Is patient uncertainty and clinician hesitancy undermining the uptake of biosimilars?

Halving the Pharmaceutical Benefits Scheme (PBS) co-payment for patients who choose biosimilars is one of the key strategies proposed by the Generic and Biosimilar Medicines Association (GBMA) in its pre-budget submission, potentially providing financial relief for up to three million Australians.

GBMA’s Independent Chair, Hon. Professor Jane Halton AO PSM, underscored the urgency of leveraging the health and fiscal benefits of biosimilars.

“We know 11% of Australians in disadvantaged communities are delaying or going without their prescription medicines,” said Professor Halton. “We should also be doing more to mobilise up to $1.5 billion in savings, expected over the next five years, with the arrival of more biosimilar medicines into the Australian market.”

Australia’s adoption has lagged behind other nations, with initial market uptake proving slow. This hesitancy has been largely driven by healthcare practitioners’ reluctance to switch patients from originator biologics, alongside patient resistance often shaped by their doctors’ opinions.

“Many patients express a preference for the original biologic, particularly when the switch is not medically necessary. This is often due to the perceived superiority of original biologics, concerns about adverse events and reduced clinical efficacy, and satisfaction with current biologic treatment,” said Australian dermatologists who have authored a recent report on the state of biosimilars.

Studies on Australian patients with rheumatic and gastroenterological conditions suggest that while many are open to using biosimilars if recommended by their specialist, their understanding of biosimilars remains limited. Instead, they frequently turn to relatives, friends, and social media for information – sources that often portray biosimilars in a negative light.

Recognising the need to strengthen biosimilar uptake, the Australian government allocated $20 million over three years as part of the PBS Access and Sustainability Package in 2015 to drive awareness and education campaigns.

In 2017, further initiatives were introduced in collaboration with Medicines Australia, the GBMA, and the Pharmacy Guild of Australia, beginning with the listing of Brenzys, a biosimilar form of etanercept, on December 1, 2017. Additional funding of over $5 million was committed between 2018 and 2019 to sustain these awareness efforts.

The GBMA is now collaborating with the Australian Patient Advocacy Alliance (APAA) to identify how the savings from biosimilar medicines can be channelled into priority chronic disease-related initiatives.

Marnie Peterson, GBMA CEO, emphasised the economic and healthcare imperatives of expanding biosimilar use, particularly given the $82 billion annual cost of chronic disease to Australian taxpayers.

“A robust biosimilar market, underpinned by effective policies, will deliver unprecedented financial and health benefits to vulnerable patients, without impacting an already overwhelmed health system,” Peterson stated.

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