To my esteemed colleagues who took time out of their day to listen online to the webinar session entitled, “Achieving Effective KOL Engagement and Intelligence Gathering at Medical Conferences”. First, gratefully acknowledge your interest and attendance.
Like any good educational session, our webinar was planned with clear learning objectives in mind. Based on some of your questions and comments, I thought it would be helpful to follow up with some additional guidance and specific tactical recommendations as you participate in upcoming medical conferences.
Overall, I’ve tried to concisely address the topic at hand (KOL/Congress Management), while drawing some parallels between our meeting and our work every day in the field. Please read on for a number of REAL tips and tricks!
Allow me to introduce myself since I came into our time together essentially with my hair on fire and technology melting at my fingertips (have you been there?).
I’m Jane Varian, and I’m a Senior Director in Field Medical for the Hematology division at BeiGene. I’m a nurse who found her way into pharmaceuticals quite by happy accident. I quickly moved from sales to medical affairs at a time when nurses were able to do so, and then earned my Nurse Practitioner degree while working as an MSL. I’ve been a “garden-variety” MSL for 16 years now, and my *minor* claims to fame are as follows:
- I live in New York and therefore cover an academic, high-profile, tiny territory no matter what company I work for (it’s kind of fun, I can’t lie).
- As a nurse, I’m usually the one reminding my team that oral adherence/diversity in clinical trials/serving the patient and advocate is a BIG deal.
- I’m fairly direct, and I don’t hesitate to ask the hard questions (see #1).
I also have a bunch of kids and pets and hobbies, so the MSL life matches my frenetic pace—the pace that we are trying to harness during Congress season. As a clinician first (like many of you), I found parallels between the way we were taught at the bedside and the way we should best approach major conferences, and our incredible medical affairs careers in general.
Follow along and see if you agree.
- If you aren’t 15 minutes early, you’re LATE!
- Learn from me—and maybe you’ve been there before yourself. To run to a crucial meeting while also juggling a mission-critical call from your manager AND reading an urgent, important email is a recipe for disaster. One cannot function with that level of cortisol pulsing through their veins. Give your calendar and yourself space to breathe. Do not overschedule yourself.
- Expect the congress shuttles to convention centers to run at least 15 minutes behind schedule; expect them to be full. Know the location of your stop the night before; they can be farther than you think. Plan accordingly by mapping your route (inside the convention center and out!). Know your nearest taxi stand/scooter rental/rickshaw outfit.
- Download the congress app, sign in, and be certain that it’s functioning properly–well in advance of the meeting. These apps can sometimes be more efficient than the web version of the congress platform. If you have “assigned abstracts”, be sure to find and favorite each one—then take a screenshot of your list just in case the app/your technology/your life crashes midweek. I like to export all my abstracts/sessions from the app to my calendar. If your phone or computer is showing signs of “imminent apoptosis”, you might want to consider replacing those devices before the meeting.
- MSL 101: being respectful of KOL’s and colleague’s time is NON-NEGOTIABLE. If you tend to run late, fix that in a hurry or face MSL peril.
2. Plan ahead, plan contingency, plan emergency
- Your meeting room is locked? Your laptop screen suddenly went black? Your CMO is stuck on the tarmac in Newark during your MOST important KOL meeting in Chicago? All can easily happen, and all have workarounds that you must implement. To be a “fixer” (this is expert-level MSL, in my view), you must have all your pieces in place well in advance of a congress in order to successfully get yourself out of any sling. Such as…
- Be sure you have congress contact information for every attendee with whom you plan to meet. Pro tip: this is a great way to ask your KOLs for the Gold Standard of contact information–the cell phone number. Extra points if you end up with some witty banter on a text by the end of the meeting.
- The above goes for all of your internal colleagues as well—especially if you are conducting joint meetings. Know “who does what” from your company before you get there, especially these functions: meeting room planner, badge/registration contact, your key Medical Directors at hand, Clinical Development for each agent, compliance partner, and friend you want in the foxhole with you. To name a few.
- Do not hesitate to confirm meetings both 24 hours and one-hour pre-start time. If you suspect that someone vital might not make the meeting, start asking delegates for backup as early as you can. If all else fails, ask your line manager to attend and take notes so that you can focus on the conversation. Don’t be afraid to ask for help.
