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Poster Discussion - Public policy

6081 - Biosimilar Substitution: European Prescriber Perspectives


29 Sep 2019


Poster Discussion - Public policy


Michael Reilly


Annals of Oncology (2019) 30 (suppl_5): v671-v682. 10.1093/annonc/mdz263


M.S. Reilly

Author affiliations

  • Health Policy, Alliance for Safe Biologic Medicines, 22307 - Alexandria/US


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Abstract 6081


As countries seek to control health costs and expand access to biologic therapies, biosimilars are a valuable tool. With the automatic subsitution of biosimilars banned in much of Europe, building physician confidence in biosimilars is critical to promoting their uptake and reaping their cost savings benefits. This study is a refresh of a study done in 2013, and documents the perspectives of European prescribers regarding biosimilar substitution and related issues, to serve as a guide to policymakers.


579 prescribers were recruited from France, Germany, Italy, Spain, Switzerland, UK. Drawn from Dermatology, Endocrinology, Gastrointestinal, Hematology oncology, Immunology, Nephrology, Neurology, Oncology, Ophthalmology, Rheumatology. 15 minute web-based survey, offered in multiple languages. The data was collected in March 2019.


Respondents consider it very important or critical that there are multiple suppliers for government tenders. They also consider it important/critical that tenders include factors besides price. Sole prescription authority is considered very important/critical, as is authority to prevent a substitution. Physicians are more comfortable switching bio-naïve patient to biosimilar, but less comfortable switching a stable patient. Physicians are more comfortable switching a patient for non-medical reasons, but less so when switching is done by a third-party.


In countries with a government tender, physicians consider it important to have several therapeutic options available, and consider factors beyond price to be important. As physicians’ familiarity has increased since the 2013 survey, so has the percentage of physicians characterizing sole prescription authority as "very important or critical". The percentage of prescribers characterizing the ability to prevent/deny a substitution very important or critical has also risen. While comfortable making biosimilar substitutions- including for cost reasons- with new/bio-naive patients, physicians remain cautious about doing so with stable patients. Physicians remain uncomfortable with third-party switching of patients for non-medical (e.g. cost) reasons.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Alliance for Safe Biologic Medicines.


Alliance for Safe Biologics which receives some funding from manufacturers of originators and biosimilars.


The author has declared no conflicts of interest.

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