MSLs: 'We are the connectors'

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Medical science liaisons rank among the most important actors in healthcare. So why are so many people in pharma unaware of the full extent of their contributions? We asked four of the industry's best-regarded MSLs and the leader of the MSL Society to discuss what they do and how they do it.


Linda Stiles, PH.D.
Principal medical science liaison for AbbVie immunology/gastroenterology AbbVie

Tell us about your professional history.
My initial career aspiration was to become a research scientist and I was well on my way after completing a Ph.D. and a short postdoctoral fellowship in immunology. But I realized my true love involved interacting with people and communicating about the science going on in the laboratory, rather than being the one doing the science.
 
However, I was not entirely sure about the type of career that would let me do that. One day I was out cycling with one of my teammates, who happened to be a sales manager at a pharma company. He was completely unaware I was looking for a new career path and spent the entire ride telling me about this job called a medical science liaison and why I would be perfect for the role. 

It sounded intriguing, so I kept it in the back of my mind. Once I completed my scientific training and was certain I was ready to leave academia, I recalled that conversation and ended up pursuing an MSL position. 

What was your professional “eureka” moment?
It was when I became a patient myself, which allowed me to see the impact of MSLs from a different perspective. I learned firsthand that most patients are interested not only in the efficacy and safety of their treatments, but also in having a quality existence despite their disease. 

Being a patient led me to realize how minor innovations or slight improvements in communication techniques can have an enormous impact in reducing the psychological and physical burden of disease. 

In the broadest possible sense, what does an MSL do?
MSLs are the connectors for their organizations to the healthcare and patient communities they serve. They are experts in their therapeutic areas and are crucial for helping healthcare providers keep up on the evolving science in their fields. They also listen for innovative ideas, changes, or trends and share them with their organizations, enabling companies to continue moving science forward in line with the needs of patients.

What is a typical day for you?
The only thing typical about an MSL's day is it is different from the one before. One day I might be in Arizona engaging physicians with a scientific presentation. The next day I might be in another state at a conference learning the latest science, or at our corporate headquarters discussing our pipeline medicines. 

Most of an MSL's time is spent interacting with healthcare professionals, researchers, and patient communities in an effort to educate and better understand the needs of patients. The variability of the job, the need to keep up on the evolving science, and the opportunity to consistently interact with smart individuals keeps it exciting and intellectually stimulating.

How will the MSL role be different a few years from now?
The healthcare landscape is rapidly evolving and, as science continues to advance, having someone who is a scientific expert, and also an expert in communicating that science, will become even more important. Due to the speed of information and an ever-expanding audience, MSLs are becoming more sophisticated in their understanding of the entire healthcare landscape and more adept in the use of tech to manage and deliver customized information to a wide variety of stakeholders. 

Despite the many changes in the industry, the role of MSLs at AbbVie will always remain rooted in our vision to make a meaningful difference for patients. 

What are your must-have work items?
Good listening ears and a smartphone. Whether I am interacting with external or internal stakeholders, I need to actively listen to understand. Because I cover a large region, I need to be connected no matter where I am in the country. Most importantly, I need to be able to FaceTime and talk with my loved ones at home.

Who are your biggest inspirations?
The patients impacted by the diseases that AbbVie's therapies are designed to benefit.



Anne VanBuskirk, PH.D.
Executive medical science liaison/associate director of medical affairs
Takeda Oncology

Tell us about your professional history.
I obtained my bachelor's in biology and math from William Woods University in Fulton, Missouri, and my Ph.D. in medical microbiology and immunology from the University of Missouri. After a post-doctoral fellowship at Northwestern, I moved to Ohio State University, where I changed my focus a few times, eventually researching the immunological aspects of cancer and of organ transplantation tolerance. 

I left academia to join pharma in 2007 and have been an MSL for more than 10 years, with the past seven in oncology. In order to further my understanding of the business aspects of pharma, I recently received a master's from Marist College. In addition to my MSL role, I coordinate our U.S. MSL training team of three regional trainers. 

What was your professional “eureka” moment?
I have always known I wanted to work in oncology. During my childhood, my mother had a long battle with non-Hodgkin's lymphoma, and she passed away while I was in graduate school. I wanted to play a part in defeating this disease. In a defining moment during my academic research, I interacted with several transplant recipients, which helped me understand the importance of my research. Knowing my work made a difference was very powerful. I wanted a career that more directly and frequently had an impact on patients' lives, so I made the move to pharma. 

When I was applying for a job at Takeda Oncology (then Millennium Pharmaceuticals), I attended an American Cancer Society training session. I had the opportunity to meet a patient who told me how drug development research saved her life. I mentioned I was hoping to work for Millennium. She said, “There isn't a better place to work, or more important work to do, than fighting to cure cancer.” I knew at that moment I wanted to be in oncology medical affairs at Millennium. I am happy to say that not only have this patient and I remained in contact, but she is also still alive and well, 22 years after diagnosis, thanks to advances in research and drug development. 

