Healthcare survey

1. Healthcare Market Research Worldwide
REPORT
BIOSIMILARS
I00119

2. 2I00119 - Biosimilars
Methodology and sample
OVERALL SAMPLE (n=211)
Diabetologist/Endocrinologist 30
Dermatologist 30
Gastroenterologist 30
Gynecologist 30
Hematologist-oncologist 30
Oncologist 31
Rheumatologist 30
COUNTRY
United States
FIELDWORK DATES
June 22, 2017 – July 3, 2017
DATA COLLECTION
5 min Online Survey
Significance test
+ (p=0.10) 10 percent chance that any differences are due to chance
++ (p=0.05) 5 percent chance that any differences are due to chance
+++ (p=0.01) 1 percent chance that any differences are due to chance
Represents a statistically significant positive trend versus France (p=0.10)
Represents a statistically significant negative trend versus France (p=0.10)

3. 3I00119 - Biosimilars
Demographics
D.1. Age / D.1.bis Years of practice within current specialty / D.2. Gender / D.3. State in which your main practice is located / D.4.bis Out of 100 patients,
which proportions are covered by the following insurance / D.5. Population of city in which your main practice is located
Age
12%
31%57%
Less than 40 years old
40 to 50 years
More than 50 years old
Insurance
52%
28%
11%
4%
4%
Commercial Insurance
Plan
Medicare
Medicaid
Other
No Insurance
Location of practice
14%
35%
23%
28%
Less than 100 000
habitants
100 000 – 499 999
habitants
500 000 – 1 000 000
habitants
More than 1 000 000
habitants
Northeast
(CT, MA, ME, NH, NJ, NY, PA, RI, VT)
26%
Midwest
(IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI)
20%
South
(AL, AR, DC, DE, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV)
32%
West
(AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, WY)
21%
Geographic Location
Experience
19.8 years on average
78%
22%
Gender

4. 4I00119 - Biosimilars
Summary
7.1/10
TRUST
81%
CURRENT
PRESCRIPTION
FUTURE
PRESCRIPTION
AWARENESS
FILGRASTIM 65.7%
EPOTEIN ALFA 62.0%
INFLIXIMAB 35.8%
INSULIN GLARGINE 16.6%
FOLLITROPIN ALFA 14.5%
ETANERCEPT 11.8%
78%
7.7/10
TRUST
90.5%
FUTURE
PRESCRIPTION
AWARENESS
FILGRASTIM 51.7%
INSULIN GLARGINE 30.7%
EPOTEIN ALFA 29.5%
FOLLITROPIN ALFA 17.7%
INFLIXIMAB 12.6%
ETANERCEPT 5.8%
84%
Mean stated % of patients
Mildly-strongly increase
CURRENT
PRESCRIPTION
Mean stated % of patients
Mildly-strongly increase
37.4% 23.7%

5. 5I00119 - Biosimilars
25%
56%
14%
4%
2%
Base: n=223
51%
39%
9%
0.5%
1 = Very well
2 = Somewhat well
3 = Somewhat poorly
4 = Very poorly
5 = Not at all
1. LEVEL OF KNOWLEDGE OF BIOSIMILARS
Base: All respondents
Biosimilars are better known (more popular) in US vs. France – by 9.5 points.
Awareness is high apart from gynaecologists, gastroenterologists and dermatologists
Q1. Would you say that you are very, somewhat well, somewhat poorly, very poorly or not at all aware of the biosimilars available for treatment within
your speciality?
Base: n=211
DIABETOLOGISTS
n=30
DERMATOLOGISTS
n=30
GASTROENTEROLOGISTS
n=30
GYNAECOLOGISTS
n=30
HAEMATOLOGISTS
n=30
ONCOLOGISTS
n=31
RHEUMATOLOGISTS
n=30
Very aware 66.7% + 43.3% 40.0% 36.7% - 66.7% + 54.8% 50.0%
Somewhat
well-aware
26.7% 33.3% 50.0% 56.7% ++ 26.7% 35.5% 46.7%
Somewhat
poorly-aware
6.7% 20.0% ++ 10.0% 6.7% 6.7% 9.7% 3.3%
Very poorly-
aware
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Not at all aware 0.0% 3.3% ++ 0.0% 0.0% 0.0% 0.0% 0.0%
MEAN* 1.4 1.9 1.7 1.7 1.4 1.5 1.5
BY SPECIALITY
TOTAL
90.5%
9.5%
81%
19%
*The lower the score is, the
most they are aware

