With 2 Biosimilars Available, Use Remains Low Among Ophthalmologists

In 2022, there were 2 ophthalmology biosimilars launched in the United States, but ophthalmologists’ comfort and familiarity with biosimilars is down compared with 2021, according to a new report.

The Spherix’s Special Topix: Biosimilars Today and Tomorrow (US) report compiled feedback from US ophthalmologists to gauge their understanding of biosimilars, perception of these agents, current and projected uptake of biosimilars, and perspectives on the pipeline.

The first FDA-approved biosimilar in the ophthalmology space was Byooviz from Samsung Bioepis and Biogen, which was approved September 2021 and launched June 2022. Cimerli from Coherus Biosciences was approved August 2022 and launched October 2022 with interchangeability status. Both products are ranibizumab biosimilars.

The December report from Spherix found ophthalmologists’ comfort and familiarity ratings with biosimilars in the space have gone down since a report from a year earlier. While they are educating themselves about biosimilars through journal articles, Continuing Medical Education activities, conference presentations, and colleagues, their increased knowledge hasn’t led to more comfort prescribing these agents.

According to the report, cost and access considerations are drivers for the use of available ranibizumab biosimilars, while concerns around comparable safety and efficacy of biosimilars compared with reference products were barriers.

Currently, use of and the market share of ophthalmology biosimilars is low and future increases are projected to be modest. However, that could change as more enter the market for other biologics. There is an aflibercept (Eylea) biosimilar under review with the FDA as well as more in the pipeline, but the report found ophthalmologists were largely unaware of these developments. The patent on Eylea expires June 16, 2023.

Past experiences have shown that time on the market ultimately increases comfort and drives up utilization. While ophthalmologists have only had biosimilars on the market in the United States beginning June 2022, oncologists have had access to biosimilars as early as 2013 when Granix, the first filgrastim biosimilar, launched in the United States. A 2022 report from Cardinal Health revealed that biosimilars accounted for 89% of the market share for filgrastim, 74% of the market share for bevacizumab, 64% of market share for rituximab, 60% market share for trastuzumab.

This same Cardinal Health report echoed the findings of the Spherix report that ophthalmologists had concerns about safety and efficacy. The Cardinal report found 38% of ophthalmologists cited their primary concern with prescribing a biosimilar as being uncomfortable from a clinical standpoint. The majority (82%) said they needed educational information around safety, efficacy, and performance in order to achieve a better understanding of biosimilars.

A recent study published in The American Journal of Accountable Care® found that of 323 oncologists from the community and noncommunity setting, 94% reported being very or somewhat familiar with biosimilars and 67% had prescribed or would prescribe them to new patients or those responding to the reference product.