Cloud Marketing: Faces in the Cloud

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In recent years there has been a huge surge in the prominence of medical science liaisons, the individuals within life-­sciences companies responsible for establishing and maintaining relationships with leading physicians at clinics and academic institutions. Over the next two years, in fact, the number of MSLs is expected to increase globally by 20%.

What's driving this growth? According to Dr. Samuel Dyer, CEO of the Medical Science Liaison Society, “KOLs [key opinion leaders] are demanding it.” Today's thought leaders are looking for detailed information as they engage in clinical conversations with life-sciences companies. Another contributing factor is the growing scientific sophistication of pharmaceutical products, particularly genomics and orphan drugs. Both therapeutic categories tend to be much more complex and technical in nature, requiring scientifically trained medical experts in these discussions. Many orphan-drug companies, in fact, are forgoing traditional commercial paths and are instead relying more heavily on MSL teams during prelaunch activities. 

And it's not just the largest life-sciences companies that are hiring more MSLs: Even biotech, veterinary health and medical device entities are getting into the act. In fact, companies are increasingly seeing the value of leveraging MSLs to educate key physicians in order to reinforce their medical messaging and brand. 

Doctors are gaining significant medical value from these conversations. According to Dyer, “The data from a recent survey conducted by the MSL Society revealed the average time a traditional sales rep has with a physician is roughly two minutes, but the average time an MSL gets is about an hour.” This is not to say that MSLs are immune to access challenges. With more MSLs than ever competing for the time of top opinion leaders, MSLs face many of the same access challenges as field sales reps. 

From clinical to commercial

The role of the medical team in a life-sciences organization has shifted significantly over the years. It was once rolled up into research and development, a completely separate entity from commercial. But these days MSLs are engaging in conversations with physicians that go beyond the translation of science to delve into issues such as health outcomes and the real-world effectiveness of drugs.

Executives from Shire Pharmaceuticals and AstraZeneca recently participated in an industry roundtable to discuss the topic. Each agrees wholeheartedly that the role of medical teams looks quite a bit different today than it did even a few years ago. 

“Medical affairs now serves as a bridge between our clinical, scientific and commercial teams and even helps drive greater patient-centricity,” says Dan DeStefano, Teva Pharmaceutical's head of global medical affairs customer-facing operations. “For example, our MSLs have been instrumental in supporting investigator-initiated studies, some of which have produced clinically relevant results that have ultimately led to company-sponsored trials and approvals.”

Glen Martin, SVP of medical sciences at Ashfield Pharmacovigilance, a division of UDG Healthcare and a provider of outsourced multichannel communications, adds, “Actually, we have found the collaboration of local MSLs in investigator-initiated studies to drive many important initiatives—such as label changes, safety updates and establishing new pathways for the development of randomized clinical studies. A local MSL's insights are truly invaluable to these studies and do much to move results forward.”

At AstraZeneca, too, medical affairs has become a better-aligned department. “Our MSL teams contribute valuable information that gives the entire company across clinical, medical and commercial functional areas a more complete view of the healthcare practitioner,” says Kevin Krause, PhD, AZ's senior therapeutic brand leader. “Traditionally, much of this information was largely siloed within each functional area.” Despite the greater collaboration between medical and commercial teams, it's a mistake to think of MSLs as a secondary sales force. The job of MSLs is to impart information, not drive prescriptions, so their function is different than that of sales even if both functional areas are striving to build relationships with key stakeholders and influencers. 

Measuring the impact

If the role of MSLs is not to drive prescriptions, how, then, does one measure their value? Defining meaningful metrics can be tricky. 

A good place to start is by looking at the prelaunch product strategy—and, more specifically, the scientific communications strategy for medical affairs—then aligning it with that of the commercial teams. Companies can measure the value of MSLs by documenting their impact on strategy execution.

Of course, that's easier said than done. “A large part of the value of an MSL is in building trusted science-based relationships with the top-tier KOLs,” explains DeStefano. “One basic way to measure this is by tracking the number of interactions MSLs have with KOLs and what came out of those discussions. Even so, all of this is very difficult to measure or track quantitatively.”

According to Dyer, measuring the value of MSLs will always involve a mix of quantitative and qualitative variables. A quantitative variable may be the amount of face time an MSL spends with a physician (30 minutes every two months, etc.). A qualitative measure might be the medical insights derived from those conversations, collected in a system that's easily accessible by other internal teams.