6. 6I00119 - Biosimilars
2. TRUST IN BIOSIMILARS
Base: All respondents
Trust in the US (of biosimilars) is high at 7.7 out of 10 points, higher than in France
Q2. On a scale from 1 to 10, how much would you say that you trust biosimilars?
ON AVERAGE
7.7
10
9
8
7
6
5
4
3
2
1
AVERAGEAVERAGE
Diabetologists 8.10 +
Dermatologists 6.70 --
Gastroenterologists 7.23
Gynaecologists 6.93 --
BY SPECIALITY
Haematologists 8.23 ++
Oncologists 8.52 +++
Rheumatologists 8.27 ++
This hierarchy matches the physician’s rationale. It is
determined as follows: each physician rates each item on a
scale from 1 to 10: 10 means that they consider this item to
be very important, 1 means not at all important
• Scores above 8 are considered to reflect high levels of
approval from the sample.
• Between 7 and 8, the sample agrees overall.
• 5.5 is the average.
Base: n=211
7.1
n=223

7. 7I00119 - Biosimilars
Overall current prescribing level
across all specialists and
treatments:
3. PRESCRIPTION (1/3)
Base: All respondents
Level of prescription of biosimilars is generally much lower than France (apart
from Etanercept –among both rheumatologists and dermatologists)
Q3/Q5.Of 100 of your infliximab prescriptions, how many are for biosimilars?
Q4. Of 100 of your Etanercept prescriptions, how many are for biosimilars?
12.8%
RHEUMATOLOGISTS
On average
12.7%
DERMATOLOGISTS
On average
INFLIXIMAB
4.2%
RHEUMATOLOGISTS
On average
7.3%
DERMATOLOGISTS
On average
ETANERCEPT
12.2%
GASTROENTEROLOGISTS
On average
38.5% 34.6% 34.5%
8.8% 14.8%
12.6%
5.8%
35.8%
11.8%
23.7%
37.4%
TOTAL
Base: n=211
Base: n=223
Mean stated % of patients

8. 8I00119 - Biosimilars
3. PRESCRIPTION (2/3)
Base: All respondents
Balanced prescription rates between US and France across treatments: higher in
the US for Insulin Glargine (diabetos), lower for Epotein Alfa and Filgrastim
(oncos), balanced for Follitropin Alfa (gynaecos)
Q6. Of 100 of your Epotein alfa prescriptions, how many are for biosimilars? Q7. Of 100 of your Filgrastim prescriptions, how many are for biosimilars?
Q8. Of 100 of your insulin Glargine prescriptions, how many are for biosimilars? Q9. Of 100 of your Follitropin alfa prescriptions, how many are for
biosimilars?
30.7%
DIABETOLOGISTS
On average
INSULIN GLARGINE
17.7%
GYNAECOLOGISTS
On average
FOLLITROPIN ALFA
16.6% 14.5%
25.5% 45.0%
ONCOLOGISTS
On average
EPOTEIN ALFA FILGRASTIM
33.5% 58.5%
HAEMATOLOGISTS
On average
ONCOLOGISTS
On average
HAEMATOLOGISTS
On average
63.7% 60.3% 67.1% 64.2%
29.5% 51.7%62.0% 65.7%
Mean stated % of patients

9. 9I00119 - Biosimilars
3. PRESCRIPTION (3/3)
Base: All respondents
DIABETOLOGISTS
30.7%
46.0%
+++
DERMATOLOGISTS GASTROENTEROLOGISTS GYNAECOLOGISTS
RHEUMATOLOGISTSONCOLOGISTSHAEMATOLOGISTS
10.0% 12.2% 17.7%
35.3% 8.5%
-
16.6% 14.5%
65.4%62.3% 23.7%
34.6%24.7%
In the US, haematologists are the highest prescribers of biologic treatments.
When compared to France, US diabetologists prescribe more, while
gastroenterologists and oncologists much less than their French colleagues.
Mean stated % of patients

10. 10I00119 - Biosimilars
3. PRESCRIPTION (3/3)
Base: All respondents
46.0%
+++
RHEUMATOLOGISTSONCOLOGISTSHAEMATOLOGISTS
35.3% 8.5%
-
65.4%62.3% 23.7%
DIABETOLOGISTS
30.7%
DERMATOLOGISTS GASTROENTEROLOGISTS GYNAECOLOGISTS
10.0% 12.2% 17.7%
16.6% 14.5%34.6%24.7%
In the US, haematologists are the highest prescribers of biologic treatments.
When compared to France, US diabetologists prescribe more, while
gastroenterologists and oncologists much less than their French colleagues.
Mean stated % of patients
Diabetologists 8.10 +
Dermatologists 6.70 --
Gastroenterologists 7.23
Gynaecologists 6.93 --
Haematologists 8.23 ++
Oncologists 8.52 +++
Rheumatologists 8.27 ++

