Canadian prescribers’ attitudes and perceptions about ophthalmic biosimilars

Introduction: The first biosimilar entered the Canadian market in 2009 and the first ophthalmic biosimilar was approved in 2022. In 2022, the Alliance for Safe Biologic Medicines (ASBM) and the International Federation on Ageing (IFA) asked prescribing ophthalmology physicians in Canada for their views on product identification, prescribing biologicals and biosimilars, and switching. Methods: In October/November 2022, the ASBM conducted a web-based quantitative survey with 41 participants practicing ophthalmology in Canada. Prescribers were asked for their views on several aspects: how products are identified; the influence of the cost of biologicals and biosimilars on prescribing; prescribing biosimilars and switching to biosimilars; pharmacist-level switching to biosimilars, and automatic substitution of biosimilars. Results: The survey reveals information about biological product identification and shows that the ophthalmologists are confident in the Canadian pharmacovigilance system’s ability to accurately identify the specific product that might be responsible for an adverse drug reaction. Most physicians are not influenced by the cost when prescribing biologicals and they are confident prescribing biosimilars and switching patients to biosimilars where appropriate. Overall, 90% of practitioners think they should have the sole authority to decide what biological is dispensed to patients and over 80% are not comfortable with third-party switching for non-medical reasons. The majority of practitioners said that the system that would best serve the patients of their province would be one in which multiple products, including innovator and biosimilars, are reimbursed, biosimilars are encouraged for new patients, and there is no automatic substitution. Conclusion: The survey reveals information about how Canadian ophthalmologists feel about the use of ophthalmic biosimilars, specifically on biological/biosimilar product identification, and prescribing and switching to biosimilars for ocular use.