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Physician Understanding and Willingness to Prescribe Biosimilars: Findings from a US National Survey



Biosimilars have the potential to increase patient access and significantly reduce healthcare costs in the US. However, uptake in the US has been slower than anticipated, limiting the benefits of biosimilar competition. Understanding the factors that affect uptake is critically important to realize the benefits of biosimilars.


A US national survey study was conducted electronically from December 11, 2019 to January 8, 2020. The survey was administered to 507 US healthcare professionals practicing in dermatology, gastroenterology, hematology, oncology, nephrology, or rheumatology. The survey evaluated prescriber attitudes toward biosimilars in general, as well as prescriber decision making, using a series of hypothetical scenarios with fictional biological products.


Fewer than half had a baseline understanding of key elements of biosimilarity, even among respondents who had previously prescribed a biosimilar. Regardless of previous experience, all respondents benefited from receiving additional information about biosimilarity, indicating the potential benefits of educational efforts for prescribers across all specialties and levels of experience. Prescriber choice was driven primarily by formulary status; however, respondents identified a variety of factors that would influence their willingness to prescribe a biosimilar, including financial savings to the patient, pharmacovigilance, patient experience, and education on the FDA approval process. Over one-third of participants indicated a preference for reference products and nearly half indicated a hesitancy to try biosimilars until they have been on the market longer. Naming conventions for biosimilars did not affect prescribers’ willingness to prescribe biosimilars.


Gaps in prescriber knowledge and hesitancy toward biosimilars remain significant challenges for biosimilar uptake. While formulary status of a biosimilar product strongly influences prescriber choice, additional prescriber education on biosimilarity is needed.

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The authors thank Elisabeth Newcomb Sinha and Zahava Hurwitz for assistance with the survey.

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Correspondence to Allison R. Kolbe.

Ethics declarations


The funding for this study was provided by the US Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (Contract No. GS-10F-0067X Task Order No. HHSP233201400379G). This project was supported in part by an appointment (ARK) to the Research Participation Program at the Department of Health and Human Services administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the Department of Health and Human Services.

Conflict of interest

The authors declare no conflicts of interest.

Availability of data and material

Data are available upon request.

Ethics approval

This survey study was reviewed by the New England Independent Review Board and was deemed exempt.

Author contributions

AJ conceived of and designed the study. ARK, AK, and JX analyzed survey results. All of the authors assisted with data interpretation. ARK prepared the manuscript with contributions from all the authors.

Additional information


Any opinions presented in this paper are of the authors only and do not represent the views of their employers. Dr Jessup’s contribution occurred entirely when she worked at the Assistant Secretary for Planning and Evaluation, Washington D.C., USA. She is currently affiliated with the HHS Office of the Inspector General.

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Kolbe, A.R., Kearsley, A., Merchant, L. et al. Physician Understanding and Willingness to Prescribe Biosimilars: Findings from a US National Survey. BioDrugs 35, 363–372 (2021).

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