Adoption of biosimilars continues to rise in the United States, but oncologists’ knowledge regarding these agents has not kept pace, according to data presented at the virtual 2021 American Society of Clinical Oncology (ASCO) Quality Care Symposium.
Findings from a survey of nearly 300 clinical oncologists identified major knowledge deficits on basic features of biosimilars. In addition, oncologists in community and private practice settings were more concerned about safety and efficacy than those in academic practices, the investigators of the study reported.
“Approximately half of oncologists surveyed did not realize that biosimilars were not the same as generic medications,” said lead study investigator John Devin Peipert, PhD, Assistant Professor, Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. “That might be a technical point, but we found it remarkable that something so basic would not be known by all oncologists.”
“Clearly, there is a great deal of opportunity for new educational interventions or quality improvement programs for oncologists,” he added.
As Dr Peipert explained, biosimilars are biologic medicines that are highly similar to existing licensed biologic products, with no clinically meaningful differences in terms of safety and efficacy. Despite the potential of biosimilars to significantly reduce healthcare costs, however, uptake in the United States has been slower than expected, which may derive from oncologists’ hesitancy about these products.
“After speaking to several providers, we learned that biosimilar adoption is not really a patient-level decision point,” said Dr Peipert. “It comes down to the physicians, specifically their ability and willingness to prescribe. Sometimes they have that freedom; sometimes they don’t.”
To examine oncologists’ knowledge, attitudes, and experience with biosimilars, the researchers conducted a large-scale survey using the ASCO Survey Research Pool. From October 6, 2020, to November 16, 2020, clinical oncologists completed a 29-question survey designed with structured input from clinical and healthcare system experts and literature review.
Knowledge Deficits and Concerns
Of the 269 survey respondents, 88% said that they treated patients with biosimilars and reported that biosimilars were required at their institution. Nevertheless, said Dr Peipert, approximately half of respondents indicated (incorrectly) that biosimilars are the same as generics. Responding oncologists also indicated a lack of knowledge about interchangeables—products that a patient may receive without consulting the prescriber.
“Although a majority of oncologists reported treating with biosimilars, their knowledge of biosimilars was limited,” said Dr Peipert.
In addition, more than one-third (38%) of oncologists in community and private practice settings each reported that concerns with efficacy have been a barrier to use of biosimilars while 30% and 29%, respectively, noted concerns about biosimilar safety. Oncologists in academic hospitals, on the other hand, were far less likely to report such concerns.
“Oncologists are aware of biosimilars, but they don’t seem to know a ton about them,” said Dr Peipert. “That lack of knowledge may cause hesitancy to prescribe these drugs in some cases, even though they are coming on the market with equivalent efficacy and safety.”
Educational Interventions Needed
As Dr Peipert explained, the gap between the supply and demand for education suggests a need for new biosimilar quality improvement and educational programs in the United States. These programs should build curricula to address key knowledge gaps and misperceptions among oncologists.
“As more and more biosimilars are approved and show up in formularies, oncologists will become increasingly interested in consuming educational resources that are available,” said Dr Peipert. “There is a huge opportunity for new educational interventions or quality improvement programs for oncologists, but we should determine the optimal way to deliver that information first.”
According to Dr Peipert, such educational resources should consist of easy-to-consume comparisons between biosimilars and generics along with statements about interchangeables and bulleted reviews of the evidence regarding biosimilar safety and efficacy.
“These resources wouldn’t have to be too intensive because some of the lack of knowledge was about very basic elements,” he concluded.