Prim. Pavel Jindra: Biosimilars are an accessible and effective treatment modality in hematooncology

Since 2006, nearly 90 biosimilars have been registered in Europe. How many are related to hematooncological treatment, and is oncology a key field for the introduction of biosimilars?

I don't have a precise idea of how many biosimilars pertain to oncology. However, I estimate that about a quarter or a fifth might relate to hematooncology. It also depends on how we understand biosimilar treatment here. We have biosimilars available for both primary oncological therapy and supportive treatment, such as growth factors, erythropoietin, or antifungals. Oncology is undoubtedly one of the key fields where biosimilars are used. Modern oncological treatment is increasingly expensive, and these drugs enable greater accessibility for a broader range of patients.

What is the ratio of original oncological drugs to biosimilars in prescriptions? Are there clear rules, or does it depend on the doctors' decisions?

I think it's a complex set of factors. Primarily, we have clear rules for when biosimilars are indicated and what their reimbursement is. Additionally, hospitals issue tenders for individual biosimilars, and based on that, departments establish their own guidelines for when to indicate the original drug and when to use a specific biosimilar.

Which indications in hematooncology were the first to see the introduction of biosimilars?

Among the first biosimilar drugs introduced into practice are rituximab, primarily used in the treatment of non-Hodgkin's lymphomas, and imatinib for the treatment of patients with chronic myeloid leukemia.

The introduction of biosimilars was accompanied by mild concerns, but their economic benefit was highlighted. Do experts now have confidence in this type of treatment?

The professional society neither has the means nor the authority to assess the safety of biosimilars. That is the role of the national regulatory authority – SÚKL. Even a doctor is not in a position to question the decisions of the regulatory authority.

Of course, we can encounter individual adverse reactions to a biosimilar drug that need to be monitored and reported. An example might be an allergic reaction. However, this adverse effect also occurs with original drugs, so it cannot be directly linked to the fact that it is a biosimilar.

Overall, I am convinced that the majority of the professional public views biosimilars as a sensible, safe, and effective alternative to original treatments.

What do patients think of biosimilars? Do some insist on the original drugs?

Of course, some patients ask questions and have certain concerns when we offer them biosimilars. It is up to the attending physician to explain to the patient that it is a safe and equally effective treatment. It mostly comes down to creating trust and good communication between the doctor and the patient.

Have biosimilars really increased the accessibility of treatment in hematooncology? Have they saved and prolonged more lives?

Yes, by reducing treatment costs, not only has accessibility increased, but it has also enabled reimbursement for new expensive drugs. It's important to realize that many of our patients need lifelong treatment. In such cases, the savings are truly significant.

Is it suitable to switch from an original drug to a biosimilar?

This cannot be said in general terms; we would need to consider each drug and each indication separately. However, I dare say that the initial concerns about switching have eased, and in practice, it is common to perform it.

Which other biosimilars can we expect in your field?

Soon, new biosimilars should appear in the treatment of multiple myeloma and non-Hodgkin's lymphomas, as well as in supportive treatment for iron overload in patients with myelodysplasia and chronic myeloid leukemia.

What besides biosimilars can help achieve better outcomes, better quality of life, and longer survival for your patients?

Definitely improving the accessibility of treatment in centers that are overloaded would help. It's not just about the availability of drugs but also about bed capacity. And last but not least, having an experienced medical staff is essential. Because even the best biosimilars are of no use if misindicated, or if there is no one to indicate them.

MUDr. Andrea Skálová
editorial staff of proLékaře.cz