The Asia Pacific Region is fast emerging as a major hub for the pharmaceutical industry. This region includes the developed APAC (Australia, Hong Kong, Japan, Singapore, Taiwan and South Korea), South-East Asia (Indonesia, Malaysia, Thailand, Phillipines and Vietnam), China and South Asia (India, Pakistan, Bangladesh, Nepal, Sri lanka, Maldives). The requirements of Health Care Providers (HCPs) across these areas are very diverse and they provide an interesting set of challenges for Medical Affairs teams, particularly in the Indian Sub-Continent where India is the major market.
India accounts for forty percent of the total generic demand in the US. The Indian pharmaceutical sector is expected to grow to US$100 billion by 2025. With such rapid growth, the opportunities for Medical Affairs are tremendous.
Challenges for Medical Affairs
Although the projected growth figures for the Indian pharmaceutical industry are impressive, most of these companies are generic manufacturers where medical affairs may have a limited role to play.
In the absence of defined deliverables, the Medical Affairs teams are seen more as a supporting function rather than a business partner. The main Medical Affairs roles include training, sales, and marketing team functions reviewing promotional materials for accuracy of medical content and providing support to the regulatory teams as needed.
Many Indian companies tend to intertwine key opinion leaders and key business leaders. Key business leaders may be the physicians who have a practice. However, they might not be the subject and research experts in their therapeutic areas and may not be the correct advice to share. A medical affairs team can prove to be very useful in this scenario. With the emphasis on medical affairs, growing the number of multiple national pharmaceutical companies based in India, and in consideration of the shift Indian companies manufacture generic brands, biosimilars and biologics, the role of medical affairs in India is also undergoing a change.
Opportunities for Medical Affairs
The pharmaceutical sales and marketing model has greatly changed over the last 15 years. Traditionally, physicians would have medical representatives coming and meeting them, with medical and scientific updates provided by the medical representatives. This model has now started to evolve and change.
Indian physicians who completed post- graduate training in the US, Europe or other western countries are moving back to India. They are sharing knowledge gained abroad, enabling collaboration between doctors in India and western counterparts, and expecting interactions with pharmaceutical companies to be similar to those in the western world. This change has resulted in Indian physicians expecting more from pharmaceutical companies in the areas of education, MSL interactions and initiatives that improve patient care. There is much opportunity for medical affairs teams in India and South Asia to step up and foster meaningful interactions with KOLs – through investigator initiated trials, medical advisory boards, one to one interactions, and Medical CMEs, among a host of opportunities.
Field Medical Affairs Teams
Business leaders in India have also started realizing the importance of having strong medical affairs, including the build-out of competent field medical teams. One key difference between MSL teams in India and western countries, is that Indian field medical teams are mainly comprised of medical doctors (unlike in the US or Europe where you see PharmDs or PhDs working as MSLs). MSL teams composed of only physicians can have their unique challenges with the lack of diversity and lack of scientific and pharmaceutical expertise that having pharmacists and scientists on the team can bring.
There are also cultural challenges to take into consideration. With the large population and the limited number of trained physicians available, physicians in this part of the world tend to be overworked and overloaded. As such, there is a limited number of KOLs in every therapeutic area and many industry representatives competing for their time. In such a scenario, face time with a KOL can become very challenging. Moreover, KOLs in India generally prefer face to face interactions over email communications. However, with the emergence of younger KOLs, there is a trend towards acceptance of more digital interactions.
Medical Affairs in India and South Asia continues to evolve. . Business leaders, as well as KOLs have gradually started to realize the value that a good medical affairs team brings to the business and patient care respectively.
Many pharmaceutical companies in India have focused energy on building strong field Medical Affairs teams. Unlike the west, field Medical Affairs teams in India still tend to be composed mainly of physicians. Implementation of good Medical Affairs training programs for pharmacists and PhDs may help companies embrace having talented pharmacists and scientists as MSLs, increasing the breadth of expertise within their teams.
Anand Lakhkar MD, MS, PhD, currently serves as a Senior Manager, Medical Affairs and Clinical Development, Vaccines and Biologics at Serum Institute of India. He has completed his MD in India, MS in Cancer/Neuro Pharmacology from Georgetown University and his MS and PhD in Pharmacology from New York Medical College. His medical affairs experience spans multiple therapeutic areas from oncology, anaesthesiology, critical care to infectious diseases. He is passionate about the field of medical affairs and medical science liaisons; he has a strong interest in mentoring and nurturing the next generation of medical affairs professionals. Anand and his wife are the proud parents of two year old twins.