Results of Biosimilar Transitions in Quebec

In collaboration with
Dr. Waqqas Affif

We surveyed 12 Quebec Gastroenterologists on:
  • their experience in transitioning patients to biosimilars
  • their perspectives on manufacturer support needed
  • how prepared they feel for RAMQ electronic submissions of biologic request forms
Over half of the physicians surveyed changed more than 50 patients to a biosimilar medication within the past 12 months.

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We partnered with Dr. Waqqas Affif, a Quebec Gastroenterologist, who has provided a reflection of his thoughts on the results throughout the final report.

The most important factors to consider when selecting biosimilar Patient Support Programs (PSP) is the interaction with nurses and ease of onboarding patients since today most physicians interact with more than 5 PSP coordinators; this is especially true for those in Academic Hospitals.

GIs lack the time to educate patients and administrative support to assist with patient transitions which is where PSPs are most valued.

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Dr. Affif says:

"A lot of effort was put into educating about the formulation of the biosimilar (volume, citrate-free) but it seems the interactions with the nurse and the breadth of services is most important and the formulation is less important."

33% said Time to educate patients, 33% voted inadequate administrative supports, 17% said physician paperwork or administrative requirements, 8% said patient reluctance, 8% voted issues related to the new PSP. 0% voted for patients having to move to a different infusion clinic or efficacy of the biosimilar.

"The liaisons are poorly trained and often make mistakes, this delays treatment."
- Dr. Gad Friedman, Gastroenterologist

"Not all programs are of good quality. Some don't offer essential services to patients such as investigations, electronic signature, bridging doses"
- Dr. Talat Bessissow, Gastroenterologist

When it comes to supporting IFX Patients, GIs have the highest confidence in Inflectra (by Pfizer).

Similarly, for ADAL patient support, they have the highest confidence in Abrilada (by Pfizer).

Full breakdown of ADAL confidence also available upon request.

When it comes to supporting IFX patients on a scale of 1-5, on average gastroenterologists said they have 4.4 of 5 confidence in inflectra by Pfizer and every respondent has used their PSP. 2.8 of 5 confidence in Renflexis by Merck and 4 respondents have not used the PSP. Finally, 2.3 of 5 confidence in Avsola by Amgen with 1 respondent has not used the PSP at all.

75% of GIs agree that having a portfolio of products under the same manufacturer increase their confidence when choosing a biosimilar option.

83% of GIs are aware of the electronic submission mandate by RAMQ.

With high concern, 82% feel they are not adequately resourced to make yet another transition.

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Dr. Affif says:

"82% of MD's did not feel supported with the transition and the switch to electronic submission will make things very difficult."

Scale of 1 - 5 from not concerned to very concerned. Physicians said they are 4.7 on average for concern about the new RAMQ requirements.
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"There has already been a tremendous struggle to switch patients to biosimilars with little support overall to ease the transition. This other change so soon after with again almost no support is unreasonable and will burden the physicians and nurses"
- Dr. Gad Friedman, Gastroenterologist

When asked about the pharmacists' role in administering biosimilars, GIs believed they would still fulfil their traditional responsibilties.

When asked about the pharmacists' role in administering biosimilars 92% said filling prescriptions, 67% said patient education and counselling, 17% said treatment follow-up, 8% said dose adjustment and 0% said treatment selection and switching.

Respondent profile


Male respondents


Academic hospitals


Average age


Average years in practice