Qiyou Wu
Chinese Academy of Medical Sciences & Peking Union Medical College, China
Title: Factors associated with the uptake of biosimilar for breast cancer treatment from the perspectives of physicians and patients-Evidence from China
Biography
Biography: Qiyou Wu
Abstract
Factors associated with the uptake of biosimilar for breast cancer treatment from the perspectives of physicians and patients-Evidence from China
The objective of this study is to investigate the factors associated with treatment of breast cancer with
biosimilars from the perspectives of physicians and patients and to generate evidence for promoting the
uptake of biosimilars. This study targeted trastuzumab and its indicated human epidermal growth factor
receptor 2 (HER2) positive breast cancer and included female HER2 positive breast cancer patients under
treatment of trastuzumab at a provincial oncology medical center in southern China from January 1st, 2021,
to December 31st, 2021. The study extracted patients’ demographic, socioeconomic and clinical information
and the basic information of their attending physicians from the hospital information system. We performed
a bivariate multiple logistic regression analysis of factors predictive of the use of trastuzumab biosimilar. A
total of 446 patients (ranged between 26 and 74, 51.4±9.06) were included in the analysis. 19.1% of them
chose biosimilar trastuzumab, of which 6 were switched from reference trastuzumab. Older patients, patients
initiated treatment after January 2021 when biosimilar of trastuzumab entered clinical use compared with those
initiated treatment before Janauary 2021, patients enrolled in the urban and rural resident health insurance
program compared with those enrolled in the urban employee health insurance program, patients with younger
attending physicians, with male attending physicians compared with female attending physicians and with
chief physicians compared with deputy chief physicians were more likely to adopt biosimilar trastuzumab for
treatment (P<0.05). Controlling the other factors unchanged, when patient’s attending physician was deputy
chief physician, increasing 1 year age of patient was associated with increased probability of adopting biosimilar
trastuzumab by 0.8% (dy/dx=0.008, 95%CI: 0.002~0.01, P=0.01). When patient was aged between 26 and 60,
the probability to adopt biosimilar trastuzumab for patient whose attending physician was chief physician was
higher than those whose attending physician was deputy chief physician. When patient was at the age of 45,
the gap of the probability to adopt biosimilar trastuzumab was the largest. The probability to adopt biosimilar
trastuzumab for patient whose attending physician was chief physician was 20% higher than those whose
attending physician was deputy chief physician (dy/dx=0.20, 95%CI: 0.13-0.27, P<0.01). To conclude, we find
that disclosure of clinical data of biosimilar to the public and making recommendation to the indicated patient
at the initiation stage of treatment are helpful to avoid reduced willingness of switching to biosimilar due to nonclinical
reasons. Patients with lower ability-to-pay gain more economically from uptake of biosimilar. Official
guidelines and professional training are critical to enhance physicians’ willingness and confidence of adoption
of biosimilar.
Key words: Biosimilar; Uptake; Breast cancer; Physician; Patient.