared with 57% of pharmacists and 25% of GPs. Familiarity with biosimilar medicines was lower than for biologic medicines for specialists and GPs, but the reverse was true for pharmacists (however this difference was not statistically significant). Figure 17: Familiarity with biosimilar medicines Q2. How familiar are you with biosimilar medicines? The figure below provides details of statistically significant sub-group differences. Figure 18: Familiarity with biosimilar medicines – sub group differences Specialists General Practitioners Community pharmacists Specialists 'very familiar' or 'familiar' with biosimilar medicines (66%) were more likely to : Have prescribed biosimilar medicines (81%) Were confident prescribing biosimilar medicines (79%) Were confident switching a patient from a reference biologic to a biosimilar medicine (74%). GP's more likely to be 'very familiar' or 'familiar' with biosimilar medicines (25%) were more likely to: Also be familiar with biologic medicines (61%) Have prescribed biologic medicines (41%) Have confidence prescribing biosimilar medicines (41%) Were confident switching (36%). Pharmacists 'very familiar' or 'familiar' with biosimilar medicines (57%) were more likely to: Also be familiar with biologic medicines (92%) Have dispensed biosimilar medicines (85%). Figure 19: Familiarity with biologic and biosimilar medicines - comparison Q1. How familiar are you with biologic medicines? Q2. How familiar are you with biosimilar medicines?
most likely to mention ‘concern over the delay of biosimilar medicines due to legal/international patent issues’ (38%, compared to 25% of specialists and 17% of pharmacists). Pharmacists felt the biggest barriers were price related overall (69%), and specifically the ‘absence of incentives for patients to use biosimilar medicines’ (61%), as well as patient outcomes overall (although pharmacists were less likely to mention this than other stakeholders), with half mentioning ‘concern about adverse outcomes for my patients’ (50% compared with 61% of specialists and 64% of GPs). Table 6: Potential barriers to prescribing/dispensing biosimilar medicines Specialists (n=128) % General practitioners (n=56) % Community pharmacists (n=64) % Patient outcomes – total 94 89 69 Concern with the availability / transparency of the evidence used to support indication extrapolation 71 63 31 Concern about adverse outcomes for my patients 61 64 50 Immunogenicity concerns 57 34 22 Concern over the strength of pharmacovigilance activities 53 45 28 Information related - total 72 93 70 Insufficient information on biosimilar medicines for 59 89 50 Insufficient information on biosimilar medicines for patients (and for specialist survey - and stakeholders) 54 59 58 Price related - total 34 32 69 Absence of incentives for patients to use biosimilar medicines 25 16 61 Absence of incentives for physicians to prescribe biosimilar medicines 23 27 17 Absence of incentives for pharmacists to dispense biosimilar medicines - - 33 Other - total 44 43 38 I don’t see the need to change what I prescribe/dispense 33 18 13 Concern over the delay of biosimilar medicines due to legal / international patent issues 17 38 25
proportion of pharmacists) expected benefits regarding industry outcomes; compared with only 20% of specialists. Almost all pharmacists mentioned price related benefits overall (98%), with greatest focus on ‘more affordable for the PBS’ (80%). Seven in ten pharmacists also expected benefits in terms of pharmacy business (71%), in terms of ‘larger profit margins’ (62%) and ‘lower stock holding costs’ (52%). Table 7: Potential benefits to prescribing/dispensing biosimilar medicines Specialists (n=170) % General practitioners (n=71) % Community pharmacists (n=87) % Price related - total 99 86 98 Lower prices through competition 88 66 47 More affordable for the PBS 84 61 80 Save taxpayers money 84 55 59 More affordable for hospitals 74 51 43 More affordable for patients 58 59 61 Enables more medicines to be listed on the PBS 58 51 66 Patient outcomes - total 59 82 75 Broadens access for patients at an earlier stage of disease 39 45 39 Treatment choice 28 52 26 Mitigate against medicine shortages 26 28 52 Positive impact on patient outcome 14 44 30 Industry outcomes - total 20 37 34 Advances in medicine technology 16 31 32 Improved manufacturing processes 8 18 11 Pharmacy business outcomes - total - - 71 Larger profit margin for pharmacies - - 62 Lower stock holding costs for pharmacies - - 52
Other (please specify) - 1 - Average number of mentions 5.76 5.62 6.60 Q9. Do you think there are any potential benefits to you prescribing/dispensing biosimilar medicines? MULTIPLE RESPONSE The figure below provides details of statistically significant sub-group differences. Figure 27: Benefits to prescribing/dispensing biosimilar medicines – sub group differences Specialists General Practitioners Community pharmacists Rheumatologists were less likely than other specialists to mention potential benefits such as ‘more affordable for hospitals’ (58%), ‘more affordable for patients’ (31%), ‘enables more medicines to be listed on the PBS’ (42%) ‘mitigates against medicine shortages’ (11%). Specialists who were confident switching a patient to biosimilar medicines were more likely to mention: ‘More affordable for hospitals’ (81%) ‘More affordable for patients’ (68%) Benefits to patient outcomes overall (68%), particularly ‘mitigate against medicine shortages’ (37%), and ‘positive impact on patient outcomes’ (23%). Benefits related to industry outcomes overall (28%), specifically ‘improved manufacturing processes’ (13%). GPs confident switching a patient to biosimilar medicines were more likely to mention ‘save taxpayers money’ (68%). Pharmacists who had dispensed biosimilar medicines were more likely to mention ‘more affordable for patients’ (74%). Pharmacists who were familiar with biosimilar medicines were more likely to mention patient outcomes overall (83%), particularly ‘mitigate against medicine shortages’ (61%). They were also more likely to mention ‘larger profit margin for pharmacies’ (70%).
