MEDICAL SPECIALISTS’ KNOWLEDGE AND PERCEPTIONS OF BIOLOGICS AND BIOSIMILARS: A LITERATURE REVIEW
Keywords:
Biologicals, Biosimilars, Medical specialists, KnowledgeAbstract
Introduction: Newly developed biological medicines offer essential treatment for many acute and chronic conditions. In addition, the increasing availability of biosimilar drugs improve access to vital biologic treatments. Medical specialists prescribe biological medicines, thus the adoption of these products in the market heavily relies on their readiness to prescribe, and integrate them into clinical practice, which depends on their knowledge, perspectives, and beliefs.
Aim: To review the scientific literature regarding knowledge and perceptions related to the use of originator biologics and biosimilars, along with the need for additional education on this topic.
Material and methods: A literature search was conducted using journal databases, such as PubMed, Cochrane Library, and Scopus, with carefully selected search terms, and applying the inclusion criteria that match the aim of the study.
Results: The majority of studies meeting the specified criteria were carried out in Europe and the USA, primarily in the form of brief surveys. Studies show that most of the medical specialists are familiar with the biologic medicines, however their measured knowledge was less extensive than their self-assessed knowledge. In general, a larger percentage of those who were surveyed expressed the need for additional education.
Conclusions: Medical specialists’ knowledge and opinions towards biologics in general are highly variable, with a general observation that there is a need of increasing the knowledge in the field. Therefore, education is a key prerequisite for better understanding the differences among originator biologics and biosimilars, which will support their inclusion into treatment plans.
References
Biosimilar medicines: Overview | European Medicines Agency (EMA); Available online: https://www.ema.europa.eu/en/human-regulatory-overview/biosimilar-medicines-overview (accessed 05.08.2025)
Directive - 2001/83 - EN - EUR-LexAvailable online: https://eur-lex.europa.eu/eli/dir/2001/83/oj/eng (accessed 05.08.2025)
Schellekens H, Smolen JS, Dicato M, Rifkin RM. Safety and efficacy of biosimilars in oncology. Lancet Oncol 2016; 17(11): e502-e509. doi: 10.1016/S1470-2045(16)30374-6. Erratum in: Lancet Oncol 2017; 18(3): e134. doi: 10.1016/S1470-2045(17)30094-3.
European Medicines Agency and European Commission. Biosimilars in the EU - Information guide for healthcare professionals v. 13.11.2023. Available online:https://www.ema.europa.eu/en/documents/leaflet/biosimilars-eu-information-guide-healthcare-professionals_en.pdf
Sarnola K, Merikoski M, Jyrkkä J, Hämeen-Anttila K. Physicians' perceptions of the uptake of biosimilars: a systematic review. BMJ Open 2020; 10(5): e034183. doi: 10.1136/bmjopen-2019-034183.
IQVIA. The Impact of Biosimilar Competition in Europe. December 2021:[White Paper]. https://w ww. iqvia. com/-/ media/ iqvia/p dfs/l ibrar y/w hite-p apers/t he-impact-o f-b iosimilar-c ompetition- in- europe- 2021. pdf.
Hung A, Vu Q, Mostovoy L. A Systematic Review of U.S. Biosimilar Approvals: What Evidence Does the FDA Require and How Are Manufacturers Responding? J Manag Care Spec Pharm 2017; 23(12): 1234-1244. doi: 10.18553/jmcp.2017.23.12.1234.
Inotai A, Csanadi M, Petrova G, Dimitrova M, Bochenek T, Tesar T, et al. Patient Access, Unmet Medical Need, Expected Benefits, and Concerns Related to the Utilisation of Biosimilars in Eastern European Countries: A Survey of Experts. Biomed Res Int 2018; 2018: 9597362. doi: 10.1155/2018/9597362.
Cross R, Stewart A, Edgerton C, Shah B, Welz J, Kay J. Implementation Strategies of Biosimilars in Healthcare Systems: The Path Forward. Am Health Drug Benefits. 2022; 15(2): 45-53. doi:
Gibofsky A, Badawi S. Biosimilar Knowledge Among US Rheumatologists – a Survey [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10).
van Overbeeke E, De Beleyr B, de Hoon J, Westhovens R, Huys I. Perception of Originator Biologics and Biosimilars: A Survey Among Belgian Rheumatoid Arthritis Patients and Rheumatologists. BioDrugs 2017; 31(5): 447-459. doi: 10.1007/s40259-017-0244-3.
Kellner H, Domènech E, Lakatos PL. Awareness and acceptance of biosimilars by rheumatologists in eleven EU countries. Ann Rheum Dis 2016; 75(Suppl 2): 1008.
Leonard E, Wascovich M, Oskouei S, Gurz P, Carpenter D. Factors Affecting Health Care Provider Knowledge and Acceptance of Biosimilar Medicines: A Systematic Review. J Manag Care Spec Pharm 2019; 25(1): 102-112. doi: 10.18553/jmcp.2019.25.1.102.
Oskouei ST, Kusmierczyk AR. Biosimilar Uptake: The Importance of Healthcare Provider Education. Pharmaceut Med 2021; 35(4): 215-224. doi: 10.1007/s40290-021-00396-7.
