20P - Physician perceptions to use of trastuzumab in HER2+ breast cancer in India

Background

Biosimilars have the potential for cost savings and thus help increase access to treatment. The study aims to understand the physicians’ perception and usage of biosimilars in HER2+ breast cancer (BC) and changes in trends from pre-biosimilar (only innovator trastuzumab was available) to current biosimilar era in India.

Methods

This virtual qualitative survey was conducted at private and government hospital settings in India between April and June 2022. Medical oncologists (MO) with experience ≥10 years, and with BC patient load ≥10 per month were included.

Results

Thirty MOs (24 private and 6 government) across 10 cities participated in the survey. The survey reported the following: All BC patients undergo HER2+ screening of which 29% test positive; 29% of patients are diagnosed at metastatic stage (MBC); 80% of patients diagnosed in non-metastatic (NMBC) stage undergoes surgery, of which 70% receive neo-adjuvant therapy. In the pre-biosimilar era, up to 30% of the prescribed patients were able to access the trastuzumab treatment. While in the current biosimilar era, access to trastuzumab in NMBC itself has increased to ≥75%, with biosimilars accounting for 84% of the total usage of trastuzumab. Currently, trastuzumab is usually taken for an average of 12 cycles in NMBC and 6 cycles in MBC as 3 weekly regimens. In patients with financial constraints, a majority (70%) of MOs offer a modified treatment plan for trastuzumab, reducing the number of cycles to 6-8 vs standard 17. MOs generally do not prefer to switch patients between different trastuzumab brands, however, the average switch from an innovator to a biosimilar is 14%. Only 16% of patients receive pertuzumab with the major limitation being a financial constraint, due to the non-availability of a biosimilar.

Conclusions

The access to trastuzumab therapy in HER2+ BC patients has increased many folds in the current biosimilar era in India, leading to reduced financial burden and improved overall healthcare.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Viatris and IPSOS Research Pvt Ltd.

Funding

Viatris.

Disclosure

N. Ramanjinappa, J. Agarwal, K.H. Upveja: Financial Interests, Personal and Institutional, Full or part-time Employment: Viatris.