In the early 2000s, pharma companies unleashed legions of sales representatives to promote their products to physicians. Pharma sales teams often had tens of thousands of reps. Medical science liaisons (MSL) teams existed but played a very different role than they do today.
This dynamic started to change the following decade for three major reasons. First, in 2010, new regulations were passed to promote transparency and unbiased medical decision-making. Companies are now required to publicly report any payments or other transfers of value made to physicians and teaching hospitals.
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Secondly, the industry focus shifted from mass promotion of blockbuster drugs to targeted therapy and precision medicine focused on rare diseases and oncology. New therapies and approaches required more of the MSL role, which now needed to accelerate and disseminate critical education and information on more specific disease states.
Finally, the amount of published medical research grew exponentially. Clinicians couldn’t stay on top of an ever-increasing number of new articles, data points and clinical studies, or sift through it all. The rate at which new data and information was produced outstripped the ability of physicians to read, retain and implement new information and practices.
The rise of the MSL
MSLs were now in a key position to engage with key opinion leaders (KOLs) and other stakeholders because they had the expertise and experience to develop peer-to-peer relationships and truly engage with doctors about the latest research.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The number of stakeholders also increased. Now there were care teams, nurse practitioners, physician assistants and patient advocacy groups. Social media also became mainstream, and doctors and patient advocacy groups started using these platforms. MSLs were needed to find and engage digital KOLs as well. In order to be successful, the new MSL needed to be more flexible and adapt to a new era utilizing different and very personalized digital communication and outreach methods to understand HCP preferences. The approach had to be much more personalized.
Covid changed things for medical affairs teams. It was a fundamental shift in the way they worked and functioned. The core of the role changed. Activities like going to congresses and going to HCPs offices aren’t happening anymore and probably won’t come back. Medical affairs and MSLs have to adjust to evolve with the changing times.
As the pandemic suddenly accelerated digital transformation, the landscape of the digital KOL shifted. MSLs had to learn what HCPs were saying in the social sphere and find new and compliant ways to engage with them.
Where we go from here: MSLs over the next five years
- “MSL insights” will drive company strategy and execution.
The role of the MSL used to be primarily data dissemination—informing and educating physicians and KOLs about research, clinical trial results, the latest therapies and the work that their companies were doing. The paradigm is now shifting from educating and informing to accelerating medical science innovation.
CMOs, CROs and CEOs of life science and medical device companies, for example, don’t simply want data; they want new insights gleaned from data and MSL expertise. They need access and insights quicker driven by sound, reliable and actionable data.
- More technologies will be developed specifically for medical affairs.
Medical affairs are increasingly being supported with larger budgets and new technologies. In fact, the top five global pharma companies are now giving medical affairs more resources, such as commercial analytics, and entering more technology partnerships.
With these new medical analytics and digital platforms, MSLs will understand what the educational gaps are in the community. They will understand the clinical protocols and guidelines of the spaces they work in. They will know the sentiment of the KOLs and stakeholders they’re engaging with. This data will be readily available and easily accessible; it won’t require Googling and spreadsheets.
- New technologies will enable MSLs to understand the impact of their work in a compliant way.
How do you begin to measure the success impact of medical affairs teams? We need to take a step back and look at what metrics we are even using to measure impact.
In addition, with the expansion of MSL teams to calling on PCPs, MSLs can see data on referrals to specialists from the PCPs they’re engaging with. One of the best ways for MSLs to know if their efforts are successful is if there are more referrals to specialists from the PCPs they’re engaging with.
Understanding the historical context and impact of medical affairs requires measurement in the form of key performance indicators (KPIs) and metrics beyond just reach and frequency. Some of these metrics can be nebulous unless paired with a sound strategy and demonstrating clinical effectiveness resulting in improved clinical outcomes.
Critical factors to consider when measuring impact beyond counting visits or insights reported:
- Historical context of medical affairs KPIs and metrics
- HCP behavior as demonstrated through identified diagnoses and procedures
- Referral patterns and changes
- Scientific Share of Voice
- Social media sentiment
- Clinical outcomes such as less readmissions or disease progression metrics
Conclusion
The future will be founded on flexibility and actionable data as well as acknowledging the digital front door: watching, contributing, and understanding who is talking, who is listening and what they are saying. Physicians are considering more than the newest therapy, they’re considering adapting to value-based care and patient engagement, and MSLs need to align to ensure improved outcomes.
MSLs are at the forefront of innovation, operations, strategy and execution. Changing regulations, advances in medical science and treatments, an enormous increase in published medical research, and accelerated digital transformation due to Covid-19 have made MSLs indispensable to the industry and improving patient care.
Photo: Irina Strelnikova, Getty Images
Stacey Rivkin is Vice President of Client Solutions at H1. She leads a team of subject matter experts who drive client insight generation. Stacey partners with leaders in pharma and biotech to help them build and maintain collaborative, mutually beneficial relationships with key global external experts and other stakeholders through optimized identification, profiling and integrated strategic engagement.
Stacey joined H1 after almost 20 years in the pharmaceutical industry including at Allergan, Boehringer Ingelheim and Merck. She has extensive experience in a broad array of disease areas and has worked globally throughout the pharmaceutical lifecycle from early-development through commercialization. A proud career highlight was working on the Boehringer team that drove the 2016 FDA approval of Jardiance® (empagliflozin) as the first approved diabetes medication to reduce cardiovascular death in adults with type 2 diabetes.
Stacey graduated from Cornell University with a BA in Government. She lives outside New York City with her husband, three children and “pandemic puppy” Otis.
