Same but different? A thematic analysis on adalimumab biosimilar switching among patients with juvenile idiopathic arthritis

William D. Renton, Helen Leveret, Catherine Guly, Heather Smee, Jamie Leveret, Athimalaipet V. Ramanan*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)
197 Downloads (Pure)


Biologic medications have dramatically enhanced the treatment of many chronic paediatric inflammatory conditions. Their high cost is a factor that prohibits their broader use. Cheaper generic versions, or biosimilars, are increasingly being used. Healthcare services are switching some patients over to biosimilars for economic reasons, known as ‘non-medical switching’. Some patients unsuccessfully switch due to perceived decreases in efficacy or non-specific drug effects. The implications of failed switching include exhaustion of therapeutic options, unnecessary exposure to other medications, increased healthcare utilisation, worse patient outcomes and higher overall healthcare costs. Patient perceptions almost certainly play a role in these ‘failed switches’.

A thematic analysis was performed to better understand patient and parent perceptions on non-medical biosimilar switching. The study was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research recommendations. Patients with juvenile idiopathic arthritis currently taking adalimumab were included.

Nine families were interviewed just prior to a hospital trust-wide non-medical switch to an adalimumab biosimilar. Several common themes were identified. The most frequent concerns were regarding practical aspects of the switch including the medication administration device type; the colour of the medication and administration device; and whether the injections would sting more. The relative safety and efficacy of the biosimilar was raised although most families felt that there would be no significant difference. Anxieties about the switch were largely placated by reassurances from the medical team.

We derived recommendations based on existing adult literature and the observations from our study to optimise the benefits from non-medical biosimilar switching.
Original languageEnglish
Article number67 (2019)
Number of pages7
JournalPediatric Rheumatology
Publication statusPublished - 4 Oct 2019


  • Paediatric rheumatology
  • Juvenile idiopathic arthritis
  • Uveitis
  • Biosimilars
  • Adalimumab
  • Qualitative


Dive into the research topics of 'Same but different? A thematic analysis on adalimumab biosimilar switching among patients with juvenile idiopathic arthritis'. Together they form a unique fingerprint.

Cite this