In the JournalsPerspective

Positive framing improves patients’ willingness to switch to biosimilar

Keith Petrie

Although patients express concerns regarding the safety and efficacy of biosimilars, physicians can improve willingness to switch to a biosimilar by using positive framing, according to findings published in Arthritis Care & Research.

“The article idea came from a previous study that identified a variety of ways doctors would explain what a biosimilar was to a patient,” Keith Petrie, PhD, DipClinPsych, FRSNZ, of the University of Auckland, in New Zealand, told Healio Rheumatology. “Some were quite positive, saying it was very similar to the reference drug and worked the same way, while other doctors were far more uncertain, eg, ‘We can’t be sure the effect will be the same and it might not work.’”

“We wondered what effect the way different information was framed would influence patient willingness to take a biosimilar,” he added. “Data from this current study shows framing can have a powerful effect on willingness to switch and the framing was just subtlety different in terms of the doctor explaining the biosimilar being more uncertain about outcome in the negative group.”

 
Physicians can improve willingness to switch to a biosimilar by using positive framing, according to findings.
Source: Adobe

To determine whether positive or negative framing can impact the willingness of patients to switch to a biosimilar in a hypothetical situation, Petrie and colleagues conducted a parallel, four-arm, controlled, randomized trial. The researchers recruited 96 adults in the Auckland area who were being treated with an originator biologic, and randomly assigned them to one of four groups. Participants in these groups watched one of four videos, which featured a physician explaining biosimilar switching.

Each video included basic information about biosimilars. However, patients in the positive framing group received a video that stressed similarities between biologics and their biosimilars, and featured the physician using positive body language, such as nodding and smiling. In the negative framing group, participants saw a video the emphasized the differences between the two classes of drugs. In this video, the physician used a less confident tone to imply uncertainty regarding the safety and efficacy of biosimilars.

In another group, participants received the positive framing video, but also with an added analogy provided by the physician. This analogy used the concept of two brand of yeast that work in a similar way to produce the same bread, despite differences in cost and manufacturing. In the last group, participants watched the negative framing video, but with an analogy that focused on the concept of baking bread with a “cheaper” yeast from a different brand.

After watching the video, participants completed a questionnaire about their perceptions regarding biosimilars and switching.

According to Petrie and colleagues, 67% of participants exposed to positive framing reported they were willing to switch to a biosimilar, compared with 46% of those who watched the negative-framing videos. In addition, framing was a significant predictor of willingness to switch. Participants in the positive framing groups were 2.36 times more willing to switch (P = .041). Those who watching the positive video also reported significantly greater perceived efficacy regarding biosimilars (P = .046), and viewed the provided explanation as more convincing (P = .03). However, the researchers found that the analogies did not enhance willingness to switch either way or improve understanding (P > .05).

“The study may be helpful for doctors to appreciate that small changes in presentation can have large impact on how comfortable patients are with drug switches, and also probably affect side effect reporting later on, although we didn’t examine that in the current study,” Petrie said. “We found the main patient concerns were around reduced efficacy of the biosimilar and reduced safety — so these clearly need to be addressed in the conversation.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.

Keith Petrie

Although patients express concerns regarding the safety and efficacy of biosimilars, physicians can improve willingness to switch to a biosimilar by using positive framing, according to findings published in Arthritis Care & Research.

“The article idea came from a previous study that identified a variety of ways doctors would explain what a biosimilar was to a patient,” Keith Petrie, PhD, DipClinPsych, FRSNZ, of the University of Auckland, in New Zealand, told Healio Rheumatology. “Some were quite positive, saying it was very similar to the reference drug and worked the same way, while other doctors were far more uncertain, eg, ‘We can’t be sure the effect will be the same and it might not work.’”

“We wondered what effect the way different information was framed would influence patient willingness to take a biosimilar,” he added. “Data from this current study shows framing can have a powerful effect on willingness to switch and the framing was just subtlety different in terms of the doctor explaining the biosimilar being more uncertain about outcome in the negative group.”

 
Physicians can improve willingness to switch to a biosimilar by using positive framing, according to findings.
Source: Adobe

To determine whether positive or negative framing can impact the willingness of patients to switch to a biosimilar in a hypothetical situation, Petrie and colleagues conducted a parallel, four-arm, controlled, randomized trial. The researchers recruited 96 adults in the Auckland area who were being treated with an originator biologic, and randomly assigned them to one of four groups. Participants in these groups watched one of four videos, which featured a physician explaining biosimilar switching.

Each video included basic information about biosimilars. However, patients in the positive framing group received a video that stressed similarities between biologics and their biosimilars, and featured the physician using positive body language, such as nodding and smiling. In the negative framing group, participants saw a video the emphasized the differences between the two classes of drugs. In this video, the physician used a less confident tone to imply uncertainty regarding the safety and efficacy of biosimilars.

In another group, participants received the positive framing video, but also with an added analogy provided by the physician. This analogy used the concept of two brand of yeast that work in a similar way to produce the same bread, despite differences in cost and manufacturing. In the last group, participants watched the negative framing video, but with an analogy that focused on the concept of baking bread with a “cheaper” yeast from a different brand.

After watching the video, participants completed a questionnaire about their perceptions regarding biosimilars and switching.

According to Petrie and colleagues, 67% of participants exposed to positive framing reported they were willing to switch to a biosimilar, compared with 46% of those who watched the negative-framing videos. In addition, framing was a significant predictor of willingness to switch. Participants in the positive framing groups were 2.36 times more willing to switch (P = .041). Those who watching the positive video also reported significantly greater perceived efficacy regarding biosimilars (P = .046), and viewed the provided explanation as more convincing (P = .03). However, the researchers found that the analogies did not enhance willingness to switch either way or improve understanding (P > .05).

“The study may be helpful for doctors to appreciate that small changes in presentation can have large impact on how comfortable patients are with drug switches, and also probably affect side effect reporting later on, although we didn’t examine that in the current study,” Petrie said. “We found the main patient concerns were around reduced efficacy of the biosimilar and reduced safety — so these clearly need to be addressed in the conversation.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.

    Perspective
    Vickie L. Sayles

    Vickie L. Sayles

    Since both patient and health care provider acceptance is necessary to ensure a successful transition from a reference medication to a biosimilar, it is essential that patients and health care providers are fully educated on biosimilar product development, efficacy, safety and interchangeability. Without this knowledge, concerns and perceived risks may make the provider hesitant to prescribe a biosimilar and the patient to refuse to try it.

    With ongoing provider educational efforts including high-level data from clinical trials and the rigorous approval process required to ensure quality, safety and efficacy of the drug, health care providers may be more accepting and confident in prescribing biosimilars. This, in turn, will lead to more positive discussions with patients, expanded patient access and ultimately decrease health care spending.

    • Vickie L. Sayles, MHA, BSN, CRNI, RN-BC
    • Treasurer, Rheumatology Nurses Society
      Clinical nurse manager
      Department of Rheumatic and Immunologic Diseases
      The Cleveland Clinic Foundation

    Disclosures: Sayles reports speaking fees from Kevzara and Sanofi Genzyme.

    See more from Biosimilars in the United States: Current Status and Future Implications