Survey of Clinicians: Lower Cost of Biosimilars Is the Main Driver of Treatment Choice in IBD

Researchers surveyed clinicians from 63 countries to better understand whether biosimilars have improved access to biologic treatment in inflammatory bowel disease (IBD). They found that adalimumab and infliximab biosimilars are available in most cases, and the lower cost of biosimilars was the main driver of treatment choice.

Crohn disease (CD) and ulcerative colitis (UC), collectively referred to as IBD, are inflammatory diseases of the digestive tract. Biologic therapies have “revolutionized the management of IBD patients by reducing the rate of negative outcomes,” the authors said. Infliximab and adalimumab, both monoclonal antibodies targeting tumor necrosis factor (TNF)-α, were the earliest biologic therapies indicated for patients with IBD unresponsive to conventional treatment.

The authors aimed to better understand the impact of biosimilar availability on patient care with their international survey that included questions on availability, cost, and recommendations for biosimilars. A total of 233 physicians from 63 countries, most of whom (86%) had more than 10 years of practice, participated in the survey. The most frequently represented countries were Italy (17%), Brazil (6%), Belgium (3%), Egypt (3%), France (3%), and Spain (3%). Most survey respondents were gastroenterologists (88%).

Almost all respondents (95%) reported that biosimilars were available in their clinical practice, 87% had access to both infliximab and adalimumab biosimilars, and at least two-thirds reported that more than 1 biosimilar of adalimumab (77%) or infliximab (67%) was available. Of the 5% who did not have access to biosimilars, most (83%) reported that their center did not purchase them, and smaller numbers reported that there was no difference in cost compared to the reference product (8%) or that they lacked confidence in the effectiveness of biosimilars (8%).

Regarding choosing 1 biosimilar over the other, the main criteria reported by respondents was availability (14%), followed by cost (13%), device characteristics (8%), hospital indications (7%), and insurance recommendations (4%).

The cost of adalimumab and infliximab biosimilars were reported to be approximately 30% less than their reference products. However, only a few physicians reported that savings from the use of biosimilars allowed them to improve patient care (1%) or improve research (1%). Just over half of respondents (52%) reported that the cost of biologics was a limitation for patient access. Forty-two percent of respondents said that the availability of biosimilars did not influence their treatment decisions in CD, and 50% said the same for UC.

The authors concluded the lower cost of infliximab and adalimumab biosimilars compared to originators was the main driver of treatment choice in IBD. They added that future research could address the effects of ustekinumab and vedolizumab biosimilars on patient access.

Reference

D'Amico F, Peyrin-Biroulet L, Danese S. Benefits of biosimilars in the management of patients with inflammatory bowel disease: an international survey. J Clin Med. 2024;13(11):3069. doi:10.3390/jcm13113069