Leveraging an Outcome-Based RWE Framework to Further Quantify Field Medical Value

The MSL role has gained significant importance in the life science industry and is becoming -critical in terms of KOL engagement. However, the value of field medical activities has not always been easily quantifiable in terms of traditional business impact due to the primary focus on scientific and clinical exchange with target physicians. We can take a chapter out of the medical and scientific playbook and apply an outcome-based / RWE assessment framework that measures impact objectively, and further elevates customer engagement effectiveness. This article will present an approach to design, plan, and monitor field medical impact using a framework inspired by the design of outcome-based clinical studies.

BioPharma Medical Affairs not only quickly pivoted to transform its way of working due to the pandemic, its customer-facing medical field function, made up of an elite group of medical science liaisons (MSLs), also raised its profile and demonstrated agility during this transformative period.  The MSL position, a challenging and rewarding role as BioPharma’s primary engagement channel to Key Opinion Leaders (KOLs), became even more complex with the shift to virtual engagement and premium placed on scientific and medical value delivery.

However, the educational, qualitative, and sometimes reactive nature of the role does not easily generate the typical kind of promotional and quantitative metrics understood by most commercially trained life science executives. As MSLs are asked to take on additional responsibilities, while maintaining and building critical KOL relationships, they can still struggle with clearly articulating their value to their larger organizations.

How can the Medical Affairs function modernize its ways of assessing MSL impact while harnessing digital innovations to elevate KOL engagement and simplify operational complexities?

To help address this assessment gap, let’s take a chapter from the Medical Affairs domain related to outcome-based clinical trials. We can define a comparable Real World Evidence (RWE) assessment framework to measure how MSLs are effectively moving physicians along a scientific knowledge continuum.  Essentially, we can forecast and track a set of behavioral end points that relate to a target physician’s knowledge of a disease area, treatment options, and even pipeline innovations as MSLs engage with them and conduct relevant scientific exchanges.

To establish this framework, it’s important for the Medical Affairs function to methodically define key behavioral end points and goals on a knowledge continuum that aligns to prioritized medical and organizational objectives. This continuum could then be graphically envisioned as a pyramid where the target physician’s knowledge of a trial, disease area, or treatment therapy can traverse from low on the bottom, to high on top and vice versa.

For each level on the pyramid, each organization can define the demonstrated knowledge and expected behaviors that align with the stage. Classifications would be driven by the real-world engagement observed, questions asked, or actions taken. Here are some examples that further demonstrate this shift away from pure reach, frequency, or time-spent metrics.

Engagement observed

• What sentiment drove their interest in the content?  Positive or negative.
• Were they distracted or focused during exchanges?
• Did they ask unsolicited questions?
• Did they request a follow-up?

Questions asked

• Did they ask general disease area questions?
• Did they ask treatment-specific questions?
• Did they ask about a specific trial or study design?
• Did they ask about pipelines and express interest to investigate?

Actions taken

• Are they applying specific treatment regimens, in which patient profile?
• Are they discussing or sharing related science on social media?
• Are they investigating related science with us or another company?
• Are they presenting on related scientific topics to their peers?

Such real-world evidence can support an initial classification on a designated level and then be systematically updated overtime on a per physician level. Positive changes in physician awareness and knowledge would generate movement in terms of the pyramid level.

In turn, this equates to Medical Affairs outcomes achieved that can be attributed to field medical efforts as well as other market factors. The same analysis can be applied to larger cohorts of KOLs to assess and quantify broader field medical impact over time (i.e., % of Level 1 KOLs that moved to Level 2 over a quarter).

One of the most important benefits of this measurement framework is that it is completely tailored to the field medical team’s core remit.  It does not risk dilution of the team’s responsibilities by confusing with traditional commercial measures.  In fact, it celebrates it by focusing on:

1. The quality of KOL engagement via RWE observed, vs. reach and frequency metrics
2. The KOL’s satisfaction with the service provided by MSLs, vs. promotionally push channels
3. The mission of advancing science through partnerships and podium advocacy, vs. prescriptions written by geography

For the field medical team to effectively adopt this framework, it’s critical that rollout and support mechanisms are implemented in partnership with the MSL team to help ensure success. These mechanisms can be synthesized using the holistic four-quadrant enablement approach below which captures key business drivers and interdependencies. These various areas can be further supported by select partners and vendors with specialized expertise and product offerings[1].