- Know clearly the objective of your KOL meeting, and bring the best folks from your side along for the ride. I don’t like to have more than a 3/1 ratio of the industry to KOL at any one meeting. Sometimes, as a leader in the field, you must make strategic decisions in order to protect your KOL relationship. Align. Be diplomatic. Communicate cross-functionally, and you’ll win.
- Send meeting agendas and any materials within the calendar invite for your meeting, so that it’s easy for everyone to quickly access.
- Have a backup for tech issues. Hard copies of vital documents, a book to jot insights, photos of important data on your phone for quick access in a pinch…whatever works for you, use it!
- Bring extra phone cords and a backup battery; meeting apps and texts drain your phone. Also, your less well-prepared teammates will think you a hero when you pull out a card to share, and there is nothing wrong with making friends. Always have a pen handy to use or lend. Carry plenty of business cards.
3. If you didn’t document it, you didn’t do it!
- #1 Rule of Competitive Intelligence (CI): like fish and houseguests, it starts to overripen after 72 hours. Be sure to report CI with haste; it’s much more meaningful to your organization when you do. Also, you remember a lot more about the fine details.
- As we mentioned in the webinar, CI is a primary function of any medical affairs team. Before you go to the meeting, be sure you have a clear understanding of WHERE, HOW, WHY, and WHEN to document CI. Assess your team’s commitment to the practice, and be sure it aligns with the leadership team’s vision. Sometimes, CI can float to a level of lower priority due to any number of events; a shift or event in personnel; life cycle management; increased interest in areas such as research, or just too much else to do puts CI at risk.
- Collect CI in whatever way works best for you, but do your best not to replicate your documentation. It’s important that the time required to document is in balance with the procurement. For MSL leaders, be as clear and concise as possible around expectations for CI, and educate your teams on exactly where and how the information will be used. Be sure to give credit to CI when events occur that benefit from that insight.
- As an “old school” MSL, I prefer not to use HCP names or even institutions or cities when providing CI. I use descriptors such as “an academic physician who specializes in [Disease State] at an urban institution in the Northeastern US”. Keep in mind, that many of your KOLs may be under a Confidentiality Agreement with your company—and usually, that means, so are you! Be careful not to share CI with external physicians in any specific way and be sure that your colleagues follow the same practice.
- If you have a CRM, do yourself a favor and record your interactions as you go. The information you provide is of far greater accuracy, and no one likes to spend the week post-ASCO recording calls. You’ll have enough to do.
- A post-congress report is often generated as the result of these meetings. Usually, the “lead” MSL of the meeting is the responsible party, but occasionally it’s led by the leadership team. Know what is expected of you in that report before you land in town. Encourage the report authors to use source documents to create a dynamic, concise report. This brings me to my personal favorite…
- A report of all KOL interactions at the congress is also usually generated. These lists usually include both commercial and medical events if your compound is a marketed agent or in launch mode. Be sure you are aligned with commercial colleagues on the objective of any compliant “joint” meetings. While cross-functional coordination can be tricky, it’s also probably where Field Medical exhibits the most value to our friends across the aisle. Be sure that the materials you plan to use in a joint call are compliant for all parties, well cited, and purely scientific in nature.
4. See one, Do one, Teach one
- In congress management, this principle applies heavily to the LEAD of your congress. These folks should be seasoned professionals, yet not so set in their ways that they cannot see the benefit of pivoting when needed. I find it a best practice to have an HEIR and a SPARE here, the heir being the expert lead while the spare is a less-tenured co-lead whose task it is to support the lead and learn the lead’s role.
- The MSL Congress Lead should be heavily involved in all appropriate company strategy meetings for any given congress, and they should be sure to benchmark the activity of their MSL team to the overall goals of both Medical Affairs and their Company. If this alignment seems deviated, then the Lead should feel empowered to address their strategic concerns with Medical Leadership.
- The Congress Lead usually also has the thankless job of combing through ALL of the abstracts and assigning them to the team for coverage. The Lead should be free to speak with an internal stakeholder who can assist. Chances are, your business intelligence gurus, med info, publications, commercial teams, and training departments are also doing the “abstract crawl”; best to share lists freely and save precious time (not to mention sanity).
- When assigning abstracts among the team, good success can be achieved if you align the Principal Investigator with their MSL as often as possible. This practice also tends to create harmony in covering smaller therapeutic settings; assigning each MSL a “theme” disease state or subset can be beneficial to all.
