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Interchangeability and the Automatic Substitution Question A biosimilar can be approved as biosimilar without being designated interchangeable. Interchangeability requires additional evidence that the biosimilar can be substituted for the reference biologic without increased risk compared to using the reference product alone, and without involvement of the prescribing physician [41]

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GSH is a non-enzymatic antioxidant, is an antioxidant synthesized by cells, and serves as a reversible oxygen donor through the conversion of the oxidation-reduction state of sulfhydryl groups, and mainly provides oxidation protection in the water phase in cells