4-Quadrant Support Model:

People Co-design the knowledge continuum pyramid with MSLs so their experiences and voices are integrated Provide frequent training on the framework for onboarding and ongoing adoption Align clear roles and responsibilities across key functions to coordinate and support the execution of the model	Process Ensure there’s a clear alignment of organizational objectives, Medical Affairs objectives, and field medical objectives Map prioritized RWE, observations along a continuum, set up a baseline for key targets Compliment with accessible, tailored, and multichannel content assets that map to behaviors along a continuum
Technology[2] Adapt CRM capture capability to accommodate the continuum design, and ensure there’s a customer database aligned for cross-functional coordination Provide a multichannel KOL engagement suite that meets KOL needs while elevating the content interaction experience Implement an agile, field-friendly content management distribution and platform that meets various multichannel needs	Analytics Track pre/post RWE engagement changes Map KOL’s behavioral movement along the continuum, quarterly at a minimum Complete feedback loop: a) To field MSLs on their targets’ movement, plus associated tips, and recommendations b) To in-house Medical Affairs leaders on priority alignment, and ways to improve the content

___________________________

[1] As an example, Alucio’s flagship product, Beacon, is a multichannel content management and HCP engagement platform built specifically for MSLs and optimized for scientific exchange.  It is a Medical Affairs-centric solution.
[2] These are generally born as sales & commercial platforms, requiring Medical Affairs adjustments to be made as afterthoughts.  It’s important to assess the fit for Medical Affairs when choosing technology partners.

By aligning field medical’s role and KOL engagement behaviors along with an outcome-based RWE pyramid framework, together with implementing the necessary support pillars outlined in the quadrant above, MSLs will be truly empowered to focus on what they do best while demonstrating measurable value at the same time.

Field medical remains a critical function with growing importance given the transformations in KOL engagement and increasing value-delivery expectations. It’s time to evolve KPI’s and provide even clearer evidence of function’s value in advancing education and delivering on organizational goals.

Authors: 

Jessica Wong, MBA

Jessica Wong is a seasoned marketer with >16 years of experience in the Biopharma industry across both US and global markets. She has held successive leadership positions and advised various organizations in launch strategy, digital health & scientific communications – in the context of product development and commercialization. Jessica has implemented numerous mission-critical and user-centric services to enable HCP disease and therapeutic education, as well as patient treatment access/adherence support. The majority of these programs are in the oncology and rare disease areas, powered by robust digital analytics and multi-channel engagement.

Before joining Alucio, Jessica worked for Roche Pharmaceuticals, Genentech, Omnicom Advertising/Digital Agency Network, closer look digital & relationship marketing agency, and Accenture. She has an MBA in Strategy/Finance from the University of Chicago, and a BA in Economics from the University of Illinois at Urbana-Champaign.

Dave Gulezian, MBA

Dave is a successful entrepreneur with 20+ years of executive management experience in innovative, technology-based companies – including the last 15 within the life science industry. His background combines deep strategy, technology, sales, marketing, product launch, and operations expertise. Before Alucio, Dave founded and led Viscira, a provider of digital marketing solutions and software applications for the life science industry. The company became a leader in the space, working with 22 of the top 25 pharma and biotech companies in the world. In early 2016, he led the successful acquisition of Viscira by WPP – the world’s largest marketing communications company.

Dave has personally built and managed business relationships with many of the market leaders in the pharmaceutical and biotech industry, both in the US and globally, including AbbVie, Amgen, BioMarin, BMS, Exelixis, Genentech, Gilead, Jazz Pharmaceuticals, Novartis, Pfizer, and Roche.

Christine Wilson, PhD

Dr.  Christine Wilson began her career as a registered nurse then Nurse practitioner focusing on Emergency care. She eventually became a Director of The Emergency Department Nurse Practitioner Program at two separate hospitals in the northeast.  Her love of teaching had her on faculty at several colleges, eventually becoming Chair of the Family Nurse Practitioner Program at MGH Institute of Health Professions specializing in teaching Advanced Pharmacology and Diagnostic Reasoning. Dr. Wilson turned to business assuming the role of Senior Vice President of Medical Affairs at PriMed where she created the Primary Care Update Series.  Dr. Wilson then merged her knowledge of academia, business, and clinical practice to become a Medical Science Liaison rising to the level of Director of Scientific Medical Liaisons.