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Patient Education Can Prevent Nocebo Effect With Adalimumab Biosimilars, Explains Laura Wingate


As Humira biosimilars enter the market, patient education about biosimilars is crucial to prevent the nocebo effect when patients switch from the reference product, explained Laura Wingate, executive vice president, Education, Support, & Advocacy, Crohn's & Colitis Foundation.

While the first adalimumab (Humira) biosimilar in the United States was approved almost 7 years ago, successful patent litigation by Humira’s maker, AbbVie, has kept biosimilars off the market. During that time, Humira became the top-selling drug in the world with revenues topping $20 billion.

In January, the first biosimilar launched in the United States, with an additional 7 entering the market in the first week of July. At least 1 more approved biosimilar is expected to launch this year, with more to potentially get approved.

This sort of increased competition for the first time for Humira will require good patient education around biosimilars to ensure they don’t experience a nocebo effect when switching from Humira to a biosimilar, explained Laura Wingate, executive vice president, Education, Support, & Advocacy, Crohn's & Colitis Foundation.

For the first time in 2 decades, Humira has competition on the market with the arrival of 8 biosimilars, and more to come. What does it mean to patients for Humira to have this competition?

For patients who are currently on Humira, this is a big change. If Humira is working for them, the switch from Humira to one of the biosimilars needs to be handled really well. There needs to be patient education, there needs to be a conversation between the physician and the patient about the move to a biosimilar.

Because we know that when a patient is appropriately educated about biosimilars and feels confident in their doctor helping to make that choice, they transition very well and there is no nocebo effect. Whereas we know from studies, both here in the United States and in Europe, that when a patient isn't appropriately educated, they experience the nocebo effect and don't believe the drug’s working as well.

So, I think this is an essential time to really—whether it's a nurse practitioner, an advanced practice provider, the physician themselves, or sending patients to organizations like the Crohn's and Colitis Foundation—to get educated about biosimilars. This is the time to do it, so people are comfortable and don't feel that this is being imposed on them, and that they have the ability to participate in the decision on their treatment option.

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