Barsell A, Rengifo-Pardo M, Ehrlich A. A Survey Assessment of US Dermatologists' Perception of Biosimilars. J Drugs Dermatol 2017; 16(6): 612-615. PMID: 28686780.
Peipert JD, Kaiser K, Kircher S, Greene GJ, Shaunfield S, Hauner K, et al. Medical Oncologists' Knowledge and Perspectives on the Use of Biosimilars in the United States. JCO Oncol Pract 2023; 19(3): e457-e464. doi: 10.1200/OP.22.00502.
Giuliani R, Tabernero J, Cardoso F, McGregor KH, Vyas M, de Vries EGE. Knowledge and use of biosimilars in oncology: a survey by the European Society for Medical Oncology. ESMO Open 2019; 4(2): e000460. doi: 10.1136/esmoopen-2018-000460.
Cook JW, McGrath MK, Dixon MD, Switchenko JM, Harvey RD, Pentz RD. Academic oncology clinicians' understanding of biosimilars and information needed before prescribing. Ther Adv Med Oncol 2019; 11: 1758835918818335. doi: 10.1177/1758835918818335.
Hu Y, Song Z, Jiang D, Zhuo L, Cheng Y, Zhao R. Knowledge, Attitudes and Practice of Healthcare Providers, Healthcare Regulatory Practitioners and Patients Toward Biosimilars in China: Insights From a Nationwide Survey. Front Pharmacol 2022; 13: 876503. doi: 10.3389/fphar.2022.876503.
Ismailov RM, Khasanova ZD. Biosimilar Knowledge Among Oncology/Hematology Team Members in Colorado, USA: An Educational Initiative and Follow-Up Survey. BioDrugs 2018; 32(5): 499-506. doi: 10.1007/s40259-018-0301-6.
Cohen H, Beydoun D, Chien D, Lessor T, McCabe D, Muenzberg M, et al. Awareness, Knowledge, and Perceptions of Biosimilars Among Specialty Physicians. Adv Ther 2017; 33(12): 2160-2172. doi: 10.1007/s12325-016-0431-5.
Chapman SR, Fitzpatrick RW, Aladul MI. Knowledge, attitude and prac tice of health care professionals towards infliximab and insulin glargine bio similars: result of a UK web-based survey. BMJ Open 2017; 7(6): e016730. doi: 10.1136/bmjopen-2017-016730.
O'Callaghan J, Bermingham M, Leonard M, Hallinan F, Morris JM, Moore U, et al. Assessing awareness and attitudes of healthcare professionals on the use of biosimilar medicines: A survey of physicians and pharmacists in Ireland. Regul Toxicol Pharmacol 2017; 88: 252-261. doi: 10.1016/j.yrtph.2017.06.013.
Micó-Pérez RM, Payares-Herrera C, Palomo-Jiménez, Sánchez-Fierro J, Avendaño-Solá C, Llisterri-Caro JL. ConocimientosobrebiosimilaresenAtención Primaria: Un estudio de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Med. Fam. Semer 2018; 44(6): 380-388. doi: 10.1016/j.semerg.2018.01.002.
Pasina L, Casadei G, Nobili A. A survey among hospital specialists and pharmacists about biosimilars. Eur J Intern Med 2016; 35: e31-e33. doi: 10.1016/j.ejim.2016.07.010.
Karateev D, Belokoneva N. Evaluation of physicians’ knowledge andattitudes towards biosimilars in Russia and issues associated withtheir prescribing. Biomolecules 2019; 9(2): 57. doi: 10.3390/biom9020057.
Poon SY, Hsu JC, Ko Y, Chiang SC. Assessing Knowledge and Attitude of Healthcare Professionals on Biosimilars: A National Survey for Pharmacists and Physicians in Taiwan. Healthcare (Basel) 2021; 9(11): 1600. doi: 10.3390/healthcare9111600.
Thongpooswan S, Das A, Patil P, Latymer M, Llamado L, Wee J. Physicians' and patients' perception of biosimilars and factors affecting biosimilar prescribing in selected Asian countries: a survey study. Expert Opin Biol Ther 2024; 24(10): 1171-1182. doi: 10.1080/14712598.2024.2400523.
Sidikou O, Mondoloni P, Leroy B, et al CP-108 Biosimilars: What do clinicians actually think? European Journal of Hospital Pharmacy 2016;23:A47-A48.
Rieger C, Dean JA, Hall L, Vasquez P, Merlo G. Barriers and Enablers Affecting the Uptake of Biosimilar Medicines Viewed Through the Lens of Actor Network Theory: A Systematic Review. BioDrugs 2024; 38(4): 541-555. doi: 10.1007/s40259-024-00659-0.
Sotirovski T, Damevska K, Peshikj N, Mirchevska Arsovska E, Filipovikj D, Batkoska Shekutkoska B, et al. Guidelines for systematic treatment of patients with psoriasis at the University clinic for dermatology-Skopje. Acad Med J 2025; 5(Suppl 1): S1-S8. UDC: 616.517-085 https://www.doi.org/10.53582/AMJ255101s Guidelines.
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