Addressing Patient Concerns About Biosimilars: Reducing Hesitation and Building Trust

When your doctor suggests switching from Humira to a biosimilar, it’s normal to feel uneasy. You’ve been on the same medication for years. It works. You know how your body reacts to it. Now, someone is asking you to try something new-something called a biosimilar. But what does that even mean? Is it just a cheaper version? Is it safe? What if it doesn’t work as well?

You’re not alone. Nearly 8 out of 10 patients with chronic conditions like rheumatoid arthritis, Crohn’s disease, or psoriasis worry about switching to biosimilars. Many fear side effects, reduced effectiveness, or even a flare-up of their condition. And here’s the real problem: even though biosimilars save the system billions, most patients don’t see those savings in their own pockets. That makes trust even harder to earn.

What Exactly Is a Biosimilar?

A biosimilar isn’t a generic. That’s the first thing to understand. Generics are exact chemical copies of small-molecule drugs-like aspirin or metformin. They’re made in labs using predictable chemical reactions. Biosimilars, on the other hand, are made from living cells-like yeast or hamster ovary cells. They’re complex proteins, often as big as a virus. No two batches are perfectly identical, even from the same manufacturer.

But here’s the key: the FDA doesn’t approve a biosimilar unless it shows no clinically meaningful differences from the original biologic. That means the same effectiveness, the same safety profile, the same risk of side effects. The only differences are in tiny, non-active parts of the molecule-like the packaging of a car might change, but the engine stays the same.

Since 2015, the FDA has approved 74 biosimilars as of April 2025. These cover major drugs used for cancer, autoimmune diseases, and diabetes. For example, the biosimilar for infliximab (Remicade) is now used by over 150,000 patients in the U.S. with no new safety signals. Real-world data from hospitals and clinics shows the same response rates and similar rates of adverse events.

Why Do Patients Hesitate?

It’s not just about science. It’s about experience.

A Reddit user named ChronicPainPatient87 shared their story: their doctor switched them to a biosimilar without explanation. Within weeks, they had a flare-up. They didn’t know if it was the drug, stress, or coincidence-but they blamed the biosimilar. That’s the nocebo effect in action: expecting something to go wrong makes it more likely you’ll feel it.

Surveys show 79% of patients worry biosimilars won’t work as well. 63% fear new or worse side effects. Only 31% of patients with chronic illness have even heard of biosimilars. Meanwhile, 64% of doctors have. That gap is dangerous. When patients aren’t involved in the decision, they feel like a number-not a person.

Another issue: cost savings aren’t reaching patients. Even though biosimilars cost 35% less for insurers, out-of-pocket prices often stay the same. For pegfilgrastim, a drug used after chemotherapy, biosimilars cut the cost of the first treatment cycle by nearly half-but patients still paid the same copay. Why? Pharmacy benefit managers (PBMs) and drug pricing structures haven’t changed. If your copay is $50, it stays $50-even if the drug now costs $100 less to make.

Biosimilars vs Generics: The Big Differences

People hear “similar to generic” and assume they’re the same. They’re not.

• Generics are chemically identical. A pill of generic metformin has the exact same atoms in the exact same arrangement as the brand name. Development takes 3-4 years and costs $2-3 million.
• Biosimilars are highly similar but not identical. They’re made from living cells, so small variations happen naturally. To prove they’re safe, manufacturers run dozens of lab tests, animal studies, and at least one small clinical trial. This takes 8-10 years and costs $100-250 million.
• Market uptake: Generics take over 90% of the market within a year. Biosimilars? Less than 10% for most drugs-even after years on the market.

That’s why you won’t find a biosimilar for every biologic. Only 21% of high-value biologics (those making over $500 million a year) have biosimilars in development. The rest sit untouched because the cost to prove similarity is so high-and the payoff uncertain.

How Do We Build Trust?

Education isn’t enough. You need transparency, involvement, and proof.

Start with the conversation. If your doctor wants to switch you, they should say: “We’re moving you to a biosimilar because it’s been approved by the FDA as just as safe and effective as your current drug. It’s not a cheaper copy-it’s a scientifically proven alternative. We’ll monitor your response closely.”

Patients who receive this kind of clear, honest explanation are far more likely to agree. One study found that when patients were given a detailed, visual explanation of how biosimilars are tested, their confidence rose by 40%.

Another key step: track your response. If you’re on a biosimilar for rheumatoid arthritis, your doctor can check your CRP and ESR blood markers before and after the switch. If your inflammation levels stay stable, that’s real evidence it’s working. Same for Crohn’s-fecal calprotectin levels can show if the drug is still controlling gut inflammation.

Some clinics now use “Clinical Trial Educators”-staff trained to walk patients through the science, answer questions, and even connect them with others who’ve switched successfully. One program in Texas saw patient enrollment in biosimilar programs jump from 12% to 58% in six months.

What’s Changing in 2025 and Beyond?

The FDA just released new draft guidance in 2024 that could speed up biosimilar approvals. Instead of requiring full clinical trials for every new biosimilar, they’ll now accept strong analytical data-like detailed protein mapping and binding tests-as proof of similarity. This could cut development time by years and lower costs.

Pharmacy benefit managers are also changing tactics. CVS stopped covering Humira in most commercial plans in April 2024. ESI and OptumRx followed in 2025. That forced prescribers to choose biosimilars-or justify why they wouldn’t. The result? The average cost of biologic drugs dropped by 2.3 percentage points in just four months.

But here’s the catch: patient satisfaction dropped 15% in that same period. Why? Because many weren’t prepared. They felt blindsided. That’s not a failure of biosimilars-it’s a failure of communication.

By 2030, over 100 biologics will lose patent protection. That’s $232 billion in potential savings. If we get this right, biosimilars could cut drug spending by $300 billion between now and 2030. But only if patients are part of the decision-not just the target.

What You Can Do Right Now

If you’re on a biologic and hear about a biosimilar:

1. Ask your doctor: “Is there a biosimilar for my drug? Has it been approved by the FDA?”
2. Ask: “Will my out-of-pocket cost go down? If not, why?”
3. Ask: “Can we monitor my response with blood tests or symptoms?”
4. Ask: “Can I talk to someone who’s switched?”
5. Don’t be afraid to say no-if you’re not ready, you don’t have to switch yet.

And if you’ve already switched? Share your story. If it worked, tell others. If it didn’t, report it to your doctor and the FDA’s MedWatch program. Real-world feedback is what makes these drugs safer for everyone.

Biosimilars aren’t a gamble. They’re science-backed alternatives that have already helped hundreds of thousands of people. But they won’t reach their potential until patients are treated like partners-not passive recipients of a cost-cutting strategy.

Why This Matters for You

Chronic illness is expensive. Biologics can cost $20,000 to $50,000 a year. Many people skip doses or stop treatment because they can’t afford it. Biosimilars offer a real chance to change that.

But savings only matter if they’re shared. And trust only grows when patients are heard.

The goal isn’t just to replace one drug with another. It’s to give people access to life-changing treatments without fear, without surprise, and without financial shock.

It’s not about lowering costs. It’s about lowering barriers.