Treatment Outcomes with Biosimilars: Be Aware of the Nocebo Effect

Rheumatol Ther. 2017 Dec;4(2):209-218. doi: 10.1007/s40744-017-0085-z. Epub 2017 Oct 14.


Over the years, biologic agents have proven their importance in the management of chronic autoimmune diseases, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease. Biosimilars, which are biologic medicines, are highly similar to approved biologic medicines, and are comprehensively developed and rigorously tested to ensure efficacy and safety are similar to the reference product. A broader armamentarium of biosimilars is expected to improve patients' access to safe and effective biologic medicines, thus offering benefits to healthcare systems around the globe. Here we consider the factors that may compromise the benefits of biosimilars being realized, including patient and physician perception of biosimilars, and an often overlooked factor, the nocebo effect, which is re-emerging with the widespread adoption of biosimilar medicines. We have also described a variety of strategies and recommendations that could help limit the nocebo effect.

Funding: Biogen.

Keywords: Adherence; Biologic; Biosimilar; Nocebo.

Publication types

  • Review