OBJECTIVES: Teriparatide (FORTEO [teriparatide (rDNA origin) injection]) is used to treat patients with established osteoporosis but often reserved for patients who have inadequate response to antiresorptive therapy. Biosimilar teriparatide is now available in Colombia, potentially enabling expansion of treatment access at decreased cost. Despite equivalent efficacy and safety, little is known about patients’ perspectives for original biologic and biosimilar treatment. Our objective was to quantify the relative importance that patients in Colombia place on potential features of injectable osteoporosis treatments.

METHODS: We used a discrete-choice experiment (DCE) to elicit preferences of patients with osteoporosis in Colombia. The survey was completed by 200 respondents at high risk of fracture with or without teriparatide experience. Within the DCE, patients repeatedly chose between two hypothetical injectable medicines characterized by five attributes: type of medicine (original biologic or biosimilar), needle length, angle of injection, how to measure the medicine dose, and how long the medicine can be left unrefrigerated. A random parameters logit regression was used to estimate preference and conditional relative attribute importance, while controlling for preference heterogeneity.

RESULTS: 200 patients (mean age = 58.3 years) completed the survey. Most were female (84.5%), married (54.5%), 50.5% had secondary education or less and 21% had current teriparatide exposure. Few patients (16%) were employed full time. The attribute relative importance, rescaled so that the most important was equal to 10, was: biologic versus biosimilar (10 [1.11]), needle length (8.06 [1.11]), dose measurement (6.38 [0.87]), refrigeration (3.81 [1.18]), and angle of injection (1.30 [0.66]). Unobserved preference heterogeneity was present and controlled for in the data.

CONCLUSIONS: Despite the availability of biosimilar teriparatide in Colombia, patients expressed a strong preference for an originator biologic osteoporosis medicine over a biosimilar osteoporosis medicine even when the efficacy and safety of the two options were assumed to be the same.