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Patient Preferences for Biologic and Biosimilar Osteoporosis Treatments in Colombia

Authors Graham-Clarke PL, Hauber B, Boeri M, Leonardi F, Burge RT, Fernandez M, Tockhorn-Heidenreich A, Florez S

Received 21 February 2020

Accepted for publication 1 June 2020

Published 23 June 2020 Volume 2020:14 Pages 1049—1064


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Peita L Graham-Clarke,1 Brett Hauber,2 Marco Boeri,3 Felice Leonardi,4 Russel T Burge,5 Maria Fernandez,2 Antje Tockhorn-Heidenreich,6 Sandra Florez4,7

1Global Patient Outcomes and Real World Evidence, Eli Lilly Australia, West Ryde, NSW 2114, Australia; 2Health Preference Assessment Group, RTI Health Solutions, Research Triangle Park, NC 27709, USA; 3Health Preference Assessment Group, RTI Health Solutions, Belfast BT2 8LA, UK; 4Eli Lilly Interamerica Inc, Bogotá, Colombia; 5Global Patient Outcomes and Real World Evidence, Eli Lilly and Co, Lilly Corporate Center, Indianapolis, IN 46285, USA; 6Global Patient Outcomes and Real World Evidence, Eli Lilly and Co, Erl Wood Manor, Surrey GU20 6PH, UK; 7Pain and Palliative Care Unit, Universidad De La Sabana, Bogotá, Colombia

Correspondence: Marco Boeri
RTI Health Solutions, Forsyth House, Cromac Square Belfast, Belfast BT2 8LA, UK
Tel +44 (0)161 447 6016
Fax +1.919.541.7222

Purpose: Teriparatide is used to treat patients with established osteoporosis but is often reserved for patients who have inadequate response to antiresorptive therapy. Biosimilar teriparatide, which is believed to have efficacy and safety similar to the originator product, is now available in Colombia. However, little is known about patients’ preferences for originator biologic and biosimilar treatments. Our objective was to quantify the relative importance that patients in Colombia place on features of injectable osteoporosis treatments including whether the treatment is an originator biologic or a biosimilar.
Patients and Methods: We used a discrete choice experiment (DCE) to elicit preferences of patients with osteoporosis treatment devices in Colombia. The survey was completed by 200 respondents at high risk of fracture, with or without teriparatide experience. Each treatment alternative within the DCE was characterized by five attributes: type of medicine (originator biologic, biosimilar), needle length, angle of injection, how to measure the medicine dose, and how long the medicine can be left unrefrigerated. A random parameters logit regression was used to estimate preferences and conditional relative attribute importance, while controlling for preference heterogeneity.
Results: A total of 200 patients (mean age = 58.3 years) completed the survey. Most were female (84.5%) and married (54.5%); 50.5% had secondary education or less, 21% had current teriparatide exposure. The attribute with the highest conditional relative importance estimate (standard error) was biologic versus biosimilar (10 [1.11]), followed by needle length (8.06 [1.11]), dose measurement (6.38 [0.87]), refrigeration (3.81 [1.18]), and angle of injection (1.30 [0.66]). Unobserved preference heterogeneity was present and controlled for in the analyses.
Conclusion: Despite the availability of biosimilar teriparatide in Colombia, patients expressed a strong preference for an originator biologic osteoporosis medicine over a biosimilar osteoporosis medicine, when the efficacy, safety, and cost of the two options were assumed to be the same.

Keywords: discrete choice experiment, injection, devices, teriparatide, fractures

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