Medical Affairs is still often confused about its role, particularly when it comes to initiatives that may result in more patients being prescribed a company’s medicines. Too many assume this is “promotion” and therefore not Medical Affairs territory. In reality, Medical Affairs is best placed to engage with the HCP community to co-develop new ways of working that improve outcomes — and yes, that means more patients on the right medicines. Far from being forbidden, this is supported by industry codes, by law, and by the direction many governments are giving industry: to collaborate transparently with healthcare systems to improve care.
The MSL role has already evolved from pure scientific exchange into something broader. But the pace of change in healthcare means evolution is no longer enough. MSLs must shift into a higher gear. The ones who thrive in 2026 will be both trusted scientific partners and drivers of transformation — people who achieve measurable, rapid impact in how patients access appropriate medicines.
That requires a sharper focus: moving beyond only traditional Medical Affairs activities such as investigator-initiated studies, publications, or multi-year real-world evidence projects. These are still vital and must continue — but they are not sufficient to address today’s urgent challenges. Patients need to change now, not only in three or five years when a study reads out. Alongside the long-term work, MSLs must take on short, decisive initiatives that identify barriers and enable prescribing change in real time.
This means not just presenting data, but conceiving, facilitating, leading, and supporting solutions that accelerate patient access to the right treatments. It demands new expectations — from the MSLs themselves, from the leaders who train them, and from the organizations that define what “good” looks like.
Here are three tenets for MSLs to embrace if they want to thrive in 2026 and beyond.
Tenet 1. Focus on Deep, Rapid Impact
Traditional Medical Affairs initiatives deliver value, but they tend to operate on long timelines. Future-ready MSLs will add to this by prioritizing short-cycle interventions that make a visible difference within months, not years.
Imagine if an oncology MSL convened a short workshop with oncologists, nurses, and pharmacists, and uncovered that the biggest barrier to appropriate therapy was inconsistent insurance paperwork — and then helped the team create a standardized checklist that sped up approvals.
Imagine if in cardiology, an MSL facilitated a meeting between primary care and specialists to agree on a shared protocol that enabled PCPs to start treatment earlier, cutting months off the patient journey.
Imagine if an MSL in neurology supported a centre to pilot a weekend infusion service, removing scheduling bottlenecks and enabling dozens more patients to start therapy on time.
Each of these scenarios shows how decisive, short-term initiatives can drive immediate impact for patients. They do not replace IIS or RWE studies — but they complement them, by ensuring that evidence translates into practice faster.
Tenet 2. Redefine the MSL Capability Set
Being a trusted scientific expert remains foundational. But thriving in 2026 requires more than scientific mastery. MSLs must also be facilitators, problem-solvers, and system thinkers. That means developing capabilities such as:
- Facilitation skills — running workshops that uncover barriers and align stakeholders around solutions.
- Change management skills — helping HCPs adopt and sustain new practices.
- Systems thinking — seeing the full ecosystem of actors (pharmacists, nurses, payers, administrators, advocacy groups) who influence outcomes.
- Decisiveness — focusing on actions that deliver immediate patient benefit, not just long-term data accumulation.
Imagine if an immunology MSL partnered with specialty nurses to co-develop a simple side-effect management guide, increasing their confidence and helping patients stay on treatment.
Imagine if a rare disease MSL, after hearing repeated frustrations about prior authorization hurdles, synthesized the insight and worked with colleagues to prepare anonymized evidence that informed payer policy change.
Imagine if an oncology MSL connected two hospital teams facing similar challenges, enabling them to share and adopt a proven service model in weeks rather than years.
For this to happen, companies must rethink training. Journal clubs and compliance refreshers are important, but they are not enough. MSLs also need coaching in facilitation, change leadership, and rapid-cycle project design — skills that are not traditionally part of the role specification, but which are now essential.
Tenet 3. Change What We Measure
If we keep measuring MSLs on call activity, slide delivery, or the number of IISs supported, we will get more of the same. These metrics are easy to count but do not reflect the true value MSLs can deliver. If we want MSLs to drive change, we must measure them on impact.
That means asking:
- Have prescribing barriers been identified and addressed?
- Are more patients receiving the most appropriate medicines more quickly?
- Has a service or pathway been improved in collaboration with HCPs?
Imagine if a diabetes MSL convened a group of PCPs and endocrinologists to design a referral template, cutting initiation times from months to weeks.
Imagine if a respiratory MSL helped a regional health system adopt a standardized patient identification tool, ensuring the right patients were diagnosed earlier and treated sooner.
Imagine if a haematology MSL facilitated a payer-provider discussion that reduced administrative hurdles, directly improving patient access.
Impact like this matters far more than the number of visits logged. Medical Affairs leaders need to create frameworks that capture and reward these outcomes, even if they are harder to quantify. Otherwise, the function risks being seen as busy rather than transformative.
The New Ethos for 2026
The MSL role has always been about trust and science. But science alone is no longer enough. Patients need change now. HCPs need partners who will help them overcome barriers, not just present data. Companies need to recognize that Medical Affairs is not “non-promotional sales support,” but a function designed to enable medicines to reach their full clinical potential.
That means training MSLs differently, tasking them differently, and measuring them differently. It means empowering them to lead short-cycle, patient-centric initiatives alongside the longer-term evidence work.
Because the MSL who thrives in 2026 will be both a trusted scientific partner and a driver of transformation — not in theory, but in visible, measurable reality for patients.
Disclaimer: This article was created with the help of AI (ChatGPT). All concepts and topics were developed by the author.
About the author:
Paul Riley, MBA, PhD, CMgr
Paul Riley has over 20 years of experience in the pharmaceutical industry in roles including medical science liaison, medical advisor, and medical affairs manager. Paul is a consultant at Nexcea, where he works with pharmaceutical and medical device companies globally, helping ensure healthcare technologies reach their clinical and commercial potential.
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