{
  "abstract": "Objectives Biosimilars represent an opportunity to reduce healthcare costs. An infliximab biosimilar (b-IFX) was introduced in our hospital in 2017. Our pharmacist-led intervention aimed to improve the adoption rate of b-IFX by rheumatology physicians and outpatients.Methods In 2020, pharmacists started educating rheumatologists via medical meetings and online surveys. When the substitution rate plateaued (63%), we initiated a prospective cohort study. A senior pharmacist interviewed patients and gave them oral and written information during their infusions with the originator infliximab (o-IFX). A semi-structured questionnaire assessed patients’ beliefs, knowledge and experiences to identify barriers to switching to biosimilars. Pharmacists’ recommendations were transmitted to physicians. Patients were categorised into ‘Switch-failure’ (≥1 b-IFX infusion administered but restarted o-IFX), ‘Switch-refusal’ (refused the switch) and ‘Switch-omission’ (switch neither suggested nor made) groups. Pharmacist follow-up continued for 3 years after the interviews, with regular reminders sent to rheumatologists.Results From 1 October 2021 to 31 January 2022, 16 of 18 patients treated using o-IFX were interviewed and three, six and seven patients were categorised into the Switch-failure, Switch-refusal and Switch-omission groups, respectively. Nine patients agreed to switch during their interviews, including one patient in the Switch-failure group. Seven patients refused to switch because they were stable or had previously discontinued b-IFX due to a perceived loss of efficacy. The 3-year post-interview assessment showed that five patients had switched but one had switched back, resulting in annual savings of €44 000 and a final switch rate of 71%, a positive return on investment in pharmacist time. Four accepted switches were not performed due to coordination issues between other healthcare professionals or health-related cancellations. No o-IFX initiations occurred during the study and no rheumatologists refused substitution.Conclusions Sustained pharmacist involvement in providing targeted education to prescribers and patients was essential to identifying barriers to change and enhancing the adoption of biosimilars.",
  "authors": [
    {
      "affiliations": [
        "Pharmacy, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Marion Duwez"
    },
    {
      "affiliations": [
        "Rheumatology Division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Axel Finckh"
    },
    {
      "affiliations": [
        "Pharmacy, Geneva University Hospitals, Geneva, Switzerland",
        "Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Pascal Bonnabry"
    }
  ],
  "title": "A pharmacist-led intervention to promote the uptake of an infliximab biosimilar by patients and physicians in a university hospital rheumatology unit",
  "uid": "72b9768d-be32-52f2-be41-3655f5bd64ae"
}