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Oncologist Perception of Efficacy, Safety, and Willingness to Prescribe Biosimilars

Researchers from CVS Health assessed the expected biosimilar prescribing behaviors of practicing oncologists for originator products bevacizumab, trastuzumab, rituximab, and pegfilgrastim.

Biosimilars are a fast-growing class of therapeutic products in the US and have the potential to lower cancer care-related costs.

Cesar Galan, CVS Health (Lincoln, RI), and colleagues conducted an online cross-sectional survey of 75 oncologists in July 2019 to gain further insight into provider perception of efficacy, safety, and willingness to prescribe biosimilar products. Among the surveyed oncologists, 46.7% were hospital-affiliated and 53.3% were community-based. Researchers noted that 62.7% of respondents worked in a for-profit practice, with 38.7% of primary practices offering exclusive in-office dispensing.

Researchers used a Likert scale rating of “Never,” “Seldom,” “Sometimes,” “Often,” and “Always” for respondent likelihood of prescribing biosimilar products.

Results of the study were presented at the American Society of Clinical Oncology (ASCO) Annual Meeting (May 29-31, 2020).

Respondents reported prescribing branded drugs “often” or “always” 76% of the time. Over 70% perceived biosimilars to bevacizumab, trastuzumab, rituximab, and pegfilgrastim to be the same or near equivalent in regard to quality, safety, and effectiveness of branded drugs.

Additionally, 60% believed that they would “often” or “always” prescribe a biosimilar in the future, and no difference in the providers’ current biosimilar prescription pattern by type of insurance plan was found.

Providers practicing in a fee-for-service reimbursement environment reported the top three drivers of using biosimilar products are out-of-pocket cost (61%), value of reimbursement (51%), and cost to the practice (52%). As for providers practicing in a value-based reimbursement environment, these drivers were considered important by 69%, 44%, and 61%, respectively.

When asked why providers would not switch from “buy-and-bill” to “white-bagging,” the top two reasons were control of the drug (43%) and financial benefit to the providers’ practice (40%).

“While providers in this study found biosimilars to be safe and effective, they reported being less likely to prescribe these drugs when there is a potential for their practice to lose money and control of the drug,” authors of the study concluded. “Payment models for biosimilars in cancer care must support practice economics.”—Zachary Bessette

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