# Assessing Nurses’ Knowledge and Attitudes Towards Biosimilars: Results from a National Survey

## TL;DR

Spanish nurses have basic knowledge of biosimilars, with training and hands-on experience improving their understanding and confidence in these therapies.

## Contribution

This is the first nationwide assessment of Spanish nurses' knowledge and attitudes toward biosimilars.

## Key findings

- Most Spanish nurses have only basic knowledge of biosimilars.
- Industry-led training and workplace use of biosimilars are strongly linked to higher knowledge and confidence.
- Confidence in biosimilar safety and efficacy increases with knowledge and real-world exposure.

## Abstract

What are the main findings?
Nurses in Spain generally demonstrate only basic knowledge of biosimilars. Higher knowledge levels are more common among those who have completed industry-led training and/or work in units where biosimilars are already in use.Working in units where biosimilars are routinely administered or prescribed increases nurses’ confidence in their safety and efficacy. This confidence also rises progressively with higher levels of biosimilar knowledge.

Nurses in Spain generally demonstrate only basic knowledge of biosimilars. Higher knowledge levels are more common among those who have completed industry-led training and/or work in units where biosimilars are already in use.

Working in units where biosimilars are routinely administered or prescribed increases nurses’ confidence in their safety and efficacy. This confidence also rises progressively with higher levels of biosimilar knowledge.

What are the implications of the main findings?
There is a substantial opportunity to improve nurses’ knowledge of biosimilars in European countries, at a moment when they are willing to learn and recognize the benefits these therapies offer to patients and healthcare systems.Strengthening education should begin with integrating biosimilar content into academic curricula and expanding diverse training modalities in collaboration with the pharmaceutical industry.

There is a substantial opportunity to improve nurses’ knowledge of biosimilars in European countries, at a moment when they are willing to learn and recognize the benefits these therapies offer to patients and healthcare systems.

Strengthening education should begin with integrating biosimilar content into academic curricula and expanding diverse training modalities in collaboration with the pharmaceutical industry.

Background/Objectives: Nurses play a key role in supporting patient adherence to biosimilars, which requires adequate knowledge of biological therapies. This study aimed to assess nurses’ knowledge and attitudes toward biosimilars in Spain, representing the first nationwide assessment of Spanish nurses’ knowledge and predictive determinants of reliance on biosimilars. Methods: A self-administered, web-based survey was distributed between May and June 2024. Associations were explored using Spearman’s correlation and Fisher’s exact tests, and predictors were examined with ordinal regression models. Results: A total of 402 nurses responded. Most (63.7%) reported at least basic knowledge of biosimilars. Access to industry-led training was strongly associated with higher knowledge (OR = 11.256; p < 0.001), while lack of awareness of workplace biosimilar use was linked to lower knowledge (OR = 0.176; p < 0.001). Confidence in biosimilar safety and efficacy increased with knowledge level (ORs 3.823–14.594; all p < 0.001) and was higher among nurses working with biosimilars in their units (OR = 3.959; p = 0.004) and in hospital ambulatory care services (OR = 2.506; p = 0.022). Conclusions: Spanish nurses predominantly demonstrate basic knowledge of biosimilars, highlighting the need for broader training access. Industry-led training was the strongest modifiable factor to improve knowledge and confidence. Strengthening collaboration with the pharmaceutical industry may support informed practice and enhance patient adherence to biosimilar therapy.