From a clinical standpoint, there should not be much apprehension to using biosimilars in gastroenterology, says Bhat. However, there tend to be some differences between the products. Biosimilars like Cyltezo or Abrilada come in both autoinjector pens and syringes, which adds variability, she notes. Humira can be administered via autoinjectors and syringes. According to some studies, there could be a preference for autoinjectors over syringes.
Also, some biosimilars contain citrate, while others like Abrilada do not. Similarly, these biosimilars can come in high and low concentrations, adds Bhat. All of this makes the transition less seamless, she notes. Citrate could also make these products unsatisfactory to the patients, says Cross. Low-concentration versions of Hadlima and Hyrimoz, produced by Sandoz, Novartis’s generic subsidiary, contain citrate.
Moreover, an individual patient’s outlook on biosimilars varies. Vulto says some may not like the idea of replacing Humira with a biosimilar. Since these are injectable treatments, rather than pills or tablets, patients need to be acquainted with them over time, he explains.
Even some physicians remain hesitant about biosimilars in general. For example, despite there being a new interchangeable biosimilar in ophthalmology, there's a lot of hesitancy in adopting it because it involves the eye, and physicians have had experience with products that have damaged the eye, says Hunter. The physicians have to get over that hurdle until they feel that this is a good option for the patient and for them to use, she adds. Coherus Biosciences’ Cimerli, an interchangeable biosimilar for the ophthalmological treatment Lucentis made by Genentech, was launched in October 2022.
Furthermore, the interest in Humira biosimilars could vary depending on the condition. For example, Cross says that the Crohn’s disease space could be open to these biosimilars. But in some chronic rheumatology conditions, the practice is to not change a patient’s medicine unless needed, which could hold physicians back, says Hunter.
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