OBJECTIVES: As EU5 healthcare budgets tighten and cost-containment strategies become ever-more convoluted, the threat of biosimilars looms large for the rheumatoid arthritis (RA) biologic brands. With the first biosimilars for RA set to penetrate these markets in 2015, this study explored their likely uptake as payers and prescribers balance clinical need with limited funds. METHODS: In September/October 2014, 253 rheumatologists across the EU5 were surveyed regarding their views on biosimilars for RA, and on current and expected biologics prescribing patterns. In addition, 15 payers who influence reimbursement at national/regional level were interviewed. RESULTS: At least three-quarters of surveyed rheumatologists in each country (>90% in Germany and Italy) plan to prescribe biosimilars of infliximab, etanercept, and rituximab within two years of launch, more frequently to new biologics patients than existing brand patients. Overall, however, in 2017, respondents expect less than half of their RA patients, on average, receiving any of these molecules to be on a biosimilar version.  Interviewed payers in France, Italy, Spain, and the UK will encourage but not mandate biosimilar prescribing, largely due to anticipated modest discounts and corresponding price cuts to the brands.  In Germany, however, payers believe that biosimilar prescribing targets and financial penalties for physicians who do not adhere will induce hefty discounts on biosimilars as robust uptake will compensate.   CONCLUSIONS: EU5 rheumatologists expect to prescribe biosimilars for RA; however, brand dominance is likely through 2017 at least, due partly to modest discounts on the biosimilars resulting in lack of incentive for payers to promote their prescribing. Both prescribers and payers are also likely somewhat wary given the dearth of long-term RA biosimilar safety data. Over time, however, increasing confidence in biosimilars is probable, as are more aggressive payer policies encouraging prescribing across the EU5, especially as a favorable price-uptake ratio looks certain in Germany.