title: Attitudes towards subsequent entry biologics/biosimilars: A survey of Canadian rheumatologists.
abstract: Globally, patents on several well established biologic agents used to treat rheumatic diseases have already or will expire over the next few years, allowing for the availability of subsequent entry biologics (SEBs or biosimilars). The objective of this study was to identify gaps in knowledge and attitudes towards SEBs among Canadian rheumatologists. Eighty-one rheumatologists completed the survey and were included in the analysis (22 % of the 369 who were contacted). We found that one third of physicians (31 %) were familiar with SEBs and that physicians with greater than 20 years of practice were significantly more likely to be familiar or very familiar with SEBs compared to respondents with less than 10 years or 10-20 years of experience (OR 11.1, 95 % CI: 2.1-55.5, p = 0.004 and OR 4.5, 95 % CI: 1.2-16.2, p = 0.023, respectively). A third (32 %) of physicians agreed or strongly agreed that they would be comfortable with indication extrapolation. Most respondents (88 %) would feel concerned or very concerned if a pharmacist had the ability to substitute a biologic drug for an SEB without the physician's approval. This survey was the first study that evaluated the position of rheumatologists on key areas surrounding SEBs from a nationwide Canadian perspective. Current physician attitudes and perceptions of SEBs can inform future educational initiatives and highlight important issues for payers, policy makers, and other stakeholders.
authors.affiliation: Institute of Management & Innovation, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Grabowski
authors.forename: Bradley
authors.initials: B
authors.lastname: Henderson
authors.forename: Dennis
authors.initials: D
authors.lastname: Lam
authors.forename: Edward C
authors.initials: EC
authors.lastname: Keystone
authors.forename: Carter
authors.initials: C
authors.lastname: Thorne
authors.forename: Shahin
authors.initials: S
authors.lastname: Jamal
authors.forename: Janet
authors.initials: J
authors.lastname: Pope
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.forename: Daming
authors.initials: D
authors.lastname: Lin
authors.forename: Leigh
authors.initials: L
authors.lastname: Revers
mesh_terms: D001291:Attitude of Health Personnel; D001688:Biological Products / Q000627:therapeutic use*; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use*; D002170:Canada; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians'; D012216:Rheumatic Diseases / Q000188:drug therapy*; D012219:Rheumatology
chemical_list: D001688:Biological Products; D059451:Biosimilar Pharmaceuticals