Why was this study done?

Pediatric patients with inflammatory bowel disease (IBD), including Crohn’s Disease and ulcerative colitis, who take biologic medications (like infliximab and adalimumab) have decreased hospitalizations, surgery rates, and improved quality of life. However, biologic medicines are expensive. Biosimilars are similar biological therapies that are just as safe and effective as the original biologic medication, although they are often less expensive. There are currently two medications (infliximab/Remicade and adalimumab/Humira) used to treat IBD that have biosimilars available. Despite the cost savings, the utilization of biosimilars in the treatment of IBD has been low. The exact reasons why the utilization of biosimilars is low is not well known or well-studied.

The objective of this study was to evaluate pediatric gastroenterologists’ perspectives of biosimilars and to evaluate factors that impact pediatric gastroenterologists’ comfort level with prescribing biosimilars.

How was the study designed?

A survey was developed by experts in the field to ask pediatric gastroenterologists their opinions about biosimilars. The survey was then distributed via email to an international pediatric gastroenterology list serv, but only included physicians practicing in the United States.

What were the results?

One hundred thirty-nine pediatric gastroenterologists from the United States completed the survey, which was a 5.4% overall response rate. Amongst these 139 physicians, 51% have been in practice for less than 10 years, 75% work at an academic institution, and 69% work at a center that participates in ImproveCareNow. Nearly 90% of the physicians who responded indicated they were comfortable prescribing and discussing using biosimilars with patients who had not been on the original biologic medication before.

When asked about switching a patient from the original biologic medication to the biosimilar if the patient was in remission, 69% of pediatric gastroenterologists felt comfortable with the switch. We found that if the pediatric gastroenterologist was at a center that was a part of ImproveCareNow and took care of greater than 50 patients with IBD, they were more comfortable starting a biosimilar and switching to a biosimilar. The study did not elicit why involvement in ImproveCareNow and seeing more patients with IBD increased biosimilar comfort, which can be a topic for future studies.  

What were the limitations of this study?

One of the limitations of this study was that only 5.4% of potential pediatric gastroenterologists that were sent the survey completed it. Another limitation is that we are not able to exclude responses from physicians who were not currently active, non-pediatric gastroenterologists, or trainees on the list serv. In addition, the majority of the physicians that responded were from academic institutions and at practices that are a part of ImproveCareNow. Only a few physicians filled out the survey that are in private practice.

What does this mean for patients, families and clinicians?

The majority of pediatric gastroenterologists are comfortable prescribing biosimilars and switching a patient to a biosimilar. Participation in ImproveCareNow contributed to pediatric gastroenterologists being more comfortable using a biosimilar or switching a patient to a biosimilar. This may be due to ImproveCareNow’s culture of continuous learning, widespread dissemination of educational resources, and community conference presentations that inform all stakeholders about biosimilars.

Overall, the study author advocates that the education of physicians and patients about biosimilars is particularly important to improve comfort levels, change prescribing habits, and ultimately decrease cost.

Next steps to learn more about biosimilars! 

The Ohio State University College of Medicine, in collaboration with ImproveCareNow and Nationwide Children's Hospital, has introduced the Breaking Biosimilars Barriers educational website - a free resource to educate healthcare professionals and patients and families on up-to-date biosimilar information. The educational materials on the website (i.e., videos, presentations, information sheets, etc.) are accessible to all learners and cover topics such as:

💚 Understanding Biosimilars

💙 Safety, Efficacy & Cost Savings

💚 Nocebo Effect

💙 Strategies to Increase Biosimilar Utilization

💚 Available IBD Biosimilars & the Biosimilar Pipeline

Study authors

Maltz RM, McClinchie MG, Boyle BM, McNicol M, Morris GA, Crawford EC, Moses J, Kim SC 

Study status

Published in February 2023. You can locate it:

About ICN Research Explained

We believe that in order to truly outsmart IBD, the questions we ask and the answers we find must be generated by and be useful to the people whose lives they will impact – patients and their families. ImproveCareNow (ICN) research is prioritized based on what matters most to patients and parents, and we are committed to sharing our results so everyone can understand and take advantage of what’s been learned. The ICN Research Committee has teamed up with patients and parents/caregivers to create and share accessible summaries of completed research called ICN Research Explained

Prepared by: Ross Maltz (first author) and Lisa Pitch (parent)


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