LAUSR

AIM To assess the awareness of biosimilar intravitreal anti-vascular endothelial growth factor (VEGF) agents among retina specialists practicing in the United States (US) and Europe. METHODS A 16-question online survey was created in English and distributed via email, WhatsApp and LinkedIn between 1 December 2021 and 31 January 2022. A total of 112 respondents (retinal physicians) from the United States (US) and Europe participated. RESULTS The majority of the physicians (56.3%) were familiar with anti-VEGF biosimilars. A significant number of physicians expressed a need for more information (18.75%) and real-world data (25%) before switching to a biosimilar. About one half of the physicians were concerned about biosimilar safety (50%), efficacy (58.9 %), immunogenicity (50%), and their efficacy with extrapolated indications (67.8 %). Retinal physicians from the US were less inclined to shift from off-label bevacizumab to biosimilar ranibizumab or on-label bevacizumab (if approved) compared to physicians from Europe (p=0.0001). Furthermore, physicians from the US were more concerned about biosimilar safety (p=0.0371) and efficacy compared to Europe (p= 0.0078). Members in training did not have a complete understanding of biosimilars compared to faculty (p = 0.0194). CONCLUSIONS The Bio-USER survey revealed that while the majority of retinal physicians need additional information regarding the safety, efficacy and immunogenicity when making clinical decisions regarding their use. Retinal physicians from US are more comfortable in continuing to use off-label bevacizumab compared to physicians from Europe. Members in training need more education related to biosimilars in the retina.