Patient Preferences for Biologic and Biosimilar Osteoporosis Treatments in Colombia.

Purpose: Teriparatide is used to treat patients with established osteoporosis but is often reserved for patients who have inadequate response to antiresorptive therapy. Biosimilar teriparatide, which is believed to have efficacy and safety similar to the originator product, is now available in Colombia. However, little is known about patients' preferences for originator biologic and biosimilar treatments. Our objective was to quantify the relative importance that patients in Colombia place on features of injectable osteoporosis treatments including whether the treatment is an originator biologic or a biosimilar.
Patients and Methods: We used a discrete choice experiment (DCE) to elicit preferences of patients with osteoporosis treatment devices in Colombia. The survey was completed by 200 respondents at high risk of fracture, with or without teriparatide experience. Each treatment alternative within the DCE was characterized by five attributes: type of medicine (originator biologic, 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 preferences and conditional relative attribute importance, while controlling for preference heterogeneity.
Results: A total of 200 patients (mean age = 58.3 years) completed the survey. Most were female (84.5%) and married (54.5%); 50.5% had secondary education or less, 21% had current teriparatide exposure. The attribute with the highest conditional relative importance estimate (standard error) was biologic versus biosimilar (10 [1.11]), followed by 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 analyses.
Conclusion: Despite the availability of biosimilar teriparatide in Colombia, patients expressed a strong preference for an originator biologic osteoporosis medicine over a biosimilar osteoporosis medicine, when the efficacy, safety, and cost of the two options were assumed to be the same.
Competing Interests: Dr Peita Graham-Clarke reports being an Employee and Shareholder of Eli Lilly; Dr Brett Hauber is an employee of RTI Health Solutions during the conduct of the study; Dr Marco Boeri report Marco Boeri is an employee of RTI Health Solutions; Dr Russel Burge is a Salaried employee and stockholder of Eli Lilly and Company during the conduct of the study; Dr Maria Fernandez is an employee of RTI-HS which received funding from Eli Lilly & Co. to conduct the study which is the subject of this manuscript; Ms Antje Tockhorn-Heidenreich is an Employee and minor stockholder of Eli Lilly and Company during the conduct of the study; Dr Sandra Florez report personal fees from Eli Lilly, during the conduct of the study and is an employee of Eli Lilly; Felice Leonardi is an employee of Eli Lilly and Company. The analysis reported in this manuscript was funded by Eli Lilly and Company through a research contract with RTI Health Solutions. The authors report no other conflicts of interest in this work.
(© 2020 Graham-Clarke et al.)