MSLs are emerging as the principal players in pharma’s post-Covid recalibration but they need to be equipped and coached in the skills to take their scientific knowledge and expertise to next level productivity
Introduction
Medical Science Liaison (MSL) teams and medical affairs are critical to industry success but the seismic shifts of the pandemic have propelled them into even more influential territory. MSLs hold the future in their hands, forming a critical bridge between pharmaceutical companies and HCPs and other key stakeholders as both sides look for knowledge and value in an uncertain world. Major organizations are restructuring. Sales forces have been trimmed or re-assigned with the emphasis heavily on delivering scientific content that is relevant to individual or small groups of HCPs. The race is now on to enhance the MSL role by upskilling their communication capabilities to ensure engagements with HCPs both broaden scientific awareness, deliver to corporate objectives and increase the Quality Use of Medicine (QUM).
Part 1 of Pharma’s New Frontier whitepaper outlines the challenges and benefits of coaching a new generation of MSLs and Part 2 focuses on what is needed to enable this well-developed skill set, and how industry can rise to deliver extra value via their MSL teams.
Liberating MSLs
It is the fastest growing sector of the industry with fortunes riding on its efficacy in an ever more complex and segmented world. The MSL now operates in an arena where precision guided science and finely-honed communications skills are the vital edges to their ability to succeed. Access to HCPs, often built on familiarity and custom, is now volatile: HCPs, liberated and empowered by digital capability, no longer adhere to tradition and now demand specific scientific content welded to a clear understanding of their needs. The rules of engagement have changed; complex new medicines are being developed, rare diseases are being decoded and fresh routes to approvals and reimbursement are being explored as healthcare navigates the most upheaval in a generation.
The MSL is now, arguably, the most influential role in the pharmaceutical industry. Albert Bourla, chief executive of Pfizer – one of the many pharma giants announcing sales force redundancies and a sharper in-field scientific focus – stated: “We are evolving into a more focused and innovative biopharma company, and evolving the way we engage with healthcare professionals in an increasingly digital world.” It is a clear indication of a major policy shift towards MSLs. AstraZeneca, Amgen and GSK are all leaning the same way.
A recruitment advertisement for a new AstraZeneca MSL post was clear in the core skills and responsibilities needed to build scientific partnerships with the latest scientific and medical information. It read: ‘These outputs are guaranteed through continuously building robust scientific and medical expertise on the therapeutic area, AstraZeneca products and its competitors in combination with a business acumen attitude and strong communication skills’.
This whitepaper focuses on the burgeoning MSL role and how it can be supported and upskilled to deliver on expectations, maintain relationships and forge new lines of communication that deliver to HCP needs and company objectives. The challenge is to enable MSLs to make the best of their new opportunity to range across a wider landscape with more meaningful engagements. Rising to it will enable MSLs to help deliver better outcomes for patients.
Michelle Bridenbaker, Global Head Medical Information for Idorsia, summed up the new paradigm: “The role and function of the MSL has changed just as the expectations of HCPs have changed,” she says. “The key now is to be flexible and to establish relationships with HCPs who know they are dealing with someone who is scientific and who has scientific support behind them.”
Telling the scientific story
Elevating MSLs to be the ‘shop window’ for organizations is not without issues. Enthusiasm and commitment to their condition and therapy area are core MSL qualities but not all are natural communicators or have significant experience in telling a broader scientific story. Making complex information compelling without losing its focus or diluting its impact is a skill and an art.
Matt Britland, an experienced Medical Director with a long history of working in the pharmaceuticals industry and clinical roles, believes organizations need to invest in MSL career development to empower them to make the best of an expanded role and sphere of influence. “In an MSL, we look for curiosity and a passion for science but, where we probably once looked more for academic qualifications as a start point, it is now a case that sublime communications come first,” he says. “It doesn’t matter what you’ve got in your head – if you can’t communicate it to internal or external stakeholders in a way they understand then it will stay in your head.
“Communication skills, soft skills, strategic mindset, working cross functionally, emotional intelligence and, I’ll say it again, good communication, is what we are looking for. If you do a presentation and people come up and say ‘that is one of the best I’ve ever seen’ then you are the person we want. If no-one asks a question at the end of it, you’re probably not. “It is not provocative. It’s a kind of sales in a way but you are selling science and what a lot of sales people often cannot do is communicate the high science. You need that scientific knowledge. If you get lost in a conversation with a key opinion leader at any point, it de-credits yourself and your organization.”