Key Findings Consumers About this chapter This chapter details the results for the consumers included in the research, namely: Patients Carers. The profile of consumers is detailed at Section 4.2. While the majority of those who completed the survey had heard of biosimilars, n=32 consumers had ‘never heard of biosimilars before’. In order to explore in detail different facets and nuances of understanding, attitudes and use of biologic and biosimilar medicines, the questionnaire covered the following, related, areas: Familiarity with biologic and biosimilars medicines; Prevalence of prescribing/dispensing biologic and biosimilar medicines; Sources of information about biosimilar medicines; Perceived benefits and barriers of biosimilar medicines; Perceived efficacy, comparability, intention to switch and associated confidence; and Understanding of the PBS. Familiarity with biologic and biosimilar medicines 6.2.1 Familiarity with biologic medicines All consumers were asked how familiar they were with biologic medicines. Less than a quarter of consumers (23%) were familiar with biologic medicines (either ‘very familiar’ or ‘familiar’), while half were ‘somewhat familiar’ (51%). Only two consumers mentioned that they had ‘never heard of them before’. Notably, carers reported higher levels of familiarity than patients (51% c.f. 33%). Figure 63: Familiarity with biologic medicines Q1. How familiar are you with biologic medicines? The figure below provides details of statistically significant sub-group differences. Figure 64: Familiarity with biologic medicines – sub group differences Consumers More likely to be familiar (so ‘very familiar’ or ‘familiar’ combined) Those from capital cities (28%) Those who have been on biological (52%) or biosimilar medicines before (49%) Consumers who were confident in taking biosimilar medicine (32%) or switching to a biosimilar medicine (28%).
Northern Territory 3 Queensland 4 South Australia 5 Tasmania 6 Victoria 7 Western Australia 8 Prefer not to answer 98 D3. Do you mainly work in a…? SR Metropolitan capital city 1 Outside of the capital city 2 Prefer not to answer 98 THANK & CLOSE That was the final question. Thank you for your time and assistance with this important survey which has been conducted by ORC International on behalf of the Australian Government Department of Health. As a reminder, please be assured that all the answers you have provided will be treated in the strictest of confidence and de-identified. This research is being conducted in keeping with the Australian Privacy Principles and the industry Privacy Code. Our privacy policy is available on our website (www.ORCInternational.com). Should you have any questions or require further information about the survey please contact Katherine Tran at ORC International via or 03 9935 5700. Quota Type Target Source Community Pharmacists 100 EKAS Sample
It would be appropriate to switch from the reference biologic to the biosimilar if [ I/the person I care for] was treatment stable 1 2 3 4 5 9 Biosimilar medicines will lead to a reduction in costs meaning the treatment is cost-effective for other patient groups, who could then access PBS subsidy for the medicine 1 2 3 4 5 9 Biosimilar medicines will lower the prices of medicines which will contribute to the sustainability of the PBS 1 2 3 4 5 9 I would accept a biosimilar medicine if recommended by my doctor 1 2 3 4 5 9 INTENTION TO SWITCH/USE/ACCEPT BIOSIMILAR MEDICINES Q15. A biosimilar medicine is a version of an already registered biologic medicine (the reference medicine) that is demonstrably similar in chemical and biologic characteristics, effectiveness and safety. The active substances of biologic medicines and their complexity as well as the way they are produced may result in a degree of variability, between brands as well as between batches within a brand of the medicine. Considering this, how confident do you feel about [taking/the person you care for taking] biosimilar medicines? SR Totally confident 1 Very confident 2 Confident enough to take biosimilar medicines 3 Little confidence 4 Not confident at all 5 Q16. Which of the following best describes generally how confident you are in switching from a reference biologic medicine to a biosimilar medicine if prescribed by your doctor? SR