Consider a physician who suggests to an MSL that a drug be studied in a particular therapeutic area or in combination with another drug. Such an insight, while difficult to measure quantitatively, has the potential to substantially impact clinical research and development efforts. 

“MSLs show their greatest value in the medical insights they bring in to the organization,” DeStefano continues. “Today's trials and products are more complex so a medically knowledgeable MSL team is often better equipped to help with trial challenges or weigh in on R&D decisions.”

Martin adds that the role the MSL can play in accumulating and analyzing competitive intelligence is not to be overlooked. “Because MSLs are engaged in earlier stages of clinical development and trial discussions, they are in a position to gather intelligence that can be quite valuable to an organization and its development efforts,” he says.

Dyer approaches the issue of adding value this way: “One question I ask of every MSL I have ever managed in any country is, ‘What is the medical value of you going in to meet with that particular KOL?' ” The only real way to know the answer to this question is to ask the KOL, and not every one values the same thing. “Some KOLs may be focused on the latest issue of a particular medical journal. Others might be looking for speaking opportunities or be primarily interested in conducting investigator-sponsored trials,” Dyer continues. “How you go about discovering what a KOL values is simply by asking.” 

While there is no universal blueprint for MSL success, some best practices are emerging. Because there's more pressure on the industry today to demonstrate the economic value of a drug, MSLs are increasingly targeting payers and regulatory agents. The physician is no longer the sole customer. An effective MSL strategy will look at segmenting MSL teams to address all key stakeholders that can affect a brand's success. It will also ensure that MSLs are carefully aligned across all customer-facing teams and channels to help nurture existing KOL relationships and build new customers across markets.

It may pay to use MSLs more judiciously, depending on where a product sits in its life cycle. MSLs may prove most valuable and effective during the prelaunch phase—which averages about seven years—rather than postlaunch. Research points to a greater need for life-sciences companies to invest more in prelaunch activities designed to create stakeholders who are already eagerly awaiting the product before launch. Here is where MSLs may have the greatest impact and impart the most value.

The most important factor that contributes to the success of an MSL/KOL relationship is communication. Dyer reports that a recent global survey on MSL job performance conducted by the MSL Society revealed that while scientific expertise and relationship management remain core requirements, these competencies are no longer a differentiator and do not provide unique value to KOLs. In fact, he adds, “MSL managers rate communication skills as the most important competency for success. Physicians are bombarded by vast amounts of information of varying quality. As a result, they desire MSLs who can communicate information that is relevant and valuable.”

The role of the cloud

Systematically capturing the insights gathered during interactions with thought leaders is critical to success. Equally critical is finding a solution that specifically addresses the unique needs of the medical team—among them, how to identify KOLs, build in-depth profiles and develop meaningful engagement plans.

Integrated cloud-based suites offer many advantages to medical teams, including the ability to bring together the numerous interactions and conversations KOLs have with various customer-facing teams. Doing so provides a holistic view of the KOL so the MSL can tailor future interactions and develop a collaborative relationship. 

“With a complete view of KOLs, companies gain a strategic advantage,” Krause explains. “We can leverage information to get a better understanding of the KOL, which not only helps enhance future KOL interactions but can also aid in setting clinical and research strategies to enhance patient care.”

Cloud-based solutions can also help break down common existing barriers between functional teams. Traditionally, software technology has consisted of disconnected systems, which prevent the flow of information and ideas. Easily accessible via the web, cloud solutions promote data sharing and allow all parties to have increasingly richer and more personal conversations with the customer.

“Cloud technology has been a huge contributor to this shift toward a larger role of medical,” says DeStefano. “The cloud puts everything out there, available in real time, with platforms that are totally connected.”

He adds that “Amazon knows more about me than most pharmaceutical companies know about their KOLs. But as we start to put key opinion leaders at the center of everything and build our systems around how we engage with them, then we can set the framework to simply click a button and see every interaction our organization has with KOLs. This is nirvana in terms of understanding their needs and, ultimately, helping patients.”

Many within life sciences see an even bigger role for medical affairs in the years ahead. “I think medical affairs will evolve to become much more customer-focused,” DeStefano says. “And this will be more broadly defined as outreach to healthcare professionals, patients and even patient communities.” 

As KOLs continue to pose accessibility challenges, MSLs looking to create real impact will need the right training and the right technological support. MSLs who have the resources needed to collaborate with other functional departments and the communication skills required for clear, personal and persuasive discussions will be well positioned to provide a truly customer-centric experience. 

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