Enhancing the MSL skills set
Britland, who is President of the Australian Medical and Scientific Professional Association (APPA) which is dedicated to promoting excellence in medical affairs, added that MSLs also need to be tuned in to the differing needs of their HCPs, and have the ability to adapt the scientific message from HCP to HCP . He adds: “For the HCP, it tended to be a question of which organization has the best packaging and delivery of a product. But now they want something more. They are saying ‘I don’t really understand this. I need someone to really decode it for my patient group; not everyone else’s, just mine.’ That is where a good MSL with good communication skills pays dividends.” Dr Maja Beilmann-Schramm, a globally recognised MSL mentor who has worked for Merck, Bristol-Myers Squibb and Shire, believes that the coaching of MSLs is fundamental to elevating the modern MSL’s skills set.
“We need more coaching to find the sweet spot of providing benefits to the physician – something they really need – while aligning with the company’s strategy,” she says. “I think this is something MSLs need to learn because they can tend towards satisfying the first part of that equation while neglecting the company’s needs. “This is why we need more focus on storytelling, wrapping the scientific content in a way that makes sense to the company’s goals as well as the HCP. “It is not just learning the story, but really how to use the story in communication with the physicians and I feel that is somewhat missing; this is where coaching comes in.”
Idorsia’s Michelle Bridenbaker sees the MSL role expanding and echoes the call for more skills to boost their capabilities. “The growing importance of MSLs is what we are seeing across industry. They are having much more contact with the customers and, because our products are so innovative, HCPs want to have that knowledge,” she says. “A lot of good things follow from that empowered relationship because behind the MSL is the digital capability to log a sponsorship request, submit an investigator-initiated study protocol. All the stuff we have behind them is our scientific offering. You also have a consistency from what the MSL is saying is what they are hearing through the rest of the channels. “The good relationship an HCP has with the MSL leads to outstanding service.”
Coaching is the Missing Link
Making MSLs more accomplished communicators takes more than flicking a switch or finessing a job description. The skills needed to energize their performance and efficacy require considered, consistent coaching. For many, it will be a departure and, for some, a challenge. “There is a lot of pushback from MSLs because this is a new aspect. They are scientists and the idea of storytelling may not be something they view as their role because they see it as not being free discussion,” says Dr Maja Beilman-Schramm. “There should be space for that free scientific discussion but there has to be a point as to why you are having that discussion.”
The commercial imperative is central to any engagement. “It is about framing scientific information and bringing it into context. For me, that is storytelling,” she adds. “It is not about relating that the data says A, B or C; it is about saying what that means to a physician and their patients. “It is about following an order that sets the basis, highlights the challenge, and provides data that helps solve the HCP’s challenge. It is telling our product’s story. I’ve seen some teams do a great job putting all that in order then the MSL tells the story in a way that is not relevant. “The challenge is to get that right and I don’t see any other way than coaching. The art is to tell the story at the pace the physician requires and employ active listening to ensure you do not lose them. This is an art; you have to train to get better at it. “We should have been doing it for years. Being of value and providing valuable scientific content to physicians targeted to their specific needs is nothing new.” But organizations also need to comprehend that endowing MSLs with new skills takes commitment and investment in coaching. They too cannot expect MSLs to be instant hits in their new, expanded roles.
MSLs are an organization’s heartbeat
“The good point for industry is that we know what has changed and have recognised that MSLs have to be supported in their soft skills,” comments Michelle Bridenbaker. “Helping the MSL ask good questions will ensure the HCP feels that they are really trying to understand the root of what they are trying to do.” This adds an extra, and key, dimension to the MSL function; one of ensuring the information and message have purpose that encompasses scientific understanding and corporate objectives. Bridenbaker adds: “As an MSL, you can no longer just sit there and say: ‘I’m just stopping by for a nice, scientific discussion related to my company’s product’. That’s not going to work out – the MSL will have to be way more targeted and structured in approach. It is a mutually beneficial discussion that provides information but also recognises learnings from the physician and builds a relationship. That is an art.”
The life sciences sector is transforming from the dominance of blockbuster drugs to a varied, innovative landscape where novel therapies are offering hope for people with intractable conditions and rare diseases. Medical affairs – with MSLs the heartbeat – is also evolving as it seeks to champion science, translate its benefits to narrower, tailored markets and enrich responsive dialogues with HCPs. It is a crowded market. The number of clinical trials registered in 2022 was 409,300 compared to 100,207 in 2010 and 2,119 in 2000, according to Statista research. They are also growing more complex and directed at smaller patient populations. Demand is also booming with a key indicator evident in the medical affairs outsourcing market being valued at $1.4 billion in 2020 and expected to achieve a compound annual growth rate of 12.2% over the next six years.
MSLs are being challenged to grow and respond. Matt Britland is convinced that MSLs and Medical Affairs are already playing a more central role across a product’s life cycle. “It is the emerging force,” he says. “But coaching is the missing link here. We need to be courageous and accept the responsibility to do more coaching and more mentoring. We cannot keep on being the ones just giving advice, that is a mediocre approach and is not what these roles are about. “It is not just about being a therapeutic expert. Now, it’s about being a leader, an innovator and change agent, being a communicator and getting things done.”
