• In 2020, 92% of 5EU physicians stated that they used biosimilars in at least 25% of their RA patients, compared to 70% of physicians in 2018.
• Between 2018 and 2020, the percentage of Japanese physicians using biosimilars in at least 25% of their RA patients jumped from 23% to 78%.
• Biosimilar usage in the US and Australia has remained relatively static from 2018 to 2020, with 20-30% of surveyed rheumatologists stating they use biosimilars in 25% or more of their patients.

In 2018 and 2020, GlobalData conducted a survey in which high-prescribing rheumatologists from the US, the 5EU*, Japan and Australia were asked about their biosimilar prescription patterns in patients with rheumatoid arthritis (RA). Survey results suggest that the acceptance of biosimilars for the treatment of RA is increasing—albeit at very different rates throughout the 8MM**. Over a span of approximately two years, biosimilar use in the 5EU and Japan escalated while remaining relatively stagnant in the US and Australia.

Rose Joachim, Pharma Analyst at GlobalData, comments: “GlobalData believes that the medical community’s overall trust in the quality of biosimilar products has begun to solidify—now the key is to incentivize physicians to try out the products for the first time or begin to use them more frequently. One key reason for the increased success of biosimilars in the 5EU and Japan is competitive pricing. Until there is a clear financial incentive, it is unlikely the use of biosimilars will increase in the US and Australia without governmental involvement.”

Biosimilar usage in the 5EU continues to outpace that in the rest of the 8MM. In GlobalData’s 2020 survey, 92% of 5EU physicians stated that they used biosimilars in at least 25% of their RA patients, compared to 70% of physicians in 2018.

Rose Joachim, Pharma Analyst at GlobalData, comments: “Key factors driving the strong overall uptake of biosimilars in Europe include more liberal interchangeability policies and government-mandated quotas for biosimilar prescription. The continued escalation in biosimilar uptake between 2018 and 2020 is likely due to the addition of new etanercept, rituximab, and infliximab biosimilar products to the market, as well as the 2018 launch of adalimumab biosimilars. Adalimumab biosimilars received a massive response in Europe due to the simultaneous launch of multiple products at historically low prices.”

According to GlobalData’s surveys, biosimilar use remains modest in Japan compared to the 5EU, but the country demonstrated a drastic change in biosimilar usage. Between 2018 and 2020, the percentage of physicians using biosimilars in at least 25% of their RA patients jumped from 23% to 78%. Furthermore, in 2018, 46% of Japanese rheumatologists said they preferred to use biologic reference products, citing potential problems with biosimilar manufacturing and doubts about the products’ reliability, while in 2020 only 6% stated as such.

Joachim explains: “Physicians in Japan have rapidly gained confidence in using biosimilar products, likely through increasing experience and familiarity. Another factor that may have spurred overall biosimilar use in the country is the launch of the first etanercept biosimilars beginning in 2018. Prior to this, only infliximab biosimilar products had been available, and some Japanese physicians interviewed by GlobalData had raised doubts about their quality.”

Meanwhile, biosimilar usage in the US has remained static from 2018 to 2020, with only 30% of surveyed rheumatologists stating they use biosimilars in 25% or more of their patients.

Joachim continues: “This is likely due to a consistent lack of access to biosimilars for the treatment of RA. In the US, only infliximab and rituximab biosimilars are currently available and infliximab biosimilars in particular have struggled to compete against branded Remicade.

“In both 2018 and 2020, around 30% of the US rheumatologists surveyed stated that they did not use any biosimilars. Half explained that biosimilars were not available to prescribe at their hospital or practice, while the other half explicitly stated that they preferred using biologic reference products because of their track records of efficacy and safety or better pricing and insurance coverage.”

Although biosimilar prescription among Australian physicians did grow slightly between 2018 and 2020, the country still lags behind the rest of the 8MM.

Joachim notes: “Australia is unique in that its level of biosimilar adoption remains low despite having similar regulatory guidelines surrounding biosimilar use as the EU  and access to infliximab, rituximab and etanercept biosimilars. One important reason for this is likely physician preference.

“In GlobalData’s 2018 and 2020 surveys, 30% of Australian rheumatologists reported preferring biologic reference products over biosimilars. When asked to explain their preference, these physicians mainly cited insufficient experience with new biosimilar products and a higher degree of confidence in the quality of biologic reference products. Perhaps even more importantly, they noted that there was a clear lack of financial incentive to select biosimilars over their branded counterparts.”

* 5EU = France, Germany, Italy, Spain, and the UK

** 8MM = US, 5EU, Japan, and Australia