Burlington, MA—While a growing number of U.S. physicians, primarily oncologists, report increasing use of biosimilars, prescribing of the therapies remains much more widespread in France and Germany, according to a recent survey.

Decision Resources Group reports that, nearly 1 year after the launch of the first biosimilar in the United States, almost half of surveyed U.S. physicians, nearly all of them oncologists, reported some level of biosimilar use.

Surveyed physicians were strongly resistant, however, to pharmacy-level substitution of a branded agent with a biosimilar alternative. Most said they would prevent substitution, at least initially and for some patients, which represents a serious barrier for wider use of the biologic products, according to the survey and review.

The online quantitative survey involved 550 physicians across six specialties—endocrinologists, gastroenterologists, nephrologists, rheumatologists, hematology-oncologists, and medical oncologists—in the U.S., France, and Germany, according to the healthcare reporting and research company.

Related research suggests that the future outlook for biosimilar uptake in the U. S. is promising, with payers seeking to contain costs and reduce spending. In fact, based on information gathered by Decision Resources Group, U.S. payers predict that, within 6 months of biosimilar launch, at least half of their beneficiaries will be receiving a TNF-alpha biosimilar.

That’s because even incremental price drops translate to meaningful cost reductions for that drug class, according to the biosimilars overview.

The report cautions, however, that while lower costs to payers, clinics, and institutions are driving uptake, according to physicians and payers, concerns about the efficacy and safety of biosimilars remain, which also is a barrier.

To ameliorate concerns surrounding biosimilar use, study authors urge companies to conduct trials for multiple indications, enroll similar numbers of patients as in the brand’s pivotal trials, and generate at least two years of positive post-marketing data.

Decision Resources Group points out that U.S. payers employ a variety of strategies to increase use of Zarxio (Sandoz’s filgrastim-sndz), which became the first biosimilar approved by the FDA last year. That includes placing it on a more favorable tier than Neupogen (Amgen’s filgrastim) and/or Granix (Teva’s tbo-filgrastim), requiring a lower co-pay, or placing Zarxio ahead of Neupogen and Granix in step-therapy protocols.

“Payer and physician attitudes and expectations of biosimilars differ across the European markets, and as such, to successfully market a biosimilar, or defend a branded agent from biosimilar competition, marketers will need to develop country-specific strategies,” analysts Hamzah Aideed and Tom Hutchings conclude.

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