The Evolving Role of Medical Affairs: 2021 Perspectives

Realities on the pharmaceutical frontline have changed – have your go-to-market models kept pace?

Dr. Debasish Talukdar

Dr. Debasish Talukdar

Kevin Baruzzi

Kevin Baruzzi

Medical Affairs (MA) is where research and business meet: It is the broad term describing the department of a pharmaceutical or medical device company that works independently of the sales and marketing teams to provide essential information to healthcare professionals about optimizing the medical value of their products based on medical or scientific knowledge.

In this white paper, we will learn about the forces that have shaped the evolution of MA in recent years and examine how strategies must change to reflect the new reality. MA is sometimes underused and often does not fulfill its true mission: to identify and generate data that help shape the perceptions of a product.

We will also consider the opportunities for companies investing intelligently in MA to realize an integrated approach to working, leading to differentiated capability, growth and strategic focus. We will look at opportunities to expand the role of MA that some pharmaceutical companies are already undertaking, as well as the role of talent in the entire process.

Finally, Debasish and Kevin recommend five actions for pharmaceutical businesses to undergo in order to support and get the best out of the expanding role of MA.

Changed realities

The go-to-market approach of most pharmaceutical businesses has been largely driven by a focus on sales.

This model has shifted in recent years as HCP-pharma interactions are under scrutiny for commercial motives, leading some countries to explicitly limit the number of times a physician and sales representative can meet. The result? Sales representatives’ in-clinic interactions have declined in frequency, duration and quality, and there has also been a redistribution of budget to cover multi-channel marketing efforts.

MA has therefore become an important strategic lever of pharmaceutical companies looking to communicate with the market. Other trends that have helped shift the spotlight onto MA include:

  • Specialty care – specifically in oncology, immunology and rare diseases – has emerged as a primary growth vector in pharma
  • Complex molecules and developmental approaches mandate a scientific bias in the communication between pharmaceutical companies and HCPs
  • Hyper-competition has led to the proliferation of scientific messaging and the need for a credible medium; expertise is becoming more valuable on both sides of the HCP-pharma company equation
  • Science no longer stops at the regulatory doorstep, highlighting the constant need to generate and communicate RWD (both clinical and HEOR)
  • Technological developments, such as digital, AI and devices, are gaining greater traction in clinics
  • Prescribers increasingly seek clinical-focused dialogue around select treatments, beyond the remit of sales representative

Obtaining this kind of information is largely outside the remit of a sales representative; with increasingly complex treatments, a greater understanding of the disease space is at the core of MA’s offerings to healthcare practitioners.

These changed realities mean the MA function needs to foster a reputation as both a credible source of knowledge for HCPs and a trusted partner for the scientific community.

Changed realities

MA has, in the past, been seen as little more than an addendum, but this is certainly not the case in 2020 and 2021. MA should be thought of as a frontline division that can help pharmaceutical businesses win in the battlegrounds.

In our experience of working with pharmaceutical companies across the board, we have seen a lag – often of five years or more – between the establishment of an MA function to the time it becomes fully integrated into the organizational decision making processes.

Prescient conducted a market poll among CEOs and CMOs at pharmaceutical companies with launched products. Respondents had experience in the US and global markets and demonstrated that there was a general enthusiasm for getting more out of the MA function at their organizations.

Prescient’s research with CEOs and CMOs demonstrates that, despite legal and compliance regulations that enforce a certain separation between the Commercial and MA teams, there is a strong desire for these two units to work together. We believe that this is one area where almost any organization can do a better job of bringing the two sides together, and although there have been varying levels of success in achieving this, almost every respondent in our study recognized the need to move in this direction.

Information flow

To break MA out of the silo, major global pharmaceutical companies of all sizes are starting to explore how a bi-directional flow of information might be encouraged. MA does not have to be a purely outward-facing communication channel; it can also be an opportunity to collect insights from stakeholders, whose perspectives of the market may differ from those of a sales force.

