At present, a large number of oncological biosimilars are under development or close to approval. However, very little is known about the prescribing practices of clinically active oncologists with regard to biosimilars. What do physicians need to know to be able to safely use these new drugs in the future?
Between January and May 2018, a total of 77 clinically active oncologists were interviewed on this important topic using a questionnaire. The main objective was to provide answers in three different core areas of biosimilar prescription: 1) state of knowledge on oncological biosimilars, 2) prescription preferences and 3) involvement of patients in therapy decisions.
When asked what a biosimilar actually is, 74% of the physicians had to pass. In many cases, the participants knew how to classify the term, but could not formulate a satisfactory and comprehensive definition. In 40.3% of the cases, biosimilars were even mistakenly equated with generic preparations.
From the point of view of clinical oncologists, the most important argument for prescribing a biosimilar was a good relationship between risk and efficacy. In addition, lower costs and, associated with this, higher cost-effectiveness seem to be decisive criteria for the use of a biosimilar. Also of interest to notice, as far as a biosimilar was considered arbitrarily interchangeable, the willingness of physicians to use it in the future also increased.
The oncologists participating in this study were clearly divided on the question of patient participation in the choice of therapy. On the one hand, about 51% voted for an important to a very important role of the patient's will in deciding for or against treatment with biosimilars.
On the other hand, 39% of physicians also stated that the patient's will in the sense of a joint therapy decision would play only a minor or no role. The oncologists were also divided with regard to pharmacists and their influence on the therapy decision for or against a biosimilar in the oncological clinical setting.
The study showed quite impressively (on a relatively small sample) that many physicians still lack the basic knowledge to make really well-founded therapy decisions in favor of their patients in the near future, especially with regard to biosimilars in oncology.
There is a great need for information, in particular on the decision-making bases that are important for everyday oncological practice, such as the safety and efficacy of biosimilars, but also on their cost-effectiveness.
Source:
Cook JW et al., Ther Adv Med Oncol 2019; 11: 1-12. doi:10.1177/1758835918818335