title: Medical specialists' attitudes to prescribing biosimilars.
abstract: OBJECTIVE
  Biosimilars are a cost-effective alternative to biologics that could improve patients' access to expensive biological medicines. Currently, there are little data on doctors' perceptions of biosimilars and in what situations they are comfortable prescribing biosimilars. In this study, we investigated medical specialists' perceptions of biosimilars and the factors associated with the acceptance of biosimilars.
  
  
  METHODS
  A national sample of 110 of 327 medical specialists working in the areas of rheumatology, dermatology, gastroenterology, oncology and haematology completed an online questionnaire examining attitudes towards prescribing biosimilars, indication extrapolation and switching patients to a biosimilar.
  
  
  RESULTS
  Most specialists held positive views of biosimilars, with between 54 and 74% confident in the safety, efficacy, manufacturing and pharmacovigilance of biosimilars. Seventy-one percent of specialists agreed that they would prescribe biosimilars for all or some conditions meeting relevant clinical criteria. Specialists were less confident about indication extrapolation and switching patients from an existing biologic. Acceptance of biosimilars was significantly associated with a lower perceived time to explain a biosimilar to a patient and lower number of weekly patient appointments. The most common situations that they would not prescribe a biosimilar was where there was a lack of clinical data supporting efficacy (32%), or evidence of adverse effects (17%).
  
  
  CONCLUSIONS
  Medical specialists held generally positive attitudes towards biosimilars but were less confident in indication extrapolation and switching patients from a biologic. Providing clinicians with guidance on how to explain biosimilars to patients and written patient material may help overcome some of the barriers to the use of biosimilars. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychological Medicine, University of Auckland, New Zealand.
authors.forename: Amy
authors.initials: A
authors.lastname: Hemmington
authors.affiliation: Department of Medicine, Auckland and Department of Dermatology Middlemore Hospital, University of Auckland, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
authors.affiliation: Department of Medicine, Auckland and Department of Dermatology Middlemore Hospital, University of Auckland, New Zealand.
authors.forename: Paul
authors.initials: P
authors.lastname: Jarrett
authors.affiliation: Department of Medicine, Auckland and Department of Dermatology Middlemore Hospital, University of Auckland, New Zealand.
authors.forename: Alan G
authors.identifier: http://orcid.org/0000-0003-3468-3260
authors.initials: AG
authors.lastname: Fraser
authors.affiliation: Regional Cancer and Blood Centre, Auckland City Hospital, New Zealand.
authors.forename: Reuben
authors.initials: R
authors.lastname: Broom
authors.affiliation: Department of Molecular Medicine, University of Auckland, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Browett
authors.affiliation: Department of Psychological Medicine, University of Auckland, New Zealand.
authors.forename: Keith J
authors.identifier: http://orcid.org/0000-0002-6337-2480
authors.initials: KJ
authors.lastname: Petrie
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D059451:Biosimilar Pharmaceuticals / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D057915:Drug Substitution / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009520:New Zealand; D060735:Pharmacovigilance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization; D011795:Surveys and Questionnaires
chemical_list: D059451:Biosimilar Pharmaceuticals
keywords: attitudes; biologics; biosimilars; generics; medical specialists; prescribing