Biosimilars in pharmacies require careful communication

Since September 1, pharmacists have had to navigate new challenges with the substitution of biosimilars, which are biological drugs that mimic existing medications. These drugs are often used for serious conditions, and their substitution can raise concerns among patients, requiring clear and empathetic communication from pharmacists.

Pharmacists should avoid financial focus in discussions

Pharmacists are advised not to begin conversations about biosimilar substitution with financial considerations, as this could create tension. Instead, they should focus on reassuring patients about the effectiveness, quality, and safety of the proposed biosimilar, starting with a statement like, "I am proposing a biosimilar for your treatment. It has the same level of effectiveness, quality, and safety."

Explaining the financial implications without pressure

If a patient refuses the biosimilar, pharmacists should explain the financial implications clearly without creating a sense of penalty. They should say, "You remain free to refuse the biosimilar. But in this case, we cannot apply the third-party payer. You will therefore have to pay upfront, and then you will be reimbursed by the Health Insurance."

Addressing patient concerns without dismissing them

If a patient becomes upset and feels forced to change medications, pharmacists should acknowledge the concern without denying it. They should respond with, "I understand that this financial consequence may be perceived as a constraint. The choice is yours, but from my side, I no longer have the right to apply the third-party payer in this situation."

Clarifying biosimilars are not exact copies

When explaining biosimilars, pharmacists should avoid saying they are "exactly the same drug." Instead, they should clarify that biosimilars are highly similar but not identical, due to the nature of biological production. They can say, "This drug has been compared to the drug you are used to taking according to strict criteria."

Handling objections about the prescriber’s choice

If a patient objects by saying their doctor prescribed a specific drug, pharmacists should explain that prescribers are required to allow biosimilar substitution unless they explicitly state otherwise. They can say, "Indeed, but he knows we must propose a biosimilar. It is the rule."

Addressing cost concerns with factual information

When patients question the effectiveness of a cheaper biosimilar, pharmacists should explain that biosimilars are cheaper because they rely on existing safety and effectiveness data from the original drug. They can clarify, "The drug is cheaper because all the studies on the safety and effectiveness of the active ingredient have already been carried out."

Handling differences in administration devices

If a patient notices a difference in the injection device, pharmacists should not dismiss the concern. Instead, they should offer assistance, saying, "Indeed, and we will look together at how to use this pen." They should also consider requesting demonstration devices from manufacturers.

Respecting patient stability with current treatment

If a patient expresses reluctance due to stability with their current treatment, pharmacists should validate their concern and ask specific questions to address the real issue. They can say, "This treatment suits you and you do not want to lose the balance you have found. That is completely normal."

Handling past negative experiences with biosimilars

If a patient has had a bad experience with a biosimilar, pharmacists should acknowledge it and suggest alternatives. They can explain that other brands may be available and better suited to the patient’s needs, and if necessary, refer to the prescriber.

Preparing patients in advance for substitution

Pharmacists are advised to inform patients about the possibility of substitution before they need to renew their prescriptions. This can help avoid unexpected financial burdens and ensure a smoother transition.

Limited list of biosimilars available for substitution

As of October 19, 2026, substitution is only allowed for 12 specific molecules, including adalimumab, aflibercept 40 mg/ml, and others. Pharmacists must inform both patients and prescribers, document the delivered drug, and ensure the continuity of the treatment with the same medication.