Abstract
Background
Although originator biologics are effective therapies for patients with ulcerative colitis (UC), they can be costly and may not be widely available. Therefore, less expensive biosimilars have been developed and approved to treat and manage symptoms. In this new treatment landscape, UC-treatment preferences are unknown. Thus, this interim analysis aimed to characterise physician preferences for biologics for the treatment of UC in France, Germany and the UK.
Methods
As part of a broader chart review study, treatment preferences were also collected from participating gastroenterologists and general practitioners (GPs) in France, Germany and the UK who had treated patients (≥ 18 years) with moderate-to-severe UC who had received ≥ 1 UC-related biologic any time from 2014 to 25 October 2019. Descriptive statistics were used to describe the sample overall, and by physician speciality and treatment preference.
Results
Physicians (161 gastroenterologists; 57 GPs) were from different clinical settings in France (39.9%), Germany (28.4%) and the UK (31.7%). Overall, infliximab (33.0%) and adalimumab (32.1%) were selected more often as first treatment options than their biosimilars (17.0% and 9.6%, respectively). Gastroenterologists preferred biosimilars more frequently than GPs did (35.4% vs. 1.8%). More physicians who preferred biosimilars were from France (48.3%) than Germany (17.2%) or the UK (34.5%). In France and the UK, 93.8% of physicians who selected biosimilars worked in hospital settings; in Germany, 50.0% worked in clinics and 50.0% worked in practice settings with statutory and private patients. Physicians who preferred biosimilars treated more patients with UC in the preceding 12 months than those who preferred originators did (mean ± SD: 110.3 ± 113.9 vs. 94.0 ± 93.2). Although most physicians reported efficacy as a reason for biologic preference (93.6%), physicians who preferred originators were more likely to report good tolerability (73.8%) and patient preference (20.6%) and less likely to report affordability or availability (11.9%) than physicians who preferred biosimilars (63.8%, 10.3% and 44.8%, respectively). In patients who failed anti-TNF therapy, vedolizumab was the preferred treatment (78.9%), although this preference differed by speciality (gastroenterologists: 83.2%; GPs: 66.7%).
Conclusion
Originator biologics for treating patients with moderate-to-severe UC dominate the treatment landscape in Europe, driven primarily by efficacy, tolerability and patient preference. However, variations and differences in preferences by speciality and clinical setting may suggest a need to explore additional treatment options to manage disease symptoms among patients with UC.
A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings