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Can Reassurance Techniques Improve Patient Confidence in Biosimilars for Psoriasis?


A number of psychologic interventions were assessed to see if they could have an effect on patient confidence in biosimilars to treat psoriasis.

Psychological interventions can positively impact patient outcomes, but do not significantly effect patient confidence in biosimilars, according to a study published in Dermatology and Therapy.

Although biosimilars reduce costs and expand access to high-quality treatments, patients may have negative perceptions because of a lack of knowledge. “There is a need to educate patients on biosimilars’ clinical equivalence to bio-originators, and specific interventions have not yet been extensively tested,” wrote the authors from Wake Forest School of Medicine.

Patients with self-reported psoriasis were recruited to complete a survey between May 17, 2020, and January 25, 2021. A total of 1253 patients completed the survey. The mean age of the participants was 36 years, and a slight majority (53%) were female. A majority were White (65%), had at least a bachelor’s degree (67%), and had annual household incomes over $50,000 (53%).

The respondents were randomized into 10 groups:

  • Group A had a hypothetical scenario where they were stepping up to a biosimilar from a topical corticosteroid cream (biosimilar control group)
  • Group B had a hypothetical scenario where they were stepping up to a biologic from a topical corticosteroid cream
  • Groups C through J were given a hypothetical scenario in which they had achieved great results on a biologic for 2 years and were being asked to switch to a biosimilar
    • Group C received no reassurance
    • Group D was informed of evidence of comparable clinical effectiveness
    • Group E was presented with an illustration depicting comparable effectiveness
    • Group F was given anecdotes of treatment success in other patients with psoriasis
    • Group G received anecdotes of treatment success in another patient with psoriasis who was a lot like them
    • Group H was explained the rigorous evaluation biosimilars go through to gain approval
    • Group I received an explanation of biologics and biosimilars and were asked to explain it to another patient with multiple choice options
    • Group J received an explanation of biologics and biosimilars and were asked to explain it to another patient with a free response format

Group D was the only intervention that did not produce slightly higher treatment confidence compared with the biosimilar switch control group. Group E, which received an illustration on comparability for biosimilars and biologics, and Group H, which received an explanation on the evaluation biosimilars go through for FDA approval, had the highest confidence scores.

Of the 2 groups receiving anecdotes of patients with psoriasis, the group receiving anecdotes of a patient a lot like them had slightly greater increases in confidence. Of the patients who were asked to explain biologics and biosimilars to another patient, the free response format was slightly more effective at improving confidence.

“Although the reassurance interventions generally produced small trends in the expected direction, no statistically significant differences were detected,” the authors noted.

They added that these psychologic interventions are easily implementable techniques that clinicians can use to improve outcomes, and that improving confidence in biosimilars is an important aspect of expanding access to medications. However, the interventions studied did not improve confidence in biosimilars by much, the researchers wrote.

“Reiterating the rigorous evaluation process that biosimilars undergo to gain FDA approval and/or providing patients with illustrations depicting biosimilars’ comparability to bio-originators appear to produce small improvements in biosimilar confidence and may be interventions to focus on for future development,” they concluded.


Hrin ML, Bray JK, Feldman SR. Reassurance techniques do not significantly impact confidence in biosimilars for psoriasis: a survey of a convenience sample of individuals with self-identified psoriasis. Dermatol Ther (Heidelb). Published online July 28, 2022. doi:10.1007/s13555-022-00781-3

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