OBJECTIVES: The entrenched positioning of biologics to treat moderate-to-severe rheumatoid arthritis (RA) has generated a lucrative market. However, amid ongoing economic constraints, the EU5 (France, Germany, Italy, Spain, and the UK) must tighten their healthcare belts. As biosimilars versions of key brands appear on the horizon, this study explored the expected impact of these cheaper options on reimbursement and prescribing for RA in each country. METHODS: Across the EU5, 254 rheumatologists were surveyed regarding their views on biosimilars for RA and on current and expected prescribing patterns. In addition, 15 payers who influence reimbursement at national or regional level were interviewed. RESULTS: Considering 54-week Phase III data, ≥80% of surveyed rheumatologists in each country believe CT-P13 (biosimilar infliximab) has similar efficacy to branded Remicade; however, respondents are less confident in the biosimilar’s safety. Furthermore, >80% of respondents in most countries are willing to prescribe biosimilars of infliximab, and of etanercept and rituximab, though largely not before branded biologics. Unsurprisingly, given likely price discounts, interviewed payers will somewhat encourage biosimilar uptake. However, excluding those in Germany, consensus is that discounts offered on biosimilars will not significantly impact their budgets. German payers, however, report that additional rebates to statutory insurers are expected; they admit to financial incentives for physicians to prescribe rebated drugs, thus manufacturers may consider robust uptake will compensate for hefty discounts. CONCLUSIONS: Available data have inspired prescriber confidence in biosimilar efficacy, although safety concerns, likely stemming from complex biosimilar manufacturing and lack of long-term safety data, will ensure continued brand uptake, at least initially. Furthermore, the expected modesty of biosimilar discounts in most countries will somewhat curb payer policy promoting use of such agents. However, as prescribers become more familiar with biosimilars, and, as the full extent of cost savings are revealed, increasing uptake of biosimilars is probable.