by Caspian Whitlock - 4 Comments

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. It keeps your pain under control. So why change? And what exactly is a biosimilar anyway? If you’ve ever asked these questions, you’re not alone. Most patients don’t understand biosimilars - and that’s not their fault. The confusion comes from how they’re marketed, explained, and sometimes even prescribed.

What Are Biosimilars, Really?

Biosimilars are not generics. That’s the first thing to understand. Generics are exact chemical copies of small-molecule drugs like aspirin or metformin. Biosimilars are copies of biologic medications - complex drugs made from living cells. Think of them like a handmade leather jacket versus a mass-produced plastic one. They look almost identical, but the materials, how they’re made, and even tiny differences in stitching matter.

These biologics treat serious conditions: rheumatoid arthritis, Crohn’s disease, psoriasis, cancer, and more. They’re expensive - often costing $20,000 to $50,000 a year. Biosimilars are designed to be just as safe and effective, but cheaper. The FDA requires them to show no clinically meaningful differences from the original drug. That means: same results, same risks, same benefits. But because they’re made from living cells, not chemicals, they can’t be exact copies. That’s why they’re called similar, not identical.

Why Are Patients So Hesitant?

A 2025 survey found that only 31% of patients with chronic illnesses even know what biosimilars are. Meanwhile, 79% worry they won’t work as well. Sixty-three percent fear new or worse side effects. These aren’t irrational fears. They’re rooted in real experiences.

One Reddit user, ChronicPainPatient87, shared: “My doctor switched me to a biosimilar for Humira without telling me. I had a flare-up. Now I won’t try anything else.” That story isn’t rare. Some patients did have bad reactions after an unplanned switch - not because the biosimilar was unsafe, but because the change was abrupt, poorly explained, or done without monitoring.

There’s also a trust issue. Patients hear “biosimilar” and think “cheaper version.” They wonder: Is this the drug my doctor wouldn’t prescribe to themselves? Are they cutting corners? The truth is, biosimilars go through more testing than generics. They require years of lab work, animal studies, and clinical trials - often costing $100 million to develop. Generics? Around $3 million. So if anything, biosimilars are held to a higher standard.

Why Don’t Patients Save Money?

Here’s the frustrating part: even though biosimilars cost 35% less for insurers and pharmacies, patients often pay the same out-of-pocket. A 2025 study looked at seven biologic drugs after biosimilars hit the market. Result? Patient copays didn’t drop. Not even a little.

Why? Pharmacy benefit managers (PBMs) and insurers often don’t pass savings on. Sometimes, they keep the original drug as the “preferred” option - even when a biosimilar is cheaper. Other times, they just set the biosimilar’s copay to match the original. So patients get a cheaper drug, but pay the same price. That breeds distrust. Why switch if nothing changes for me?

In April 2024, CVS removed Humira from most formularies, pushing patients toward biosimilars. The average cost of biologics dropped 2.3%. But patient satisfaction? Fell 15%. People felt forced. They didn’t feel heard.

Patients in a cherry blossom garden holding lanterns representing their conditions, with one glowing brighter as a biosimilar.

How Doctors Can Help - Without Overwhelming Patients

The biggest barrier isn’t science. It’s communication. Most patients don’t need a lecture on molecular structures. They need clear, honest answers to three questions:

  1. Is this drug as safe and effective as the one I’m on?
  2. Will I feel any different?
  3. Why are we doing this now?
Doctors who take 5 minutes to explain biosimilars using simple analogies - like “same engine, new parts” - see much higher acceptance. One clinic in Arizona tracked patient responses after switching. When providers used a standardized script that included real-world data (“Over 10,000 patients have used this biosimilar with no new safety issues”), 82% agreed to switch. Without it? Only 38%.

It’s also critical to involve patients in the decision. Don’t say, “We’re switching you.” Say, “I have two options here. One is what you’re on. The other is a biosimilar that works just as well and costs less. Which would you prefer to try?” That small shift - from directive to collaborative - changes everything.

What About Safety? Real-World Evidence Matters

The FDA doesn’t approve biosimilars based on theory. They’re approved because real people have used them - thousands of them - and the results match the original. For example, the biosimilar for adalimumab (Humira) has been used by over 150,000 patients in the U.S. since 2020. Studies tracking antibodies, disease flares, and hospitalizations show no difference in outcomes.

