First monoclonal antibody biosimilars: tackling the challenge of substitution

Awareness and Knowledge of Pharmacists toward Biosimilar Medicines: A Survey in Jordan

Aims

Pharmacists in all clinical settings are recognized drug experts and integral educators of biosimilar medicines. Therefore, the objective of this study was to assess pharmacists' knowledge, predictors of knowledge, and views toward biosimilar medicines in Jordan.

Methods

A cross-sectional study was conducted in Jordan during October-December 2020. An Internet-based self-administrated questionnaire on knowledge and views was distributed using social media groups to the pharmacists among different areas in Jordan. A descriptive and univariate analysis was performed. Binary logistic regression was conducted to determine the predictors of knowledge including all variables with p < 0.20 on univariate analysis.

Results

A total 536 responses were received, 502 of which were completed (93.7% response rate). A total of 52.6% of the pharmacists were knowledgeable about biosimilar medicines and the mean of knowledge level was 6.47 ± 1.62 (range 2-10). Multivariate analysis identified that respondents who had heard about biosimilars before (OR = 1.942, 95% CI = 1.231-3.063, p < 0.05) was more likely to be knowledgeable. Respondents who had not taken the course or the postgraduating training course about biosimilars that were less likely to be knowledgeable (OR = 0.548, 95% CI = 0.357-0.839, p < 0.05). A positive response was noted in pharmacist's view regarding the implementation of biosimilar medicines in healthcare setting, biosimilar medicine prescription related to decreased costs, self-study about biosimilar medicine, and incorporating biosimilar education program at the pharmacy school curriculum universities level.

Conclusions

Pharmacists' views and knowledge vary regarding the particularities and key issues on biosimilar medicines in Jordan. Incorporating biosimilar course in pharmacy school curriculum could improve their acceptance for future pharmacy jobs.

[Knowledge and perceptions of biosimilar medicines by health professionals in Tunisia]

INTRODUCTION

Biosimilar drugs occupy a strategic place in the global pharmaceutical market. However, there are brakes on their use. The objective of our study is to assess the knowledge and perceptions of healthcare professionals on biosimilar drugs in a developing country.

MATERIAL AND METHODS

This is a prospective survey via an anonymous 18-question multiple-choice questionnaire developed and published online through the "Google Forms" application over a period of one month. This questionnaire is intended for Tunisian pharmacists and doctors of all ranks.

RESULTS

A total of 240 health professionals responded to this questionnaire, including 158 pharmacists and 82 physicians. Among them, 73 are not informed about the biosimilar drugs and were excluded from the rest of the questionnaire. Questions regarding the definition of biosimilar drugs and their differences from generic drugs obtained the best rate of 76 % of correct answers. In contrast, the questions that generated the most errors mainly concerned the regulation of biosimilar drugs. Participants felt that they were under-informed about biosimilar drugs in 65 % of the cases. In addition, 92 % were in favor of the development of this class of drugs and 85 % estimated significant to very significant savings related to their use.

CONCLUSION

Our study confirms the lack of information of pharmacists and physicians on biosimilar drugs. Sensitization of healthcare professionals on the safety and effectiveness of the use of these drugs seems to be necessary in order to allow their development.

Developing the Totality of Evidence for Biosimilars: Regulatory Considerations and Building Confidence for the Healthcare Community

Biosimilars are highly similar versions of approved branded biologics. Unlike generics, they are not exact replicas of reference products. Minor differences between biosimilars and reference products in some aspects are expected; likewise, biosimilar products will differ from each other. The objective of this review is to discuss the challenges associated with the development and approval of biosimilar products that are unique because of their complex structure and specialized manufacturing processes, which can impact not only efficacy but also immunogenicity and safety. Regulatory guidelines recommend a totality-of-evidence approach focused on stepwise development that involves demonstration of structural similarity and functional equivalence. Structural and functional characteristics of the proposed biosimilar are compared with the reference product; similarity of these functions forms the foundation of the biosimilar development program, including potential animal studies, a human pharmacokinetics/pharmacodynamics equivalence study, and a clinical study to confirm similar efficacy, safety, and immunogenicity. The clinical study should be performed in a sensitive population using appropriate endpoints to allow detection of any clinically meaningful differences between the biosimilar and the reference product if such differences exist. In conclusion, development of biosimilars is focused on the minimization of potential differences between the proposed biosimilar and reference product and the establishment of a robust manufacturing process to consistently produce a high-quality biosimilar product.