11. 11I00119 - Biosimilars
4. LOCAL STATE REGULATIONS/HEALTH AUTHORITIES ATTITUDES TOWARDS BIOSIMILARS**
Base: All respondents
Q10. Are there any restrictions or encouragements by the local state regulations/health authorities to use biosimilars?
1%
13%
64%
16%
7%1 = Strong restrictions
2 = Some restrictions
3 = Neither restrictions nor encouragements
4 = Some encouragements
5 = Strong encouragements
DIABETOLOGISTS
n=30
DERMATOLOGISTS
n=30
GASTROENTEROLOGISTS
n=30
GYNAECOLOGISTS
n=30
HAEMATOLOGISTS
n=30
ONCOLOGISTS
n=31
RHEUMATOLOGISTS
n=30
Strong restrictions 0.0% 0.0% 0.0% 3.3% 3.3% 0.0% 3.3%
Some restrictions 13.3% 13.3% 16.7% 10.0% 3.3% - 22.6% + 10.0%
Neither restrictions nor
encouragements
53.3% 80.0% ++ 56.7% 76.7% 60.0% 48.4% - 70.0%
Some encouragements 26.7% + 3.3% -- 23.3% 10.0% 16.7% ++ 22.6% 6.7%
Strong encouragements 6.7% 3.3% 3.3% 0.0% 16.7% 6.5% 10.0%
MEAN 3.3 3.0 3.1 2.9 - 3.4 3.1 3.1
BY SPECIALITY
Base: n=211
TOTAL
** Only for the US
23%
14%

12. 12I00119 - Biosimilars
5. CONTEXT OF THE SUBSTITUTION OF A BRANDED BIOLOGIC TREATMENT WITH A BIOSIMILAR**
Base: All respondents
Generally US specialists are very positive to substitute a biologic with a biosimilar.
31 points more positive
Q11. How favorable or unfavorable are you for the substitution of a branded biologic treatment with a biosimilar?
17%
34%30%
15%
5%
1 = Very favorable
2 = Fairly favorable
3 = Neither favorable nor unfavorable
4 = Fairly unfavorable
5 = Very unfavorable
DIABETOLOGISTS
n=30
DERMATOLOGISTS
n=30
GASTROENTEROLOGISTS
n=30
GYNAECOLOGISTS
n=30
HAEMATOLOGISTS
n=30
ONCOLOGISTS
n=31
RHEUMATOLOGISTS
n=30
Very favorable 20.0% 16.7% 10.0% 10.0% 26.7% 19.4% 13.3%
Fairly favorable 33.3% 3.3% --- 40.0% 40.0% 30.0% 51.6% ++ 36.7%
Neither favorable nor
unfavorable
36.7% 33.3% 20.0% 26.7% 43.3% + 29.0% 20.0%
Fairly unfavorable 10.0% 26.7% + 23.3% 16.7% 0.0% -- 0.0% -- 30.0% ++
Very unfavorable 0.0% 20.0% +++ 6.7% 6.7% 0.0% 0.0% 0.0%
MEAN* 2.4 3.3 --- 2.8 2.7 2.2 ++ 2.1 +++ 2.7
BY SPECIALITY
Base: n=211
TOTAL
** Only for the US
51%
20%
*The lower the score is,
the most they find favorable

13. 13I00119 - Biosimilars
6. EXPECTED CHANGES IN BIOSIMILAR PRESCRIPTION
Base: All respondents
84%/US vs. 78%/France will increase biosimilar prescription
Q12. In the future, do you expect your prescribing of biosimilars to:
22%
27%
35%
14%
1%
1%
1 = Strongly increase
2 = Fairly strongly increase
3 = Mildly increase
4 = Remain the same
5 = Mildly decrease
6 = Fairly strongly decrease
7 = Strongly decrease
DIABETOLOGISTS
n=30
DERMATOLOGISTS
n=30
GASTROENTEROLOGISTS
n=30
GYNAECOLOGISTS
n=30
HAEMATOLOGISTS
n=30
ONCOLOGISTS
n=31
RHEUMATOLOGISTS
n=30
Strongly increase 20.0% 16.7% 13.3% 10.0% - 36.7% ++ 25.8% 30.0%
Fairly-strongly increase 20.0% 16.7% 36.7% 10.0% -- 40.0% + 38.7% 30.0%
Increase slightly 50.0% + 40.0% 40.0% 36.7% 10.0% --- 32.3% 36.7%
Stay the same 6.7% 23.3% + 6.7% 40.0% +++ 13.3% 3.2% - 3.3% -
Decrease slightly 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Decrease fairly-strongly 3.3% 0.0% 3.3% 0.0% 0.0% 0.0% 0.0%
Decrease strongly 0.0% 3.3% 0.0% 3.3% 0.0% 0.0% 0.0%
MEAN* 2.6 2.9 2.5 3.2 --- 2.0 ++ 2.1 ++ 2.1 ++
BY SPECIALITY
Base: n=211
TOTAL
13%
37%
29%
20%
0.4%
Base: n=223
84%
2%
78%
0.4%
*The lower the score is,
the most they plan to increase

14. LyonNew York London Paris
Healthcare Market Research Worldwide
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