a Janssen Scientific Affairs, LLC , Horsham , PA , USA.
b Global Health Living Foundation , Upper Nyack , NY , USA.
Curr Med Res Opin. 2019 Apr;35(4):603-609. doi: 10.1080/03007995.2018.1560221. Epub 2019 Jan 8.
To evaluate patient attitudes regarding non-medical switching (NMS) to biosimilars among patients with autoimmune disease currently receiving a biologic.
An online survey was conducted among patients meeting the following criteria: ≥18 years of age; residing in the US; diagnosis of rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis or psoriatic arthritis; currently taking a biologic; and consenting to participate. Patients answered questions about their attitudes and experiences related to NMS. Descriptive statistics were used to summarize responses.
A total of 1696 patients completed the 20-min survey. Eighty-five per cent of patients were concerned that biosimilars wouldn't treat their disease as well; 85% didn't want to switch to a biosimilar if their current biologic was helping their disease; and 83% were concerned that switching may cause more side-effects. Twenty per cent of patients had previously received notification about a potential NMS to another biologic (that was not a biosimilar) from their insurance company. Of these, 79% took at least one action to avoid the NMS and 45% ultimately switched. Of these patients (n = 150), 67% indicated that their previous biologic worked well for them and 70% didn't want to switch to another biologic. Most patients who switched (67%) did so to avoid paying a higher cost. More than half (56%) went without therapy for administrative reasons during the period of transition from the old biologic to the other treatment.
Patients reported multiple concerns about NMS that might impact treatment outcomes, and many of the patients who non-medically switched in this survey missed treatments. Future studies should be conducted on patient expectations and experiences with NMS to understand the impact on healthcare delivery, treatment persistency, and patient outcomes. The patient perspective and experience should be considered by decision-makers when developing coverage policies for biosimilar medications and associated communication strategies.
评估当前正在接受生物制剂治疗的自身免疫性疾病患者对非医学转换（NMS）为生物类似药的患者态度。
一项在线调查在符合以下标准的患者中进行：≥18 岁；居住在美国；诊断为类风湿关节炎、克罗恩病、溃疡性结肠炎、银屑病或银屑病关节炎；目前正在服用生物制剂；并同意参加。患者回答了与 NMS 相关的态度和经验问题。使用描述性统计数据总结了应答情况。
共有 1696 名患者完成了 20 分钟的调查。85%的患者担心生物类似药不能像他们治疗疾病；85%的患者不想在当前生物制剂对疾病有帮助的情况下转换为生物类似药；83%的患者担心转换可能会引起更多的副作用。20%的患者之前曾收到过保险公司关于潜在的 NMS 通知（非生物类似药）。其中，79%的患者至少采取了一次行动来避免 NMS，45%的患者最终进行了转换。在这些患者（n=150）中，67%的患者表示他们之前的生物制剂对他们的疗效很好，70%的患者不想换用另一种生物制剂。大多数转换的患者（67%）是为了避免支付更高的费用。在从旧生物制剂转换为其他治疗期间，由于行政原因，超过一半（56%）的患者没有接受治疗。
患者报告了对 NMS 的多种担忧，这可能会影响治疗结果，而且本调查中许多非医学转换的患者错过了治疗。未来应开展关于患者对 NMS 的期望和经验的研究，以了解对医疗保健提供、治疗持续时间和患者结果的影响。在制定生物类似药物覆盖政策和相关沟通策略时，决策者应考虑患者的观点和经验。