The companies seeing the best results so far operate in a framework where:

While MA should not wholly take over insight generation, it certainly deserves a place at the table to weigh in on questions related to competitive threats and the scientific pillars that complement the commercial and marketing angle.

In some of the larger pharmaceutical companies taking this approach, it is becoming increasingly common for MA to run a strong competitive insights and intelligence function, particularly as it is at the major congresses and symposia where the most relevant competitive insights are generated.

Other opportunities for the engagement of MA include early development decisions, evaluating opportunities for partnering, and in- or out-licensing due to the close connection that MA has with opinion leaders who are in touch with the pulse of the market.

Working in tandem with Commercial, MA has a role to play in two-frontier growth models, each complementing the other. This growth is likely strengthened by enhanced communication and a more aligned approach on overall strategy.

Information flow

There are many opportunities to expand the role of MA. In the graphic below, the bottom row lists the functions and roles considered essential to MA today.

Further up the pyramid are other elements that MA is already expanding into. While few (if any) companies are doing all of these, there is a trend for MA to look beyond its traditional role and become much more influential within a business.

While some organizations are more proactive than others in expanding the role of MA, Prescient recommends looking for opportunities wherever possible; a proactive approach to predicting where an organization wants to go means the output will be stronger and more appropriately resourced.

The role of talent in MA

As MA is not driven by sales incentives, it has historically been very difficult to link it to an ROI.

As the value of MA is better understood and realized by an organization, it is likely that the attitude toward talent – a major cost consideration – will also undergo a change, though every department will be familiar with asking for more and getting less. Talent in MA will be expensive because the right people are difficult to find; in fact, one major player anecdotally reported that four positions have remained open for six months, as the company has been unable to fill roles with the right candidates. Additionally, these individuals are likely to hold a PhD, MD or MPharm, with both strong life science backgrounds and longitudinal market experience so that they can have peer-to-peer conversations with KOLs and scientific leaders.

MA should not be only about field deployment; there should also be a wholehearted embrace of multi-channel and digital forms of engagement, which came to the fore in 2020 and will only gain more traction in the coming years. This year has also seen some teams struggle to retain talent, as workloads have increased dramatically. There is no easy answer regarding how to attract and retain top talent; but flexibility will likely be key to address the desires in a changing environment.

MA teams need to operate such that their organization becomes a preferred place for top medical talent who are inspired by the division’s mission. There must be clear opportunities for professional growth and sustainable ways to work that allow talent to operate at the peak of productive power.

As pharmaceutical companies look at expanding the role of MA, they should adopt approaches that will make better use of their capabilities to add value.

There are many opportunities to expand the role of MA. In the graphic below, the bottom row lists the functions and roles considered essential to MA today.

1

Inject a strategic mindset beyond the annual planning process, particularly global MA

2

Widen the intake funnel and invest in professional development to grow talent

3

Embrace mutli-channel and digital communications as a complement to “traditional” medical engagements

4

Develop MA points of view proactive based on key priorities of the disease area/molecule and/or brand

5

Set aside time to refresh strategic priorities and build the business case for associated investment and resourcing decisions

We recommend that businesses inject a strategic mindset into their planning, especially in global MA, so that the attitude revolves around being forward-looking and extending the vision well beyond annual plans.

Companies must also address the supply of high-quality pharmaceutical talent by widening intake and investments in professional development.

There are major opportunities for pharmaceutical companies to embrace multi-channel and digital communications as a complement to medical engagements in the field; making such approaches standard will enable MA teams to reach more KOLs globally.

MA points of view should be proactively developed based on the key priorities of the disease area, molecule and/or brand.

Time should be ringfenced to build the business case for investment and resourcing decisions based on refreshed priorities.

Taking a broader view of MA enables companies to see it as it truly is: not as a cost center, but as a value and strategic capability center; however, this flip can only occur when reform takes place in a compliant and business-savvy manner.
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