Opportunities to Maximize Engagements With External Stakeholders

The Field Based Medical (FBM) role was first established in 1967 by Upjohn Pharmaceuticals^1-3. This role is considered scientifically trained personnel who are oriented to build long term relationships with key opinion leaders. This important role has existed for around 55 years and continues to evolve according to the changes in the healthcare environment.

FBM engagement with external stakeholders* is a critical activity and a high level interaction must be done to ensure maximizing the value to the stakeholder, and to the MSL objectives.

In most of the Pharma Companies a general engagement model is in place to harmonize the approach with stakeholders (fig 1). This generally consist of a sequence of actions grouped in three major steps:

• Before engagement
• During engagement
• After engagement

After several years of experience attending global conferences related to the MSL role, participating in person or virtually in global webinars, interchanging with pharma colleagues, and working in the field with MSLs, I have identified important actions to be considered to ensure maximizing the value of each engagement with stakeholders.
The main objective of this article is to provide several insights, to aspiring, new and experienced MSLs, responsible for stakeholder engagements. Ensuring implementation of those recommendations will undoubtedly lead to a more productive engagement, with related benefits to the stakeholder practice, and to the MSL’s objectives.

1. BEFORE ENGAGEMENT
   Alignment of the engagement with the medical strategy. To ensure each interaction brings value to medical strategy, the MSL must master the strategy of the products. A deep understanding of the medical strategy (if possible, the brand strategy also) is critical to ensure MSL resources and time invested in the engagement with each one of the stakeholders will be beneficial for the medical plan (and, in consequence, for the brand plan), and for the stakeholder practice and/or the patients.

   Also relevant is having a deep knowledge of the stakeholder (background, role, academic and scientific activities, congress participation, mindset, behaviors, professional network, influences, etc.). This must be deeply analyzed before each engagement and must be permanently updated. All information of the stakeholder profile must be consolidated in a unique repository. Under the omnichannel vision, all contacts with the same stakeholder from other areas/functions (other Medical roles, Marketing, Commercial, Public Affairs, Clinical studies, etc.) must be also documented in the same profile allowing 360 degree knowledge of the stakeholder profile.

   Finally, having a clear (SMART) objective for the corresponding interaction is critical. Important to mention this objective must be oriented not to actions the MSL will do (“Discuss the most recent paper…” or “Share the new slide deck on…”), but to change stakeholder mindset and, more importantly, change behavior. Finally, each engagement objective must be aligned to the long-term goal we want to achieve with the stakeholder. In this sense, the vision is to ensure creating a long term relationship with each one of the stakeholders the MSL is engaging in their territory.

   My experience: It is common to learn that MSLs often do not have access to a Medical Plan, and they do not understand the strategy behind the products they are supporting. Also, sometimes the stakeholder profile is poor, incomplete, or not updated. It is very important to mention that in several cases an engagement objective may be more oriented to activities the MSL will do during the interaction, and not oriented to change a stakeholder behavior. Also, it is relevant to highlight the lack of long term vision the MSL may have in relation to the engagement objective with the stakeholder (what the MSL wants to achieve in a period of 6 months or 1 year).

2. DURING ENGAGEMENT
   MSLs must ensure the time the stakeholder is dedicating to the engagement brings value to their practice and/or their patients; also, the benefit to the MSL objective must be considered. In this sense, the objective of the engagement must be clearly stated by the MSL at the beginning of the conversation and agreed upon mutually with the stakeholder.

   Considering that MSLs are the scientific face of the pharma industry in the field, it is critical, while interfacing pharma companies with the medical community stakeholders, to ensure gathering relevant, timely and actionable insights for the company, relevant to the medical plan or the product strategy. This is an important part of the value proposition of the MSL role4.

   During engagement MSLs must master all content related to the topics they are managing according to the product life cycle. In this sense, a deep knowledge of related science behind their products, like slide decks, papers, related documents, guidelines, health care environment highlights, etc. must be demonstrated during the conversation with the stakeholder.

   Also important, the MSL must master all required capabilities and skills to conduct a successful engagement: managing objections, active listening, probing, how to do powerful questions, how to answer questions, voice intonation, verbal, and nonverbal communication, etc.

