| Abstrakt: |
Background: The implementation of biosimilars has been shown to reduce costs and improve access to biological medicines in many countries around the world. This is important in the field of oncology where the use of targeted biological medicines has improved cancer outcomes in several tumour types. In 2019, an ISOPP survey identified several barriers to biosimilar implementation faced by oncology pharmacists internationally. The African region was identified as facing several challenges to implementation that were different from those experienced in higher-income settings. Purpose: The survey was designed to explore these challenges further, with a view to designing educationalmaterials and resources which meet the specific needs of oncology pharmacists and other oncology professionals in Africa. Method: A questionnaire was drafted based on the original international questionnaire, and then discussed with a focus group of African pharmacists via Zoom to adapt the questions to reflect African practice. The finished questionnaire was distributed to ISOPP members and shared further using local professional networks and national oncology pharmacy associations. Results: Sixteen responses were received from a range of African countries: Nigeria (n = 5), Kenya (n = 3), Ghana (n = 2), Malawi (n = 2), Rwanda (n = 1), South Africa (n = 1), Uganda (n = 1) and Zambia (n = 1). The majority (94%) of respondents were hospital pharmacists from a range of institutions including private, government, academic and specialist hospitals. 94% of respondents were already using biosimilars, and all planned to use them in the future. The biggest factor influencing the decision to use biosimilars was cost, with most treatments being funded completely or partly out of pocket or via a health insurance scheme. The range of products available varied. Supportive medicine biosimilars such as filgrastim and epoetin were available to 87% and 69% of respondents, respectively; around 60% of respondents had access to rituximab, trastuzumab and bevacizumab biosimilars. Infliximab (16%) and cetuximab (25%) were the least available biosimilar products. The biggest barriers to implementation were a lack of availability of licensed biosimilar products and the reluctance of prescribers to switch established patients to a biosimilar. A quarter of respondents indicated the availability of unlicensed biologic medicines, known as ‘biomimics’. Knowledge and awareness of biosimilars were rated as low among both patients and healthcare professionals, highlighting a continued need for education and training. Suggested resources to address these needs were prescribing guidelines, patient education materials and healthcare professional education materials, with in-person training and webinars being the preferred platform for education. Conclusion: African pharmacists are keen to use biosimilars in their institutions, seeing cost savings as the main advantage. The main challenges identified were the availability of licensed products, suggesting regulatory issues of problems with the market for biosimilars in Africa, and a lack of understanding about biosimilar products among both patients and healthcare professionals. It would be useful for ISOPP to develop some education and training materials adapted for use in the African region, but further work is required at the governmental level to improve biosimilar availability. [ABSTRACT FROM AUTHOR] |
