MSLs on the Frontline: Asking Great Questions to Support Biopharma Launch Success

The impactful role MSLs play in maximizing new innovation for patients

Launching innovative therapies in the competitive biopharma space is increasingly challenging. Launch Excellence research by IQVIA highlights the three key challenges to achieving launch success are healthcare system capacity gaps, achieving timely and compelling evidence and HCP engagement¹. Each of these challenges require much deeper understanding and granular strategic planning of local priorities and care pathways, multi-stakeholder integrated date generation and dissemination and personalized, preference-led engagement. These are just some of the reasons why the role of Medical Affairs, and MSLs, is now viewed as more critical than ever.

Launch success usually starts with a robust pre-launch plan and seamless execution, including early resource allocation, a learn-and-adapt strategy setting, and a continuous focus on learning from the market.

A core objective of Medical Affairs teams is to improve patient outcomes. That is also the core objective of launching any new therapy into the healthcare ecosystem. Field medical teams (MSLs) are usually the first field teams deployed externally as pre-launch efforts start and they play a key role, including stakeholder identification and engagement, medical education and data dissemination. And in view of the launch challenges noted above, MSLs can play an even more invaluable role by gaining a more comprehensive understanding of the local patient journey, the treatment algorithms/protocols and the potential partnerships that may enable the unblocking of care pathways to support flows through the system.

Therefore, MSLs can provide unique strategic insights for pre-launch planning and launch success. But is the MSL role being leveraged to its full breadth and potential? And How much are we empowering our MSL teams in the leadership journey, from a scientific dissemination standpoint, inside out (push), to a role of gathering meaningful external knowledge and insights (pull) from the market to inform and shape strategy in pre-launch planning?

Could MSLs play a greater role as a learning soundboard, earlier in the pre-launch stage, collecting insights from HCPs, including on key unmet needs and patient and caregiver experience? Could MSLs play a more significant role in understanding healthcare system bottlenecks and patient journeys? And could they be more active and early participants in strategy building as “the customer voice” into the decision making matrix? We strongly believe that the answer is yes, however, there may be some opportunities for how we are setting MSLs up to successfully gather insights, and this is directly related to how well field teams are prepared with the right questions and their level of interpersonal skills.

Catarina’s “two person” monologue

A few years ago, as an MSL, I traveled more than 300 km to have an important meeting with a key opinion leader. The appointment seemed to go very well, and I achieved my objectives of data sharing and medical education, as for half an hour I shared a lot of useful information for his clinical practice. Or, so I thought.

Just a couple of weeks later I received an email from the same KOL, sharing with me a publication link to an important article that he thought I should read.

When I checked the article, to my surprise, I realized that this was the exact same article that I had shared and discussed with him in our meeting a few weeks earlier. It became apparent that, in fact, rather than sharing and discussing the article with him, I had presented it, and not paused for his thoughts or asked open questions to prompt a discussion that may have generated insights and real engagement.

Great questions: Powerful forces for engagement and insights

While awareness of a new product, its evidence, and potential benefits is important, sharing of this information can have much greater impact if it is presented with an understanding of the role it may play for the HCP.
The only way to know this is to gather precise details by asking great questions that seek to understand the physician’s context and behavioral drivers. What are their hopes, fears and needs?

In Hal Gregersen’s book Questions are the Answer² he describes how questions can undo certain assumptions and open up space for the perspective of the other. As soon as we start reframing, we start challenging assumptions and true learning starts.

For MSLs, diligent preparation for interactions and “reframing”can help to craft a great set of questions that can lead to a mutually fruitful discussion and develop rapport for future interactions. It will also empower MSLs to collect high quality insights to inform and support product strategy and ultimately help to improve patient outcomes.

Our pre-call preparation should cover all bases, including:

What have my company colleagues noted in the CRM after previous interactions?
Have they attended any company activities recently?
What has the physician disseminated on my topics and/or product class?
What studies have they been involved in?
What can claim data or eMedical records show about the types of patients they manage?
Is there understaffing in their center/area?
Do we know of patient backlogs in their region?

