UK Patients Report Negative Experiences With Switches to Biosimilars

Last month, UK group The Patients Association released results of a survey and focus group that sought to understand patient needs in switching to biosimilars from reference products.

In September 2018, the association surveyed 262 patients, 208 of whom were taking a biologic drug. (Notably, the survey took place prior to the launch of biosimilar adalimumab products in the United Kingdom.) The online survey contained 17 questions and was distributed to the group’s social media channels and weekly email newsletter. The group also held a 7-member focus group in Birmingham, United Kingdom, in order to understand patients’ views about whether they are receiving appropriate support during a switch to a biosimilar.

Among the survey respondents, 60.54% had rheumatoid arthritis, 10.73% had Crohn disease, 4.60% had ulcerative colitis, 4.60% had psoriatic arthritis, 0.77% had psoriasis, and 0.77% had ankylosing spondylitis. An additional 18.01% had other diseases. In total 69 people—27% of the total number of respondents—had already switched to a biosimilar.

While 63% of respondents who had switched to a biosimilar said that they had been consulted in some form prior to the transition, 37% said that they had not been consulted (despite the fact that National Health Service guidelines require the patient to be consulted about such a switch).

In total, 9 patients said that they had been given a verbal explanation of the switch, while another 9 patients reported having received both written and verbal explanations plus consultations with providers. Seven patients received a verbal explanation only, while 5 received both written and verbal explanations. Nine patients reported that they were not given any explanation of the switch. Furthermore, 49 patients (60%) said they had not been given any training or homecare support for the switch.

In free-response answers to a question asking what information would be helpful in the case of a switch, 101 patients indicated that they would like reassurance that changing to a biosimilar would not negatively affect their current health, or that if there was a change in disease activity, they could switch back to the originator product.

In the focus group, patients who had already been switched exhibited a high level of awareness of biosimilars. However, they “reported a very poor experience,” according to the association’s report. The respondents cited lack of information, lack of choice, multiple switches because of a lack of drug stock, fear about the biosimilar’s supply related to the United Kingdom’s withdrawal from the European Union, and not being monitored during administration of the new product.

“From the concerns raised and the suggestions about need for better information, shared decision making, and collaborative working between patients and clinicians, it would seem helpful to co-produce a set of tools to assist patients in the journey they describe,” wrote the report’s authors. “The aim would be to better inform and empower patients to take control of their situation and be more equal partners in their treatment plan and choice of medication.”