A Survey Assessment of US Dermatologists’ Perception of Biosimilars

June 2017 | Volume 16 | Issue 6 | Original Article | 612 | Copyright © June 2017

Alexandra Barsell MD, Monica Rengifo-Pardo MD, and Alison Ehrlich MD MHS

The George Washington University, Washington, DC


BACKGROUND: Biologics have transformed the treatment of psoriasis and psoriatic arthritis, but at a significant cost to payers and patients. The introduction of biosimilars into the US market could reduce costs while increasing access to biologic medications.

OBJECTIVE: We sought to identify gaps in biosimilar knowledge and perception among US dermatologists.

METHODS: An online survey was sent to dermatologists from January to April 2015.

RESULTS: Ninety-seven US dermatologists responded, of which 84% state they prescribe biologics in their practice. Only 37% of dermatologists were aware that a biosimilar is highly similar to a US-licensed reference biological product, 26% incorrectly described a biosimilar as a “generic” of a known biologic, and 10% of dermatologists stated they did not know the definition. Most dermatologists (88%) believe that substitutions from biologics to biosimilars will be made by pharmacists without consulting the physician. A total of 37% of dermatologists believed that a biosimilar with the same name as a biologic suggested they are “structurally identical.” Only 25% said they would likely prescribe biosimilars to their patients, while 38% stated they would try using them on a very select, small group of patients before trying it on a majority of their patients.

LIMITATIONS: Limitations include small sample size and non-responder bias.

CONCLUSION: A biosimilars knowledge gap exists amongst dermatologists, suggesting the need for more educational initiatives.

J Drugs Dermatol. 2017;16(6):612-615.


Over the past decade, biologics have transformed the treatment of many chronic illnesses, cancers, and rheumatic diseases including psoriasis and psoriatic arthritis.1-4 Biologics are genetically engineered large, complex molecules produced from living cells that essentially copy the effects of natural substances made by the body’s immune system.1,3 Due to their nature and complexity, biologics are not only difficult to produce and manufacture, but they can cost up to 22 times more than traditional medications.1,5 In 2010, the average cost of maintenance therapy for a patient on a biologic was $26,708 per year, with increasing cost trends over the past 5 years.6 This high cost of therapy can limit patient access to biologic medicines. Additionally, many clinicians have difficulty prescribing biologics to patients because of insurance company policies.In 2010, the Food and Drug Administration (FDA) created an approval pathway for not identical but highly similar versions of biologics, known as biosimilars.1 According to the FDA, biosimilars are “highly similar to a licensed reference biological product notwithstanding minor differences in clinically inactive components, and for which there are no clinically meaningful differences between the biological product and the reference product in terms of safety, purity, and potency of the product.”7 In the United States, the use of biosimilars may be a more affordable, alternative treatment to currently available biologics and could potentially increase patient access. Nineteen biosimilars are already approved and in use in Europe, which is expected to result in savings between 11.8 and 33.4 billion euros between 2007 and 2020.8,9 Furthermore, the Congressional Budget Office has estimated that the entrance of biosimilars in the US market could save the nation up to $25 billion over the next 10 years.10 Biosimilars are thus of considerable clinical and economical interest to both payers and patients with diseases treated with biologics.The objective of this study was to ascertain US dermatologists’ knowledge and perceptions of biosimilars. This study aimed to provide valuable information on whether a practice gap exists regarding biosimilars. Furthermore, by examining the attitudes of dermatologists on the use of biosimilars, this study investigated the misconceptions and barriers to biosimilar usage in the field.


Multiple state dermatologic societies and the National Psoriasis Foundation were contacted and requested to send an online survey to their members (5 out of 19 dermatology societies accepted). A link to an electronic survey (SurveyMonkey) was distributed by email to US dermatologists who are members of the District of Columbia, Maryland, Pennsylvania, Florida, and North Carolina state society organizations and also the