The Power of a Name

Just how important is a name? A new study suggests that the name of a biosimilar product could influence pharmacist confidence levels when dispensing a biosimilar in place of a reference biologic. 

The study, published in The Journal of Managed Care & Specialty Pharmacy, found that although one naming option was preferred by most survey respondents, another naming option was reported to give pharmacists higher levels of confidence when dispensing the product.

“Pharmacists still aren’t sure what the best answer is regarding the naming of biosimilars, and I think that talks to their hesitation to some degree with the biosimilar product outright,” said Daniel Tomaszewski, PharmD, PhD, the study’s author and an assistant professor at Chapman University.

Community pharmacists agree that when it comes to biosimilar naming preferences and presumed confidence levels, there are still discrepancies in the field.

“There is no consensus,” said Marshal Abdullah, PharmD, RPh, a clinical pharmacist for Mickey Fine Pharmacy in Beverly Hills, California.

According to Tomaszewski’s study,“Biosimilar Naming Conventions: Pharmacist Perceptions and Impact on Confidence in Dispensing Biologics,” 48% of the pharmacists surveyed preferred a biosimilar naming convention that uses a nonproprietary base with a designated suffix. This option outranked the use of a nonproprietary base alone, which appealed to 26% of survey respondents; a nonproprietary base plus a prefix, which was chosen by 14.2% of participants; and a unique brand name, preferred by only 11.4%.

However, when it came to pharmacist confidence levels, the majority (62.9%) reported high levels of confidence when the product shared the same nonproprietary name as the reference biologic.

 “It tells me . . . that a name can add confidence even if it’s not the same.” Tomaszewski said.

When Drug Topics asked community pharmacists for their take on the study’s findings, we found a wide range of differing opinions- particularly when it came to the preferred naming convention for biosimilar products.

“It seems like we’ve made this more convoluted than it needs to be. It calls to mind birth control where you have different branded versions, but the generic name is the generic name. So why aren’t we doing that?” said Jake Galdo, PharmD, BCPS, CGP, who practices at Family Medical Services in Bessemer, Alabama.

Hali Gipson, a pharmacy student, says she would prefer a nonproprietary base and a suffix, particularly if the suffix related to the drug’s specific class.

“As a dispensing pharmacist, I would be more comfortable knowing the exact indication for each one by seeing that suffix,” she said.

Some, however, feel that a suffix, could lead to confusion. For instance, Galdo, who also serves as an assistant professor at Samford University, points to the recent passage of biosimilar filgrastim-sndz [a leukocyte growth factor designed to decrease the chance of infection in people who have certain types of cancer and who are receiving chemotherapy medications that may decrease the number of neutrophils].

In this case, the suffix only relates to the drug’s manufacturer, Sandoz. However, Galdo says that without proper education, pharmacists could see the suffix and assume it signals a difference in the product-much like the difference that exists between hydroxyzine hydrochloride and hydroxyzine pamoate.

Abdullah, who also serves as the AMCP Southern California State Advocacy Coordinator, asserts that he is fine with any naming convention as long as it doesn’t add confusion. He thinks the best way to eliminate confusion is to have an international society for naming biosimilars to ensure names are consistent across the globe.

The study also found that the majority of pharmacists surveyed, nearly 65%, believed there would be an increased burden for pharmacists when dispensing biosimilars because of post-dispense notifications.

Abdullah said he agrees that dispensing biosimilars will likely lead to increased paperwork, mostly led by insurance company requirements. That’s why many of these medications will likely be handled by specialty pharmacies, he noted.

Regardless of the ultimate naming convention, pharmacists agree that education will be essential to reducing confusion and increasing confidence in prescribing biosimilars.

“The unknown is always scary or not so welcomed initially until we get enough wide exposure and evidence to show the efficacy is still the same and patients are responding to treatment.” Abdullah said. “It’s just going to take time for people to get comfortable.”

Tomaszewski says it’s important that pharmacists are comfortable and confident with the biosimilars so that patients are equally confident about the medication they receive.

“If the pharmacist is not building confidence and a positive medication belief, you start to limit the likelihood that the patient is going to take it as prescribed or as recommended,” he said.

Jill Sederstrom is a freelance writer based in Kansas City