Enriching the Business
Matt Britland is also clear that MSLs can add benefit and boost the bottom line across an organization’s activities by generating greater internal collaboration and efficiencies with knowledge-sharing the sledgehammer that busts through corporate silos. This, he and others believe, can bring scientific concepts and medical strategies to life, and enliven engagement with key opinion leaders. The key areas of challenge for organizations are how they deploy MSLs to respond to a fragmented market and multi-channel opportunities and then coach and equip them with an enhanced set of skills. “Their role will still be as a conduit to the clinician but as part of a multi-channel approach,” adds Michelle Brindenbaker. “They will still be the super scientific expert but their biggest task is to make sure that the clinician gets exactly what they need, based on their preferences. Before it was more: “Here’s a reactive slide deck and have a nice day, Doctor’. They have to change the way they interact. There is no going back.
“One thing an organization can do for an MSL is to support them in developing good communication skills.” The listening and learning element of these reshaped relationships is fuel for the entire organization, she adds, as knowledge from HCP interactions can be fed back into the business to inform future strategy. It is vital front-line intelligence.
Conclusion
A cohesive scientific approach with the MSL creates benefits across the healthcare landscape: HCPs get the information and data they need, patients benefit from more targeted application of therapies and the business flourishes across multiple metrics, from sales through internal collaboration to brand reputation. The MSL has always been a focal point in industry but now they are becoming crucibles where knowledge is distilled and shared and their influence is radiating across corporate performance. They have the opportunity to champion scientific excellence and, with the right support, the ability to maximize their professional returns. Their scientific prowess remains paramount but the days of operating in an academic corral have gone. With strong interpersonal engagement and communication skills, they can emerge from the shadows to become industry’s main players in a highly-segmented and demanding market. The recognition of the value and potential of MSLs has been achieved. It is time to provide them with the skills and the freedom to rise to the challenge.
About the interviewees
Matthew Britland, Global Platform Medical Director (Haem) & Medical Director Australia, Amgen. Matthew is also president of APPA Australia since November 2021. Matthew is an experienced Medical Affairs professional with a demonstrated history of working in the pharmaceuticals industry and clinical roles. Skilled in Pharmaceutical Medicine, Oncology and Haematology . Strong professional with a MMedSc focused in Pharmaceutical Medicine from UNSW Australia. Currently working towards DrPH which focuses on the role of Medical Affairs in the Quality use of Medicine (QUM) and its impact on patient outcomes.
Dr Maja Beilmann-Schramm, Director, Global Field Medical Excellence and HCP Exchange, Merck Germany. Maja has previous experience in a variety of roles with Shire Pharmaceuticals where she worked for 8 years. Most notably, Maja was Director of International Medical Science Liaison and Medical Scientific Strategy, Medical Affairs. Maja also has previous experience as a Product Manager for Sanofi.
Michelle Bridenbaker, Global Head, Global Medical Information and Communications, Idorsia Pharmaceuticals Ltd. Michelle is a senior leader in pharma and biotech for over 15 years in various capacities including: sales, pharmacovigilance, medical information & communications, quality assurance, and medical affairs. She has extensive international experience creating and innovating organizations. Michelle advises technology partners and other service providers that support the pharma/biotech industry, healthcare organizations, and not for profit organizations. Michelle is very passionate about optimizing the customer experience, leveraging technology to improve organizations, and creating highly successful and engaged teams.
About the author:
Marcus West
I have directed 35 plays and coached performances for 30 years. I have worked with the likes of LA director, Robert Benedetti, US playwrights, Edward Albee and Will Eno, voice coaches, Kristin Linklater and Cicely Berry, Alexander teacher, Nadia Kevan, LA acting coach, Ivana Chubbuck, British playwright and screenwriter, Stephen Jeffreys, LA screenwriting master teachers, Steven Kaplan, Chris Vogler and Michael Hauge. I use these experiences with the world’s leading performing arts practitioners and my own background in theatre, to inform my work in presentation coaching. I work with a host of CEOs and their firms around Australia including KPMG, DLA Piper, CBA, QBE, Merck, and BOQ, as well as politicians and barristers, to help them present their message with punch. I am also a talent coach with Seven, Nine, SBS, ABC, and Fox Sports working with reporters and presenters on their presentation and storytelling skills, as well as many of Australia’s leading sportspeople. Clients have included Michael Slater, Wally Lewis, John Aloisi, Sharelle McMahon, Lara Bingle, Mark Ferguson, Ben Fordham, Allison Langdon, Mike Baird, Jonathon Brown, Glen Boss, and Tom Carroll.
In the past five years, I have created a new performance coaching app called 60 Seconds which is a crystallization of my experience.
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