A New Frontier: Field Medical plays an integral role within the Healthcare Ecosystem
Medical affairs teams play a multifaceted role within healthcare. By definition, field medical (often referred to as medical science liaisons or MSLs) engage health care providers (HCPs) and Key Opinion Leaders (KOLs) at a peer level, provide guidance, and collect medical insights. Medical affairs communications are fair, balanced, and non-promotional. By fostering relationships throughout the medical ecosystem, these roles aim to improve patient care. As healthcare has evolved, opportunities to partner with field medical have only grown. It becomes clear that the advancement of medicine is inextricably linked with medical affairs activities.
As summarized in Figure 1, it is undeniable that the role of medical affairs is expanding. As the therapeutic landscape rapidly changes, field medical representatives have earned a seat at the table as a trusted scientific partner. They work to keep HCPs abreast of advancements in science, mechanism of action, and real-world evidence (RWE) in a manner that is digestible and clinically relevant. As new products launch, they address crucial product inquiries and continue to support the lifespan of a product by addressing data gaps and RWE. For rare and ultra-rare conditions, this function plays a crucial role in spreading disease state awareness for diseases that may not be on the radar for differential diagnosis.
From a company perspective, field medical personnel act as scientific representatives who not only address inquiries but also act as observers and informants. Using insights gathered during engagements, the company dynamically refines short and long-term strategies. Insight collection becomes the value currency of the medical affairs team, as no other field function can reliably provide their scientific or clinical perspective. Although there is no consistent definition of a medical insight, it is generally understood to be a critical piece of information about diseases or therapeutics shared by external stakeholders, health system executives, and payers. Companies can strategize these insights through various avenues, including improved company services, RWE projects, educational activities, and further endeavors in clinical development or the commercial organization.
Tailored Engagement Across Clinical Practice
For a medical affairs representative to be successful, there are several hard and soft skills that must be mastered. While “hard skills” are often obtained during their scientific or clinical training, many of the “soft skills” are not taught in the classroom. In a fast-paced world where patient needs will always be priority, it is incredibly important to practice emotional intelligence and awareness to understand the HCP persona for a tailored engagement. Given the diverse and broad possibility of activities, the planning and engagement for each interaction is unique. Figure 2 summarizes field medical activities that align with the scientific needs of HCPs at various levels of influence. By tailoring a unique approach for each type of provider, medical personnel can maximize their impact and expand their value.
Tailored Scientific Engagement with “Local” Level HCPs
Local-level HCPs often include those who are new to treating a specific condition and may lack long-term experience in management, treatment, or patient identification. Here, the objective is clear: provide education and spread disease state awareness. This is especially true when it comes to highly specialized or rare disorders that physicians get minimal exposure to during training. These HCPs are important targets for engagement due to their impact on patient care through diagnosis and their potential to adopt new treatments and protocols. Over time, local HCPs can become advocates and serve as a resource to patient communities by adopting new information into their practice.
Tailored Scientific Engagement with “Regional” Level KOLs
Regional-level KOLs have more experience diagnosing, managing, and treating within a specific disease state. Based on their level of influence in the region, they may serve leadership roles within local societies, hold journal clubs, and mentor trainees. From a collaborative standpoint, they are likely to engage with industry by serving as a speaker or participating in a sponsored clinical trial program. These KOLs are less likely to publish on a regular basis, have independent research, or contribute to guidelines. Their role serves as a bridge between the local community and broader medical advancements. Unlike the activities at a local level, field medical personnel engage for a deeper dive into treatment guidelines, emerging data/ RWE, and product differentiation.
Tailored Scientific Engagement with National/Global Level KOLs
National and global-level KOLs are at the pinnacle of influence within a specific therapeutic area. These experts are likely at an academic institution, NIH funded, and often develop or contribute to guidelines. Engaging with these KOLs requires a high level of scientific expertise that meets at a peer-peer level. The National/Global KOL is likely familiar with the basics of disease mechanisms and future opportunities for therapeutic development. Therefore, it is paramount that engagement involves highly scientific rigor and seeks to collect insights by leading with scientific curiosity. Resources to support preparation and engagement include Pubmed, NIH tracker, and communications regarding scientific interests of the KOL. Engagement opportunities may include publications, advisory board meetings, investigator sponsored studies, and partnerships with patient advocacy groups. Ultimately, the relationship with a national/global level KOL should be viewed as a partnership that aligns opportunities with the company to that of the KOL’s interest to advance the scientific community at large.
A New Frontier of Possibilities within Medical Affairs
While the last decade has witnessed a dramatic expansion of medical affairs capabilities, evolution over the next 10 years is sure to witness even more growth. As the utilization of artificial intelligence increases in healthcare, field medical is uniquely positioned to partner with HCPs and institutions to utilize and transfer new tools and technologies related to big data and AI application. As possibilities such as EHR algorithm development begin to unfold, field medical is uniquely positioned to support the translation of new therapies and technologies into medical practice. Additionally, digital presence and omnichannel strategies are becoming increasingly important factors in the dissemination of science by medical personnel. By taking a tailored scientific approach to relationship building, engagements with KOLs can be amplified.
Figure 1.1 Medical Affairs Partnerships Enter a New Era of Collaboration within the Healthcare Ecosystem. Acronyms: MOA= Mechanism of Action, MOD= Mechanism of Disease, HQ= Headquarters, APP= Advanced Practice Providers, GC= Genetic Counselors, PhDs= Scientists, PharmDs= Pharmacists
Figure 2.1 Field Medical-KOL Engagement Across HCP Tiers Using a Scientifically Tailored Approach. Listed activities include those common to each type of HCP. Note that engagement can also consider HCP “Persona” as a way to tailor interactions based on communication preferences, personalities, and clinic demands. HCP “Tier” provides a basic framework of operation that operates different than “Persona” and can function independently.
Disclaimer: The ideas discussed in this manuscript belong to the authors and do not represent views or endorsements of their employer.
About the authors:
Christopher N. Hansen, PhD, MBA
Chris is a translational scientist by training with extensive experience in medical affairs. Chris completed his PhD and postdoctoral training at the Ohio State University and later completed his MBA with a specialization in healthcare leadership. During his 10+ years in industry, he’s supported 13 product/indication launches working as a MSL, Medical Director, and MSL Director. Throughout this time, Chris has consistently looked for opportunities to mentor new and aspiring MSLs. He is a dedicated medical strategist that seeks to transform healthcare by inspiring field medical teams to deliver high quality patient-focused engagement. When not at work, Chris is an avid runner and loves spending time with his wife and four children.
Sean Kazemi, MD, MSc, PhD
Sean is the US Senior Medical Director in Rare Diseases at Sanofi, with eight years of experience in the Rare Diseases Medical Affairs team in Canada and the US. He is dedicated to strategizing innovative digital tools in medical affairs. Sean asserts that a reasonable and pragmatic medical strategy should be capable of being effectively implemented in the field by MSLs, resulting in dynamic scientific engagement with KOLs. He holds an MD, an MSc in Biomedical Sciences from Radboud University, Netherlands, and a PhD focused on cardio-oncology clinical studies from the University of Alberta, Canada, providing him with extensive formal training in clinical research and trials.
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