Prescribing of biosimilar infliximab in biologic-naïve, inflammatory bowel disease patients, relative to the reference brand, has grown slightly over the past two years. The rate of physician acceptance of requests from pharmacists and insurance companies, to switch from the reference brand to the biosimilar has increased at a similar rate. In a patient chart study conducted in June 2020, the majority of biologic-naïve patients placed on infliximab were prescribed the reference brand despite the availability of two infliximab biosimilars. Additionally, physicians were not requested to switch the reference brand to a biosimilar in a majority of prescribing situations. A comparison of these trends to an identical study, from two years ago, are presented.
An independent market analytics firm collaborated with US gastroenterologists (n = 218) to conduct a retrospective chart review of patients with inflammatory bowel disease (IBD) (n = 1,001), who were started on a biologic agent for the first time. Gastroenterologists submitted patient-level data via a HIPAA-compliant audit form which included both clinical and non-clinical data. The collaborating physicians also completed a brief survey about their practices and their opinions regarding IBD patient management. The data were collected and analyzed in June 2020. The data are then compared to a similar study with US gastroenterologists (n = 218) with a retrospective chart review of patients with inflammatory bowel disease (IBD) (n = 1,001) that was collected in 2018.
26% of the patients starting on a biologic for the first time were initiated on infliximab. Of those, 73% were placed on the reference brand, while 27% were placed on a biosimilar. This represents a ten-point increase in biosimilar infliximab prescribing since the last assessment was conducted in 2018 (17%). However, the majority of infliximab prescribing is still for the reference brand. In 82% of the cases where the patient was placed on the reference brand, the physician was not contacted by a pharmacist or insurance company about using a biosimilar in place of the reference brand. This was a decrease of eight points since the last assessment in 2018 (90%). Physicians indicated that if they had been contacted, in 52% of the cases they would have switched to a biosimilar, a nine-point increase from two years ago (43%). Rather than switch, in 39% of the request situations physicians indicated would have pressed to use the reference brand, a twelve-point decrease from two years ago (51%). Finally, in 9% of the request situations physicians would have chosen a non-infliximab alternative, vs switching to a biosimilar or pressing to use the reference brand; only a three-point increase from the data in 2018 (6%).
While prescribing of infliximab biosimilars has increased slightly over the past two years, use of the reference brand still occurs in the majority of potential substitution situations. Physicians’ receptivity to a requested switch to the biosimilar by a pharmacist or insurance company has increased slightly in the same timeframe.