Understand Patient Experiences With Biosimilar Transitions


Study participants’ overall satisfaction with a mandatory nationwide adalimumab transition in New Zealand varied but was generally low.

Transitioning from originator biologics to biosimilars is an effective way to reduce the cost burden of biologics, but many patients are hesitant to switch brands for a wide variety of reasons, including biosimilar quality, safety, and efficacy. Transitions may also include an administration device change, a different formulation, and a change to self-administration, all of which may impact the patients’ experiences. Availability of more information about patients’ experiences will benefit patients who are mandated to switch or who are struggling with the decision of a voluntary switch.

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A nationwide adalimumab brand change in Aotearoa, New Zealand, provided an opportunity for researchers to collect information about patients’ experiences with a mandatory transition. ACR Open Rheumatology published survey results from 117 patients with rheumatoid arthritis. The participants answered questions about their satisfaction with logistics, patient care supplies, administrative burdens (e.g. receiving authorization or prescriptions), communication, education, and availability of support.

The researchers reported that the participants’ overall satisfaction with the mandatory nationwide adalimumab transition varied but was generally low. Patients reported mixed experiences with treatment outcomes, with some reporting increased flares and disease control loss.

Participants were satisfied with the early transition notification, the biosimilar supply, and pharmacists’ support during the transition period. Patients reported less injection pain with the biosimilar due to a different formulation.

Participants were less satisfied with the support and information received from the manufacturer, the lack of care supplies (alcohol wipes and sharps bins), and loss of general patient support (primarily text/email reminders of timing for next dose and a help number for nursing support).

Participants provided key recommendations for future transitions, including the following:

  • Improve communication before the transition starts
  • Provide more information (e.g. reason for change, cost, list supplies provided)
  • Match the biosimilar patient support program to the bio-originator’s
  • Provide expected supplies (i.e. alcohol wipes)
  • Having the option to stay on bio-originator or change back would allay fears

The authors acknowledge several limitations of their work. The study included less than 5% of the rheumatology patients who were impacted by the brand change, and therefore may have been prone to selection bias. Furthermore, patients with negative experiences may have been more likely to have answered the survey. Participant recruitment was mainly through social media, and therefore the survey may not have reached all of the patients eligible.

About the Author

Sandra Casinghino, MS, is a retired drug development biologist in Connecticut.

The researchers recommend that future biosimilar transitions should provide a similar support level and the supplies that patients are accustomed to with the originator biologics. Patients should also receive ample communication and information about the biosimilar and the transition process. The researchers suggest that a better understanding of the satisfaction and dissatisfaction patterns would enable health care teams to identify patients who may require more information, reassurance, and support.


Gasteiger C, Lobo M, Stanley R, Wong LS, Murdoch R, Dalbeth N. Rheumatology patients' experiences of a mandatory nationwide transition to an adalimumab biosimilar. ACR Open Rheumatology. 2024;6(2):64-71. doi:10.1002/acr2.11634

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