The findings of an online, cross-sectional survey indicate oncologists were less likely to prescribe biosimilars if their practice could lose money and control of the drug, despite clinical safety and efficacy between the biosimilar and originator.
An online, cross-sectional survey assessed the prescribing patterns of practicing oncologists for biosimilars to reference products including bevacizumab, trastuzumab, rituximab, and pegfilgrastim for different cancers in the community setting; the results of this study were reported at the 2020 American Society of Clinical Oncology Virtual Scientific Program.
In this study, the surveys were administered to 75 oncologists who were either affiliated with hospitals (46.7%) or were community-based (53.3%) in July 2019. The survey used a Likert scale rating of “Never,” “Seldom,” “Sometimes,” “Often,” and “Always.”
Among the oncologists who participated in the survey, 62.7% worked in a for-profit practice and 38.7% in primary practices with in-office dispensing. The physicians indicated they predominantly prescribed branded drugs (often or always, 76%). The majority of the oncologists (70%) rated biosimilars to be similar or near equivalent to the branded drug in terms of quality, safety, and effectiveness. In terms of their likelihood of prescribing a biosimilar in the future, the majority of oncologists (60%) indicated they would prescribe a biosimilar (often or always). The biosimilar prescription pattern of the oncologists surveyed did not vary by type of insurance plan. The oncologists were significantly more likely to prescribe a biosimilar to new patients (85.3%) compared with existing patients (69.3%; P = .019), assuming the financial equivalence of new and current patients.
The surveyed oncologists rated patients’ out-of-pocket cost (61% for fee-for-service reimbursement; 69% for value-based reimbursement) as the primary determinant of prescribing biosimilar cancer therapies, followed by cost to the practice (52% and 61%, respectively) and value of reimbursement (51% and 44%, respectively). In response to a question on reasons for not switching from buy-and-bill to white-bagging, the oncologists indicated the primary reasons were control of the drug (41.3%) and financial benefit to the providers’ practice (40%).
Based on the findings of the cross-sectional survey, the authors concluded that oncologists were unwilling to prescribe biosimilars if their practice could potentially lose money and control of the drug, although they acknowledged the safety and efficacy equivalence between biosimilars and branded drugs.
Galan C, et al. ASCO 2020. Abstract e15213.