Physician Views: The first US biosimilar has been launched – will oncologists use it and how?

Approved by the FDA in March, Novartis' Zarxio – a version of Amgen's Neupogen – has become the first biosimilar product to launch in the US pharmaceutical market. Having overcome challenges in the legal arena, focus will now sharpen on how rapidly Zarxio can gain market share (Spotlight On: US biosimilars market off and running, but several hurdles still remain).

Multiple stakeholders will dictate the commercial performance of Zarxio and any legacy it provides for subsequent biosimilar launches in the US, but the role of oncologists will be critical. A Physician Views poll run by FirstWord in January – when Zarxio received positive AdCom recommendation prior to full FDA approval – suggests that oncologists are largely comfortable with the concept of biosimilar Neupogen, while a subsequent survey carried out in March indicates a neutral impact from biosimilar naming conventions now adopted by the FDA.

This week's poll is designed to provide an updated view on a handful of key commercial parameters following Zarxio's US launch last week. Specifically, we are asking US-based oncologists the following questions…

Will you be comfortable prescribing Zarxio for each of the indications that Neupogen is approved for?
Slightly comfortable
Moderately comfortable
Very comfortable
Extremely comfortable

Taking into account real-world factors – such as the role of payers – how rapidly do you expect adoption of Zarxio to occur?
No adoption
Very quickly

Zarxio has been launched with a 15 percent list price discount versus Amgen's Neupogen. Presumably, Sandoz will offer additional discounts through rebating, but is this pricing strategy in line with your expectation?
Significantly lower discount than I expected
Moderately lower discount than I expected
Slightly lower discount than I expected
In-line with expectation
Slightly higher discount than I expected
Moderately higher discount than I expected
Significantly higher discount than I expected

If you had your choice, which process would be used to prescribe filgrastim to a patient? (note: Zarxio is yet to be approved as interchangeable with Neupogen)
I specify the prescription of either Neupogen or Zarxio and the pharmacist must dispense which product I have specified
I prescribe filgrastim and the pharmacist is responsible for dispensing either Neupogen or Zarxio
I prescribe only Zarxio – assuming it costs less than Neupogen
I prescribe only Neupogen as I do not want to prescribe a biosimilar

Would a positive experience in prescribing Zarxio over the next 12 to 24 months provide you with increased confidence in prescribing more complex biosimilar monoclonal antibody products in the future?
No – I don't intend to prescribe Zarxio out of choice
No – I intend to prescribe Zarxio but this will provide no relevant experience to support prescription of biosimilar antibody products
Yes – slightly more confident
Yes – moderately more confident
Yes – much more confident

You will be able to read the results and analysis later this week.

Results and related analysis will be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions.

Note: FirstWord Polls are powered by MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialities and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at

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