   My experience: MSLs really master all science behind the products or topics they are managing. It is clear the knowledge level of each individual MSL is comparable to that of the stakeholders (of course, for specificities about the products MSL is supporting, their knowledge is even above their counterparts). On the other hand, permanent training on skills and capabilities is required because sometimes the MSL has areas for improvement to enhance conducting conversations with stakeholders in the field.

3. AFTER ENGAGEMENT
   MSL team must ensure documenting all relevant information gathered during engagements with stakeholders (in a CRM or any available, approved repository). This information could be related to the stakeholder activity (published papers, speaker in Congresses, participation in clinical studies, etc.) to keep an updated profile. As previously mentioned, all contact done with the stakeholder by any other function should be also added (omnichannel approach to the stakeholder).

   It is very important to document any identified insight gathered during the conversation (considering that not in all engagements insights will necessarily be identified). This must be then consolidated and communicated to the relevant internal functions.

   An objective for the next engagement must be clearly defined at this moment (when all information is fresh) and uploaded into the CRM. Even if this objective could change during the time between engagement,it will be a solid base to maintain continuity of the several engagements with the long term goal.

   My experience: There are still gaps in the industry to document notes after the interaction with stakeholders. Also, when insights are identified and communicated, it is not always clear what the impact on the strategy is or what actions were taken with such insights. Finally, a next engagement objective is not always written, losing a great opportunity to maintain the continuum in the progression to the long-term objective.

MAIN RECOMMENDATIONS
To maximize the value of each engagement with stakeholders I identify several areas with room for improvement. Although not an exhaustive list, here recommendations I consider critical:

1. Ensure mastering the strategy related to the products you are involved in.
2. Having a clear long-term goal of the relationship with stakeholders is relevant to ensure bringing value to them, and support achieving the objectives of the Medical plan.
3. Each engagement must have a SMART objective, aligned with the long-term goal,
4. Gathering external health care environment insights is a critical role of the field medical team. They must clearly document and communicate to the internal teams (medical team, brand team…)
5. Engagement objectives must be oriented to change a stakeholder behavior, not to actions the MSL will do during the interaction.
6. Having a holistic view of the stakeholder is critical. In this sense, an omnichannel strategy is relevant.

*External stakeholders will depend on the local health care environment: Physicians, Nurses, Digital Opinion Leaders, Key Decision Makers, Payers, Governmental Institutions, Patient Societies, Medical Associations, etc.

1. Sandeep Kumar Gupta and Roopa P Nayak. An insight into the emerging role of regional medical advisor in the pharmaceutical industry. Perspect Clin Res. 2013 Jul;4(3):186-90. doi: 10.4103/2229-3485.115386.
2. Samuel Jacob Dyer 2023. The Medical Science Liaison Career Guide.
3. Morgan DK, Domann DE, Collins GE, et al. History and evolution of field-based medical programs. Drug Inf J. 2000;34:1049–1052. doi: 10.1177/009286150003400408
4. Paul Theron et al. Promoting Best Practices for Medical Science Liaisons Position Statement from the APPA, IFAPP, MAPS and MSLS. Therapeutic Innovation & Regulatory Science (2021) 55:1139–1144

About the author:

Jorge Fragoso, MS

Jorge´s current role is Global Field Based Medical Excellence Lead in Sanofi Vaccines. In this function he oversees coordinating several initiatives related with Medical Science Liaison team around the globe.

Jorge was born in Mexico City and is graduated from the National University of Mexico. He is a Biologist and holds a master’s degree with honors in Neurosciences. Jorge joined Sanofi in 1991 and he drives his knowledge in Sales, Marketing, Business Support, e-business, training and Medical through more than 32 years of experience holding various roles in Pharma Mexico.

Jorge joined the Latin America region team in 2010 and, since 2015, he has been coordinating several important initiatives at a Global level in Sanofi Vaccines. Those multidisciplinary functions provide to Jorge an interesting transversal view of the Pharma environment. When not traveling to interact with the Regions, Jorge enjoys writing science fiction short stories, reading, watching movies, and listening Heavy metal! He also loves savoring food of the world (his biggest challenge: a crunchy and spicy scorpion in a Beijing market!)

LinkedIn: https://www.linkedin.com/in/jorge-fragoso-14327ba/