How to Reduce Nocebo Concerns in Biosimilar Use

Switching from an originator biologic to a biosimilar can sometimes trigger a nocebo effect, where negative expectations lead to worsened symptoms, reduced treatment efficacy, or perceived adverse events.

A Belgian and Dutch research team conducted a systematic review, published in Pharmaceutical Medicine, outlining strategies to support patients and improve adherence to biosimilar treatments.

The nocebo effect, derived from the Latin term meaning “I will do harm,” occurs when negative perceptions influence treatment outcomes independently of a drug’s pharmacological effects. 

Research suggests that this effect may develop faster and have a stronger clinical impact than the placebo effect as people tend to be more sensitive to negative information.

Given the crucial role of biosimilars in reducing healthcare costs and expanding access to safe biotherapies, addressing nocebo effects is essential. The patient-healthcare provider relationship plays a key role in shaping perceptions of treatment efficacy and potential side effects.

To minimize the nocebo effect, Elif Car and colleagues reviewed strategies applied in clinical practice and proposed 13 key approaches:

1. Open nonverbal communication: Maintain eye contact, nod, smile, use a clear tone of voice, and adopt open body language
2. Positive framing: Highlight the similarities between biosimilars and originator biologics
3. Empathetic communication: Use open-ended questions about the patient’s concerns about treatment-related side effects
4. Validation: Reassure patients that their concerns are legitimate and taken seriously
5. Shared decision-making: Actively involve patients in treatment choices to enhance engagement
6. Self-affirmation: Encourages patients to reflect on their strengths and values
7. Education on the nocebo effect: Inform both patients and healthcare professionals about its impact 
8. Biosimilar education: Improve patient and provider understanding of biosimilars to enhance acceptance 
9. Health economics training: Equip healthcare professionals with knowledge about biosimilars’ cost-effectiveness
10. Personalized information: Tailor explanations to individual patient needs
11. Additional resources: Offer supplementary information as needed to address patient concerns
12. Multidisciplinary approach: Involving various healthcare providers to ensure comprehensive patient support
13. Proactive transition planning: Develop plans for managing treatment switches smoothly

This story was translated fromMediQuality using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.