Rheumatology nurses generally support the automatic substitution of biological medicines, viewing it as a viable cost-saving measure when paired with strict safety protocols. A 2025 qualitative study involving ten experienced nurses reveals that while the practice can reduce healthcare expenditure through increased price competition, its success hinges on comprehensive patient counseling and seamless coordination between community pharmacies and clinical teams.
Automatic substitution allows pharmacists to dispense an interchangeable biologic without contacting the prescriber. Nurses emphasized that this shift is not merely administrative; it impacts patient confidence, injection routines, and device familiarity. Key concerns include the potential for increased workload among healthcare professionals and the risk of patient confusion when switching products or delivery devices.
The study identifies four critical categories: perceptions of substitution, supportive factors, safety concerns, and implementation strategies. Nurses noted that patients with prior experience in generic substitution adapt more easily. However, safe implementation requires adequate clinical resources to manage the transition. Clinicians must anticipate heightened counseling demands to ensure patients fully understand any changes to their medication regimen before and after the switch.