In the broadest possible sense, what does an MSL do?
We are conduits of information between medical affairs and our stakeholders. In terms of our external stakeholders, we're the “face” of medical affairs to key opinion leaders and are sometimes the only person from a company they see on a regular basis. We also support company-sponsored clinical trials and investigator-initiated studies as a scientific resource. 
 
Tell us something about the MSL role that people in the industry don't know.
It's the best job you can have in pharma. You discuss science with some of the most intelligent people in the world, see the direct impact your company's products have on people's lives, support cutting edge clinical research, and have a role in making patients' lives better. 

Tell us something about the MSL role that people in the industry don't appreciate.
MSLs have a unique opportunity to straddle both academia and industry, and can provide valuable insights to their companies and external KOLs. 

These insights can make a huge difference in safeguarding patients — by optimizing clinical trial design, understanding a therapy's real-world usage, or optimizing symptom management and patient adherence. 
 
How will the MSL role be different a few years from now?
Two aspects are changing right now: One, access to KOLs is becoming more limited, and two, companies are revamping their research approach to be more effective. Many companies are moving away from individual investigator-initiated studies and toward larger partnership studies.




Ariane Natale
Executive medical science liaison, oncology
AstraZeneca

Tell us your professional history.
I am a doctor of pharmacy with a 25-year career that has spanned clinical practice, academia, and biotech. 

My first job was as a pharmacist at the Veterans Affairs Medical Center, where I oversaw drug treatment plans for patients in long-term care facilities and managed drug formulary for the medical center.
 
I transitioned to academia as an assistant professor in pharmacy practice, then became an MSL at Amgen. I joined AstraZeneca four years ago. 

What was your “eureka” moment?
It happened early in my career as an MSL, when I realized it takes more than good science to change or shape clinical practice outside of academia. 

Academic oncologists are, for the most part, tumor-focused and very knowledgeable regarding emerging new treatments in their specific areas of expertise. Community oncologists are generalists and are faced with the ever-increasing challenge of keeping up with the rapidly evolving treatment landscape across multiple tumor types.

MSLs can serve an important and often critical role in helping general oncologists update their knowledge base. “Data dumping” from the most recent practice-changing clinical trial typically doesn't accomplish this. Rather, presenting the data in a patient-oriented manner, often in a specific case-based manner, and asking thought-provoking questions are highly successful strategies. 

But this requires that the MSL establish a trusting peer-to-peer connection that is sensitive to the enormous time demands of practicing general oncologists. Earning trust is a foundation to our work. 

In the broadest possible sense, what does an MSL do?
We work on a peer-to-peer level with top researchers and thought leaders in our field to improve patient care. 

We serve as a catalyst to build collaborations between external thought leaders and internal stakeholders, bringing research ideas to fruition, increasing participation in company-sponsored trials, and engaging in the exchange of scientific knowledge with the medical community to shape clinical practice. 

We also support our sales colleagues in the field by managing unsolicited requests for off-label information, which often require in-depth clinical expertise. 

Taken together, this work contributes to redefining the standards of cancer care. 

What is a typical day for you?
It's never typical. There are teleconferences with my AstraZeneca teams, meetings with external scientific experts, work on various projects, participation in national congresses or regional and local medical meetings, and more. In between it all, we keep up with the current literature by reading journals, conducting journal clubs, and attending grand rounds and training seminars.

Tell us something about the MSL role that people in the industry don't know.
We spend a fair amount of time working behind the scenes to navigate institutional barriers to move research forward or prepare thought leaders for speaking engagements regarding important medical progress.

Tell us something about the MSL role that people in the industry don't appreciate.
We serve as an advocate for everyone with whom we work. 

How will the MSL role be different a few years from now?
There will be more social media engagement — for example, following external scientific experts on Twitter to gather insights and breaking research news. We must be equipped with knowledge to work in a value-based environment.

What are your must-have work items?
Entrepreneurship, a sense of humor, and the right tools and data to support scientific discussions.

Who are your biggest inspirations?
Professionals who have devoted their lives to finding a cure for cancer, to giving patients the gift of time, and to improving their quality of life.
 


Dr. Samuel Dyer
CEO/chairman of the board
Medical Science Liaison Society

In the broadest possible sense, what does an MSL do?
MSLs serve as scientific or disease state experts both for internal colleagues, including sales and marketing, and for physicians and healthcare providers in the therapeutic area of the medical community in which they work. However, the primary purpose of the role is to establish and maintain value-added relationships with KOLs at major academic institutions and clinics.

