Treating patients and improving their quality of life is the aim for all HCPs across therapy areas. Knowing the benefits of biosimilar therapy and recognising their potential in improving/optimising therapies will support this aim and help them in addressing the needs of their patients. Because of this, the MDT is a crucial element in the treatment process, with each member of the disciplinary team bringing unique skills in providing patient support. Hence, it is vital that the MDT receive full training around biologics, their impact on treatment, and has access to any supporting guidance to help with any challenges they may encounter.
Current guidelines often reserve biologics for patients with more severe disease and/or patients who have failed to respond to multiple other treatments.1 In some countries, access to biologics may then be further limited by the implementation of national eligibility and reimbursement criteria,1 creating an unmet need in many countries worldwide.
In the past two decades, the treatment of debilitating, progressive diseases including immune-mediated inflammatory diseases (IMIDs) has been transformed by the introduction of biological therapies.1 However, the clinical benefits of biologic therapy are offset by challenges related to affordability of and accessibility to biologic medicines.2 Development costs remain a critical issue in biologic therapy affordability. Reference biologic drug development ranges around $1-$2 billion.3 Biosimilars on the other hand are less expensive to develop, costing around $200 million.4 This discrepancy in development costs explains how biosimilars may be more affordable, driving improved accessibility for patients.
*More side effects are reported by patients who use the internet.
†Costs or pressure from health insurance or representatives.
AE, adverse event.
Adapted by Taylor P, Braun J, et al. Anti-TNF in rheumatic diseases: Inventory and outlook. EMJ Rheumatol 2018;5:36–43
The crucial role of nurses in optimizing patient communication
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The importance of IBD nurses in discussing biologic switch with patients
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Improving patient communication through the understanding of their need to share the information
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Numerous studies have revealed non-adherence to prescribed therapies in a large proportion of patients with IMIDs including psoriasis, rheumatoid arthritis, Crohn’s disease, ulcerative colitis.1
A number of factors have been associated with non-adherence, including ‘non-specific side effects’, which have been attributed to the so-called nocebo phenomena2
Placebo versus nocebo
Nocebo effects are a result of complex interactions between the patient, their surrounding general psychosocial situation, the healthcare provider, and the way information is delivered and received1,2
Negative expectations of the patient and/or negative verbal and non-verbal communications of the physician can contribute to a nocebo effect1,2
Adapted from Colloca L, Benedetti F. Nat Rev Neurosci 2005;6:545–52
Recently, discontinuation rates reported in clinical trials for patients switching from originator biologics to biosimilar drugs have been attributed to a possible nocebo effect1-5
Nocebo effect has been shown to impact the number of AEs experienced by a patient, resulting in perceived loss of efficacy, and leading to non-adherence1
Not only does this affect patients’ QoL, but it can also affect:1
Collectively, dealing with nocebo effects results in: 2,3
Results of an international survey on biosimilars
Adapted from Jacobs I, Singh E, et al. Patient Prefer Adherence 2016;26:937–48.
*Indicates the respondent answered 'never heard of a biosimilar' in response to the survey question "Which of the following types of medications have you heard of before today?"
The nocebo effect can be mitigated through physician and patient education, effective communication, and managed care programmes1-4
Adapted from Pouillon L, Danese S, et al. Consensus report: clinical recommendations for the prevention and management of the nocebo effect in biosimilar-treated IBD patients. Aliment Pharmacol Ther 2019;49:1181–7