Biological medicines are essential for many acute and chronic conditions . A biosimilar is a version similar to an authorized original biological product with clinical comparability that must be demonstrated in terms of quality, biological activity, safety and efficacy . The consumption of biosimilar medicines differs widely among European countries. Germany has the highest use of biosimilars in Europe, with around 50% volume uptake. Despite initial resistance, Italy and Spain are now catching up and the uptake of biosimilars is increasing , but concerns about efficacy, safety and interchangeability with reference products are frequently expressed by specialists and position papers [4,5].