Promoting Biosimilar Uptake Requires a Well-Brewed Approach

Metaphors of brewing beer and other concepts may help overcome some of the reluctance to prescribing biosimilars.

Would it be useful for advanced practitioners (APs) to compare the development of biosimilars to the making of a copycat beer? Yes, say investigators, if the purpose is to find context outside of medical jargon to convince patients that biosimilars are every bit as safe and efficacious as reference biologics.

In a report that suggests ways APs and clinical pharmacists in oncology can warm patients to accepting biosimilars, lead author and oncology/hematology AP at Ballad Health Cancer Care in Bristol, Tennessee, Kelley D. Mayden, DNP, APRN-FNP, AOCNP, and her fellow investigators note that even federal regulators have taken this approach.

“The FDA has likened the manufacturing of a biosimilar to the approach taken when brewing beer that is intended to be just like someone else’s beer,” they wrote in a new report recommending strategies for integrating biosimilars into oncology practice.

There are many reasons why patients may refuse to be treated with biosimilars, and a coordinated, well-prepared approach by APs and clinical pharmacists can help overcome these objections, Mayden’s investigative team wrote.

Prior studies have shown that APs may not be well versed in biosimilars and may lack the confidence to recommend them to patients. Clinical pharmacists are ideally suited to give APs the background information they need to feel comfortable endorsing the use of these agents, they wrote.

In addition, adequate time needs to be spent with patients to explain biosimilars and answer any questions they may have. One danger is that without this support, patients may resort to their own research and become overwhelmed by the amount of information on the web.

“Each discussion should be tailored to the patient’s specific circumstances, disease, and how much they want to know,” the authors said. “Education will be particularly important when switching patients from a reference product to a biosimilar; this is because the patients will assume they are already receiving the optimum medication.”

Even a biosimilar’s lower cost can be a cause for rejection, as patients often associate a higher drug price with higher quality,” they wrote.

In infusion centers, oncology nurses can play a role in this effort because they are often familiar with biosimilars and can dedicate face-to-face time with patients.“Teaching techniques and communication style will need to be adapted to each patient’s individual learning preferences for maximal effect, reinforced by periodically evaluating each patient’s comprehension,” Mayden’s team wrote.

For patients who will go further than the examination room discussion to find out about biosimilars, treatment centers should cherry-pick online information that can be recommended to patients. The report provided a list of such sites that offer reliable information about biosimilars in clear, patient-friendly terms. These include web pages managed by the FDA, Susan G. Komen, the American Cancer Society, and others.

“This approach will help avoid random internet searches about oncology medications that could provide misleading or incorrect information,” the report states.

It is essential for APs to be absolutely convincing about their own faith in the safety and efficacy of biosimilars, the authors wrote. “If APs advise their patients that they would have no reservations about receiving a biosimilar or prescribing biosimilars for their own family members, this can provide some welcome personal context and insight,” they wrote.

APs should also familiarize themselves with individual state laws that govern how biosimilars may be substituted for reference products and when physicians must be notified of these switches. They should also monitor safety information about biosimilars that emerges post-approval,” the authors wrote.

There are multiple websites that can be useful in this regard, and many of them are listed within the report.

“Based on the potential for improvements in the affordability of and access to biologics afforded by biosimilars, in addition to their comparable safety and efficacy to reference biologics, biosimilars warrant fair consideration by APs as a value-based treatment option for patients with cancer,” Mayden and her fellow authors concluded.