Background The introduction of biosimilars of originator medicines reduces cost, increases competition, expands public access and allows re-direction of healthcare funds.1,2 A tertiary hospital in Queensland informed and educated patients planned to switch from originator to biosimilar trastuzumab or rituximab, prior to their first dose of the biosimilar; in line with the Council of Australian Therapeutic Advisory Groups guiding principle number 5.3 Informing and educating patients about biosimilars is important, since gaps in awareness, understanding, and perception of biosimilars by patients and clinicians may contribute to nocebo effects and affect clinical outcomes.4-7
Aim To identify patient questions, comments or concerns with regards to switching from an originator to a biosimilar, during a patient-pharmacist interaction; and to investigate if any nocebo effects have been reported. 4
Method Patients receiving originator trastuzumab or rituximab who were planned to switch to a biosimilar were identified using pharmacy oncology software, CHARMTM. Questions, comments and concerns at the patient-cancer pharmacist interaction were documented to elucidate themes and to facilitate an accessible record. A retrospective analysis of this data was carried out. In addition, RiskMan incident reporting system was reviewed for the 9-month period post-biosimilar introduction and any reported biosimilar nocebo effects were recorded.8
Results Of the 32 patients in this study, 15 patients (47%) had comments, questions or concerns. The main themes expressed by patients included: desire to know which country the biosimilar was manufactured in, reason for switch, and efficacy of biosimilar compared to originator medicine. Over the 9-month period post-biosimilar introduction, there were no known reports by cancer services doctors of nocebo effects due to biosimilar use.8
Conclusions Pharmacists play a central role in educating patients on biosimilar medicines.3,9 By analysing patient questions and concerns, clinicians can identify gaps in current patient education, inform future biosimilar education, and potentially assist in biosimilar uptake.