Résumé
Purpose: In France, the integration of biosimilars into medical practice in rheumatology and gastroenterology is well established. Despite a high penetration rate in hospitals, the adoption of biosimilars varies depending on the molecules. This adoption differs between new patients, for whom biosimilars are prescribed as initial biologic treatment, and those receiving these medications as part of a treatment switch from reference biologics. The objective of the COMPRENDRE study was to identify and understand the obstacles to switching from reference biologic products to their biosimilars by examining prescription practices and patient decisions. This study proposes recommendations to overcome these barriers.Patients and methods: A total of twelve rheumatology and gastroenterology prescribers and fourteen patients with rheumatologic and gastrointestinal disorders were interviewed for qualitative insights. Subsequently, one hundred prescribing physicians and one hundred ninety patients responded to a quantitative survey to validate and explore these findings. The study was supervised by a multidisciplinary expert committee.Results: The results from the quantitative and qualitative surveys show similarities in the outcomes. In the qualitative study, 71% (10/14) of patients accepted the switch to a biosimilar. For half of them (7/14), trust in the physician-patient relationship was the main reason for acceptance. Key barriers identified by prescribers included the limited time available during consultations and patient anxiety due to their illness, both of which negatively impacted willingness to switch. In the quantitative study, 89% (89/100) prescribers reported prescribing biosimilars through switching from the reference biologic. However, only 33% (29/89) indicated that they systematically switch eligible patients. Overall, 55% (104/190) of the patients surveyed had never been offered a switch to a biosimilar.Conclusion: Switching from a reference biologic to biosimilars is hampered by several factors, including the lack of systemic proposals in the practice of prescribers as well as the lack of information given to patients.