Drs Mark G. Lebwohl and Joseph F. Merola discuss the use of biosimilars in psoriasis and how biosimilars will change the treatment landscape.
Mark G. Lebwohl, MD: The last question, which is important, is about biosimilars that are coming. How do you think that will impact the treatment landscape for psoriasis and psoriatic arthritis, specifically TNF [tumor necrosis factor] biosimilars?
Joseph F. Merola, MD, MMSc: There’s the good and the bad. I’ll start with the good first. More drugs mean more access. We need access for many of our patients who can’t get anything in many cases. I hope that some of that competitive landscape means more access. I’m sure Mark feels similarly. We needed many of our patients. That’s good. I’ll also say that there’s always some apprehension about what it means to change patients who are on a drug that’s working for them. We have support from studies like NOR SWITCH and others that support that switching. It seems to be well tolerated and to continue to provide efficacy for our patients with these diseases. That’s a positive.
On the flip side, there’s the potential for what many will call a nocebo effect: a patient hears they have to change a drug, and suddenly they develop new or worsening symptoms. They have negative expectations about what that means. Guess what that generates? Calls to the office, failure of drugs, etc. I also have some concern that all the devices that these things come in are going to look and feel different. That’s going to generate a burden on the office because of more prior authorizations, more patient calls, more confusion, more misfiring. Mark, you’ve thought about this deeply. Tell me what I’m not thinking about, good and bad.
Mark G. Lebwohl, MD: We have a whole staff dedicated to getting approvals and generating prior authorization forms for biologics. We have an entire team. I can tell you that we have managed to make it worth our while. It certainly helps our patients, and that’s going to get worse, but we’re going to have to move with it. We’re going to have to comply with whatever is thrown our way.
Transcript Edited for Clarity