Inventions and Patents: A Practical Tutorial

Patents are designed to protect and encourage creativity and innovation. Patenting a biomedical discovery can be a requirement before a pharmaceutical company or biotech entity will invest in the lengthy and capital-intensive drug development and clinical trials necessary to achieve patient benefit. Although scientists and clinicians are well versed in research publication requirements, patent descriptions and claims are formatted in a manner quite different from a research paper. Patents require (a) a series of logical statements clearly delineating the boundaries of the novel aspects of the invention and (b) sufficient disclosure of the invention so that it can be reproduced by others. Patents are granted only for inventions that meet three conditions: novelty, non-obviousness, and usefulness. Recent changes to US patent law limit the scope of patentable material. Products of nature such as nucleic acids and proteins, or steps used to observe natural events, are no longer patent eligible. This chapter provides basic guidelines and definitions for inventions, inventorship, and patent filing which are summarized using a question and answer format.

A survey of pharmacists' knowledge and views of biosimilars in Quebec and France

OBJECTIVE

The objective of this study was to survey pharmacists' knowledge and views of biosimilars in Quebec and France.

METHODS

An online and anonymous survey was conducted. The survey was divided into two parts including: (1) ten multiple choice questions on main characteristics that distinguish biosimilars from generic drugs; (2) fifteen statements on biosimilars key issues (interchangeability, immunogenicity risk management…). Pharmacists were asked to indicate their level of agreement to these statements using a 5-item Likert scale. A descriptive statistical analysis of the results was performed.

RESULTS

A total of 229 pharmacists answered the survey (141 in Quebec and 88 in France). Pharmacists know the main differences between generic drugs and biosimilars. Viewpoints of pharmacists on biosimilars key issues are alike: nomenclature of biosimilars is essential to avoid confusions with the reference drug; the creation of a list of biosimilar and interchangeable biologic drugs is necessary; responsibilities for immunogenicity risk management should be shared between pharmacists and physicians. However, viewpoints vary regarding the patient informed consent for biologic drugs substitution.

CONCLUSION

Knowledge and views of pharmacists about biosimilars in Quebec and in France are alike. Pharmacists should be knowledgeable about the particularities and key issues of biosimilars because they will play a key role for their introduction in clinical practice. They should be aware of the evolution of the legal framework of biosimilars to ensure their safe and optimal use.

Knowledge, behaviors and practices of community and hospital pharmacists towards biosimilar medicines: Results of a French web-based survey

This study's aims were: 1) to extract a comprehensive overview of the knowledge, experience and opinions of both community pharmacists and hospital pharmacists regarding biosimilar medicines in France; and 2) to identify the perceived problems and solutions to promoting their prescription. A 2015 web-based survey was conducted by the Observatoire des Médicaments, des Dispositifs Médicaux et de l'Innovation Thérapeutique of Alsace. A total of 802 pharmacists responded to the survey. Many (536, 66.8%, [95% confidence interval (CI) 63.6-70.1]) indicated that they were not familiar with biosimilars. Half of community pharmacists (95% CI 42.7-57.3) stated that they were not at all informed about biosimilar drugs, compared with 15.7% (95% CI 12.9-18.6) of hospital pharmacists. Almost all respondents (781, 97.4%, [95% CI 96.3-98.5]) had at least one pending question on biosimilars. Most of the questions were related to the manufacturing process, safety, substitution rules and the international non-proprietary name prescription. At the time of the study, 467 pharmacists (58.2%, [95% CI 54.8-61.6]) had already validated a prescription for a biosimilar drug, mainly for filgrastim. These latter were more comfortable in explaining the benefit of biosimilar medicines to the patient. Pharmacists were rather favorable to biosimilar drugs, and about 9 of 10 quoted healthcare cost savings as incentives to their prescription. However, many did not agree with allowing biosimilar substitution. "Patients' wishes to be treated with the originator" and "indication extrapolation" were the two main constraints identified. The survey highlighted the need to provide French pharmacists with accurate and comprehensive information regarding biosimilar medicines.