OBJECTIVES : To explore European stakeholders’ opinions, behaviours, and views on biosimilars.

METHODS : A systematic literature review was undertaken using Scopus, PubMed, ScienceDirect and Ovid MEDLINE(R). Articles published between 2006 and 2018 were included. Those selected were primary research studies, available in English that examined perceptions and preferences of European stakeholders. A quality appraisal of these articles was undertaken by adapting the Young and Solomon (2009) guidance.

RESULTS

: Out of the 1,757 articles initially found, 17 articles were incorporated in the analysis. The level of knowledge, familiarity and understanding of what biosimilars actually are, seems to be quite satisfactory. However, there are still several misconceptions regarding biosimilars and their degree of similarity compared to the reference products. Overall, differences among stakeholders have been noticed, as regards their beliefs, opinions and degree of familiarity with the term of biosimilars.

Most healthcare professionals and patients have recognised the value of biosimilars, in terms of reducing costs. However, benefits such as opportunities for more treatment options have not been highlighted by demand-side stakeholders to such an extent. The fact that healthcare professionals are directed to prefer practices that reduce costs, together with the fact that patients need to deal with higher out-of-pocket costs, has probably led to recognising the need for choosing biologic treatments of lower costs. However, this awareness does not ensure the voluntary choice of cost-effective behaviours. As regards interchangeability, switching and substitution between biologics, it is evident that assessment of clinical condition is considered as a prerequisite.

CONCLUSIONS

: Biosimilars are a promising opportunity. However, stakeholders’ concerns on biosimilars’ effectiveness and safety, form obstacles to biosimilars’ uptake. Although, these concerns have been answered by European authorities, reluctance on selecting a biosimilar instead of the reference product still exists.