In our real-world infliximab transition study among consented immune-mediated inflammatory disease patients, we corroborated a nocebo-effect rate of 13% [1].

Regarding these results, one can conclude that we did observe a relatively high rate of non-specific treatment effects for costly, “state-of-the-art” drug therapy. This presupposes that physicians and other healthcare providers have influence on the extent to which patients experience the effect of their medicines. Therefore, the confidence of physicians with biosimilars and the biosimilarity concept is key, which is also underscored in the study of van Overbeeke et al. [2].

Given the high degree of uncertainty about the effectiveness and safety of biosimilars, even in bio-naïve patients, as reported by Pineles and colleagues, it seems that the more emphasis is placed on the alleged risk differences between the originator drug and its biosimilar, the more patients become uncertain. After all, the product changes that were made to the originator drug during the patent period did not concern any physician or patient [3].