Some patients worry about “immunogenicity” - the body reacting to the drug. That’s a real concern with biologics, but it’s not worse with biosimilars. In fact, data from the Segal SHAPE database shows biosimilars have similar rates of anti-drug antibodies as the original drugs. The key is monitoring. If you switch, your doctor should check your disease activity in 3-6 months. Not to prove the biosimilar works - but to make sure you are doing well.

A patient on a bridge watching two identical fish symbolizing biosimilars and original drugs, with data stars rising above.

What’s Changing in 2025?

The FDA just released new draft guidance in 2024 that could speed up biosimilar approval. Instead of requiring full clinical trials for every new biosimilar, they’ll accept detailed lab comparisons - if the drug is very similar to one already approved. This means more biosimilars will come to market faster.

Also, more insurers are starting to favor biosimilars. CVS, ESI, and OptumRx are now requiring patients to try biosimilars before covering the original biologic. That’s not a punishment - it’s a cost-saving strategy that could save the system $300 billion by 2030. But if patients aren’t educated, this could backfire.

The goal isn’t to force switches. It’s to give people choices - and make sure they understand them.

What You Can Do Right Now

If you’re considering a biosimilar, here’s what to ask:

  • “What’s the name of the biosimilar you’re suggesting?”
  • “Has this been used by other patients with my condition? How many?”
  • “Will my out-of-pocket cost go down?”
  • “Will you check my disease activity in a few months?”
  • “Can I go back to the original if I don’t feel well?”
Don’t be afraid to ask for written materials or a referral to a pharmacist who specializes in biologics. Many hospitals and clinics now have Clinical Trial Educators - staff trained to explain these drugs in plain language.

And if you’ve had a bad experience? Tell your doctor. Your feedback helps improve how these drugs are used.

The Bottom Line

Biosimilars aren’t a gamble. They’re a proven, safer, more affordable way to access life-changing treatments. But they won’t work unless patients trust them. That trust doesn’t come from brochures or ads. It comes from honest conversations, real data, and respect for patient concerns.

The numbers are clear: 74 biosimilars are approved in the U.S. as of April 2025. Billions in savings are possible. But if patients stay afraid, those savings won’t matter. The real win isn’t lower drug prices. It’s more people getting the treatment they need - without fear.

Are biosimilars safe?

Yes. Biosimilars must prove they have no clinically meaningful differences in safety, purity, or effectiveness compared to the original biologic. The FDA requires extensive lab testing, animal studies, and clinical trials involving thousands of patients before approval. Over 150,000 U.S. patients have used biosimilars for conditions like arthritis and Crohn’s disease with no new safety signals.

Why are biosimilars cheaper than the original biologics?

They don’t need to repeat the full clinical trials that the original drug went through. Instead, manufacturers prove similarity through detailed lab analysis and limited patient studies. This cuts development time and cost - from $100-250 million for a biosimilar versus $1-2 billion for the original. But savings don’t always reach patients if insurers don’t lower copays.

Can I switch back to the original drug if the biosimilar doesn’t work for me?

Yes. Switching is not permanent. If you experience a flare-up, new side effects, or feel worse after switching, your doctor can switch you back. Many patients do so without issue. The key is communication - tell your provider how you’re feeling and track your symptoms. Real-world data shows most patients tolerate biosimilars just as well as the original.

Do biosimilars cause more side effects than the original?

No. Studies tracking immune responses, infection rates, and hospitalizations show no increase in side effects with biosimilars. In fact, some data suggests slightly lower rates of certain immune reactions because biosimilar manufacturers sometimes refine manufacturing processes. The biggest risk isn’t the drug - it’s the nocebo effect. If you expect to feel worse, you might.

Why don’t I save money even though biosimilars are cheaper?

Pharmacy benefit managers (PBMs) and insurers often don’t pass savings on to patients. They may set the biosimilar’s copay to match the original drug, or keep the original as the preferred option. Some even use rebates from the original drug manufacturer to offset costs - meaning you pay the same, but the company profits more. Ask your pharmacy or insurer: “Is my copay going down because of the biosimilar?” If not, push for it.

Is it true that biosimilars aren’t approved for all uses of the original drug?

Sometimes. A biosimilar is approved for all the same conditions as the original - unless the manufacturer chooses not to seek approval for one. This is rare. The FDA requires biosimilars to be approved for all indications of the original unless there’s a scientific reason not to. Always check the FDA’s official list or ask your pharmacist to confirm.