This information helps us to prepare our questions. The starting point for the interaction should be the physician/HCP’s context and their drivers. Amongst Stephen R. Covey’s The 7 Habits of Highly Effective People³ habit 5 – Seek First to Understand, Then to Be Understood® – is particularly resonant. It emphasizes that the pathway to influencing others is by developing a deep understanding of their needs and perspectives.

“The question has to catch people where they are, to meet them where there is the most energy and relevance for them, and then use that energy to go deeper.”
Eric Vogt et al. The art of powerful questions⁴.

When someone speaks openly in response to a question, this is a good sign that we have asked a great question. The ability to do this, and do it consistently, is highly underestimated, as it differentiates one MSL from another. In the current environment of increasing investment in field medical, identifying ways to stand out and generate value for customers is of paramount importance.

Equipped just with reams of data and slides, we are often prone to the “half question, half data dump” approach, where we start asking a question and then begin answering it ourselves. Every conversation needs oxygen. We can give our interactions oxygen by keeping questions succinct and then pausing for the HCP’s response and practice active listening. While we may be desperately keen to move onto our next morsel of knowledge or impressive data point – this information can wait – it will likely have even more relevance if we are patient and listen – really really listen closely – and then probe, go deeper for further information that will, when the moment is right, enable us then to be understood.

Conclusion

MSLs can play a central role in a successful launch plan in biopharma. As the first field force deployed to prepare the market, their work includes key early stakeholder identification and engagement via scientific dissemination and medical education activities. However, in a world characterized by uncertainty and constant change, the ability to adapt and balance a traditional ‘inside out’ data dissemination approach with an ‘outside in’ strategic insights framework, underpinned by posing mutually relevant questions, has become a critical skill for MSLs and organizations alike. Asking questions demystifies beliefs and catalyzes learning, innovation, and transformation – critical factors for strategic differentiation and launch success. Can the MSL role, as the voice of the customer, be elevated to inform launch strategy?
If your answer is no, why not? If your answer is yes, how can we proceed?

References:

Kelaher D, Berkels R, Gores M. IQVIA EMEA Thought Leadership White Paper: In Pursuit of Medical Launch Excellence. 2023. https://www.iqvia.com/library/white-papers/in-pursuit-of-medical-launch-excellence
Covey SR. The 7 Habits of Highly Effective People. Free Pr; Anniversary edition (9 Nov. 2004)
Gregersen H. Questions are the answer: A Breakthrough Approach to Your Most Vexing Problems at Work and in Life. Harper Business; Illustrated edition (27 Dec. 2018).
Vogt EE, Brown J, Isaacs D. The art of powerful questions: Catalyzing Insight, Innovation, and Action Eric E. Vogt, Juanita Brown, and David Isaacs.

About the authors:

Catarina Santos, PhD, MBA

Catarina Santos PhD MBA is the Executive Director for Medical Launch in Europe in Novartis Pharma, Basel. With 15+ years of Pharma experience, Catarina specialized in market assessment and readiness for key asset’s launch & pre-launch across European markets, for Pharma Specialty Care brands. Catarina is also a board member in a Swiss Biotech and a frequent speaker in several Pharma and Biotech conferences.

David Kelaher, BPharm, MSc

David has 20 years of experience in pharmaceutical Medical Affairs and healthcare communications. He spent a decade in Medical Affairs at Sanofi, including roles in the Australian affiliate, and as a Global Medical Director in the company’s Paris headquarters. Following this he was Managing Director of BBH Health, a specialist strategic and creative business within BBH, one of the world’s most awarded agencies. During his five years at the agency, BBH Health became the global agency of record for Humira, Symbicort, and Brilinta, and led the global brand development and launch assets for Fasenra, Skyrizi, and Rinvoq. David provides leadership and support on IQVIA’s KOL, Share of Scientific Voice and strategic planning capabilities. He holds a Bachelor of Pharmacy from the University of Sydney and a Master of Science in Medical Science from the University of Oxford.