title: Perceived Risks Contra Benefits of Using Biosimilar Drugs in Ulcerative Colitis: Discrete Choice Experiment among Gastroenterologists.
abstract: In middle-income countries, access to biological therapy is limited in ulcerative colitis in terms of the number of patients and the length of therapy. Because of their cost advantages, biosimilars have the potential to improve access to therapy, but physicians have concerns toward their use because of the lack of evidence from randomized clinical trials.
  
  
  
  To explore the preferences of gastroenterologists for biosimilar drugs in ulcerative colitis as well as to compare our results with results of previous studies on gastroenterologists' preferences toward biosimilars.
  
  
  
  A discrete choice experiment was carried out involving 51 Hungarian gastroenterologists treating patients with inflammatory bowel disease in May 2014 with the following attributes: type of treatment (biosimilar/originator), severity of disease, availability of continuous medicine supply, and the stopping rule (whether the treatment is covered after 12 months). A conditional logit model was used to estimate the probabilities of choosing a given profile.
  
  
  
  According to the results, the stopping rule was the most important attribute. The type of treatment mattered only for patients already on biologicals. The probabilities of choosing the biosimilar option with all the benefits offered in the discrete choice experiment over the originator option under the present reimbursement conditions are 85% for new patients and 63% for patients already treated.
  
  
  
  Most gastroenterologists have concerns about using biosimilars. They, however, are willing to consider the use of biosimilars if they could reallocate the potential savings to provide their patients better access to biological treatment.
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; CERGE-EI, Nové Město, The Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Baji
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary. Electronic address: laszlo.gulacsi@uni-corvinus.hu.
authors.forename: László
authors.initials: L
authors.lastname: Gulácsi
authors.affiliation: First Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Petra A
authors.initials: PA
authors.lastname: Golovics
authors.affiliation: First Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Lovász
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Department of Rheumatology, Flór Ferenc County Hospital, Kistarcsa, Hungary.
authors.forename: Márta
authors.initials: M
authors.lastname: Péntek
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary.
authors.forename: Fanni
authors.initials: F
authors.lastname: Rencz
authors.affiliation: First Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Péter L
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D000911:Antibodies, Monoclonal; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease; D000072102:Gastroenterologists; D005765:Gastrointestinal Agents; D006801:Humans; D006814:Hungary; D015212:Inflammatory Bowel Diseases; D000069285:Infliximab; D010818:Practice Patterns, Physicians'
chemical_list: D000911:Antibodies, Monoclonal; D059451:Biosimilar Pharmaceuticals; D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: biologicals; biosimilars; discrete choice experiment; preferences; ulcerative colitis