Tell us something about the MSL role that people in the industry don't know.
The MSL career has been around for more than 50 years. It's one of the best kept secrets in pharma. MSLs were first established by the Upjohn Co. in 1967 as a response to the need for scientifically trained field staff who would be able to build rapport with KOLs in various therapeutic areas of research.

Although originally called medical science liaisons by Upjohn, over the years companies have used various names for the role, including medical liaisons, medical managers, regional scientific managers, clinical liaisons, and scientific affairs managers. The first MSLs were experienced sales reps with strong scientific backgrounds and brought a higher degree of clinical and educational expertise.

What is the typical educational background for an MSL?
In the late 1980s, a number of companies required applicants to hold a doctorate degree (M.D., doctor of pharmacy, or Ph.D.). Today, a doctorate degree has become the educational standard for the MSL. According to our 2017 MSL Salary and Compensation Survey, more than 85% of all MSLs in the U.S. hold a doctorate degree. In fact, 89% of all new MSLs in the U.S. hold a doctorate degree.

Do MSLs face the same access challenges that sales reps now do?
MSLs are clearly concerned about KOL access. In a survey we conducted, 62% of MSLs reported KOLs are becoming less accessible. 

However, when MSLs engage and access KOLs, their impact is obvious. A top 10 global pharma company recently hired the MSL Society to survey its KOLs. The survey revealed the average time a pharma sales rep has with a KOL is two minutes, while the average time for an MSL is 45 minutes. KOLs place a high value on the relationship. 

There is no physician in the world practicing medicine who is going to give up 45 minutes of their clinical time to anyone, unless that person is providing value. 



Katie Long, MS, LCGC
Medical Science Liaison
Sanofi

Tell us about your professional history. I am a licensed, certified genetic counselor by training and completed my Master of Science degree in genetic counseling at the University of Pittsburgh in 2007. I began my career after graduation as a genetic counselor at the Cleveland Clinic Foundation Genomic Medicine Institute and was quickly presented with an opportunity to return to my “hometown city” to coordinate the Lysosomal Storage Disorders (LSD) program at the University of Pittsburgh/Children's Hospital of Pittsburgh. There I provided genetic counseling and coordination for the LSD Program exclusively until 2014, when I added the role of genetic counseling supervisor at Children's Hospital of Pittsburgh. In 2016, I decided to explore a new opportunity as a medical science liaison with Sanofi Genzyme Rare Disease and was fortunate to be given the chance to join the team.

What was your professional “eureka!” moment? In my role as genetic counselor with the LSD Program, I had the good fortune to work closely with the regional Sanofi Genzyme rare disease MSL. She had a depth of clinical experience and knowledge I valued tremendously and I admired her as a colleague and friend. She provided me with many opportunities for growth and development in this space and helped me to become a leader and expert in this arena.

As a MSL in the rare disease and lysosomal disease space, I knew I could have an even greater impact on the landscape of clinical care and research in this field and to reach a far greater number of physicians and allied providers. Working with rare diseases is a calling and I am fortunate to have found it.

In the broadest possible sense, what does a MSL do? I interact with and develop KOLs in a four-state area through scientific information exchange, disease education, and championing the interests of investigators with regard to investigator-sponsored studies, clinical trials, and the Lysosomal Storage Disease Registries.

What is a typical day for you? I love the variability that each day brings! There is no typical day and that is a good thing. I respond to the needs of my region with a strategic vision, which may include meeting with KOLs in the field, organizing educational programs, connecting KOLs with the appropriate internal resources to answer a question, or compliantly collaborating with my commercial colleagues.

Tell us something about the MSL role that people in the industry don't know. When there is a spark of enthusiasm from a healthcare provider, it is our job to help nurture and foster it while also being incredibly respectful of the demands placed on HCPs in the current environment. This is what leads to lasting bonds with the physicians and allied providers we work with and greater potential for better patient outcomes.

Tell us something about the MSL role that people in the industry don't appreciate. Although we do not interact with patients, the work we do with HCPs is important to improving the overall quality and continuity of patient care.

How will the MSL role be different a few years from now? The volume of disease information being generated on a daily basis continues to grow exponentially. It will require greater depth of knowledge.

What is your must-have work item? A backpack! It's life-changing.

Who are your biggest inspirations, professionally or otherwise? When I departed from clinical practice, I knew I was following my intended path but it was still hard. I had given a lot of myself and had an emotional connection and investment in my patients' lives, many of whom I worked with for nearly 10 years. I had walked alongside them through great joys and great sorrows. I had heard their fears and concerns and I had listened to their hope. Patients and families with rare diseases are courageous and I am grateful to have had the chance to work for them. They are my inspiration.

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