Treatment journey in rheumatoid arthritis with biosimilars: from better access to good disease control through cost savings and prevention of nocebo effects.

Early diagnosis and treatment of rheumatoid arthritis (RA) are of critical importance to halt the progression of the disease. Optimal use of advanced imaging techniques or biomarkers may facilitate early diagnosis of RA. Even though many disease-modifying anti-rheumatic drugs (DMARDs) are available for RA treatment, biological DMARDs (bDMARDs) offer expanding therapeutic options and good outcomes in patients with RA who do not have a sufficient response to conventional synthetic DMARDs. However, high costs of bDMARDs have limited patient access to optimised disease management and increased the cost burden for healthcare systems. The advent of biosimilars led to significant cost savings driven by price competition among the reference products, which could be beneficial for healthcare systems. Healthcare provider (HCP)-patient communication and informed shared decision-making are crucial to prevent the occurrence of a nocebo effect, which results from negative perceptions that patients may have and could lead to less effective outcomes. Research has demonstrated that effective communication between HCPs and patients utilising positive framing can improve acceptance by patients to be initiated on or switched to a biosimilar and can help to integrate biosimilars into routine clinical practice to maximise benefits for patients with RA.

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Competing interests: JSS received personal remuneration from AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Celgene, Celltrion, ILTOO, Janssen, Eli Lilly and Company, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung Bioepis, Sanofi and UCB and research funding from AbbVie, Janssen, Eli Lilly and Company, Novartis-Sandoz, Pfizer and Roche. MJ received research funding from Bristol-Myers Squibb, Crescendo Bioscience and Sanofi/Regeneron; has served as a consultant and/or advisory board member for AbbVie, Amgen, Bristol-MyersSquibb, Crescendo Bioscience, Corrona, GSK, Gilead, Eli Lilly and Company, Lycera, Merck, Novartis, Pfizer, Roche, Samsung Bioepis and Set Point and has financial interests/stock ownership in Lycera, Canfite, Scipher and Vorso. RC received speaker and advisory fees from AbbVie, Bristol Myers Squibb, Celgene, Celltrion, Eli Lilly and Company, Galapagos, Gilead, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, Samsung Bioepis and UCB. TD received grant support for conducting clinical studies from Janssen, Novartis, BMS, Sanofi, Roche, AbbVie and received consultancy support from AbbVie, BMS/Celgene, Eli Lilly and Company, Janssen, Novartis, Genentech/Roche, Samsung Bioepis and UCB, and speaker bureau fees from Eli Lilly and Company and Samsung Bioepis. BF received consulting fees from AbbVie, Amgen, Biogen, Bristol-Meyers Squibb, Celgene, Hospira, Janssen, Eli Lilly and Company, Medac, MSD, NORDIC Pharma, Novartis, Pfizer, Roche, Sobi and UCB and research grants from AbbVie, Eli Lilly and Company, MSD, Pfizer. The remaining author has no conflicts of interests.