- Booth duty can be very fruitful but creating those assignments can be a real task. Sending out an empty schedule grid for the booth in the same communication as the abstract assignments, with the request that each MSL signs up for their own booth duty, can get 90% of the work done for you. Booth duty cleanup is a good task for the co-lead. • Now then, say you’re newer to the group—you’re not leading the congress, heck you’ve never been! My advice to you? Find a buddy. A VETERAN buddy you respect. Then listen closely. Keep up with them. Take their good advice.
- Are you a veteran MSL and you mercifully avoided the lead role this year? Be a mentor. Show what good looks like. Offer to come to a colleague’s meeting that’s falling apart, simply for support or to offer a scientific exchange if needed. Keep your attitude positive and productive. MSLs are, by nature, very good at “growing their own” and supporting newer colleagues.
5. Stay in your lane
- Let’s face it, there are a LOT of people at these major conferences. That means many requests for your KOL’s time. The respect we show for their time impacts the entire relationship. Be sure that you have a reasonable business objective for meeting them at the venue. If you are seeking CI, but have no other pressing research or development need, consider requesting a shorter, more casual meeting this time.
- For marketed agents, your commercial team will play a role in how your plan for the meeting. Be sure you read and understand your company’s compliance manual. Be transparent. If the content of your meeting is appropriate for a broader attendance (say, an introduction to a KOL), then support joint meetings to respect everyone’s time. If your meeting is not appropriate for commercial attendance, be clear and unapologetic. The key is to ALIGN BEFORE the congress, not during.
- The last few weeks before the congress, expect a lot of planning calls. Weekly cross-functional status calls between commercial and medical may seem painful, but they are quite informative and can prevent problems.
- Keep your assigned abstracts straight! As mentioned in the previous section, a good way to split abstracts among the team is by geography or therapeutic subset. This usually will create some themes that are important to carry through to post-congress meetings and initiatives. If you are assigned to a major abstract, consider yourself the “company expert” on that abstract and be prepared to thoroughly present and discuss the data set at any moment. Your role in presenting a key data set may be one of the more high-profile cross-functional internal activities you do all year.
6. Know your role (Why are you in the room?)
- The role of the MSL (and the MSL leader) varies among organizations at congresses. I submit that there are two variables that greatly impact this role: 1) the life cycle of your lead compound and 2) the size of your medical affairs organization. Meeting attendance for a 5-year-old gold standard PD-1 inhibitor looks a lot different than it does for a niche, novel CAR-T therapy in the prelaunch phase.
- Are you a part of a small Medical Affairs team, where you do everything from procurement of abstracts to slide development and medical writing? Well then, NAIL IT! Be sure you have role clarity about the expectations of you from a KOL engagement/CI standpoint in this type of setting. You cannot do all the tasks; you simply will run out of YOU.
- Are you in pre-launch at a biotech or young company? Follow ALL the Principal Investigators and abstracts that you can in your disease state. Watch social media hashtags. Synthesize your understanding of the current landscape and key players. Get to know them. Ask a lot of questions. Observe how your potential competitors are moving about in the space. Who’s funding all the Independent Medical Education? Sometimes, it’s not so easy to see that from the cover letter; dig deep to understand the supporters of each session you attend.
- Are you launching soon??! Hooray! Fun times ahead! You better know your data cold, and theirs too. At this point, your academic physicians should have been well engaged—this is the time to start seeing a broader audience. If the treatment space is crowded, this will be one of the more challenging access issues at large congresses. The more prevalent the disease state and the more prevalent the treatment, the more competition for time at the KOL level. Plan meetings with CLEAR objectives in mind; if the KOL senses that you are simply meeting to “say hi”, it may feel frustrating. Understand that sometimes, a well-timed cup of coffee in the convention center and a longer follow-up meeting two weeks later upon return home can win the day for these busy KOLs.
- Are you at a Big Company, working on a Big Drug? You’ve got a LOT of resources behind you, so let them do their jobs (see also: stay in your lane). Your job, likely, is to continue Competitive Intelligence and Scientific Engagement with as many KOLs as possible. Your company may be so large that you even have internal colleagues doing a lot of the research work you used to do, so you may not have that direct access to research any longer. Your job is to create some value in what you provide to your KOLs, and that is your clinical expertise. Focus on that. Meet with everyone. Be seen everywhere.
- Are you in the Data Desert? Is your compound or device a bit advanced in age, with not a lot of news to tell? Or worse, have you had some setbacks in the development of late? BE PRESENT. Have a clear understanding of the reasons. Be frank with your KOLs about the utility of your compound, and ask good questions. Your work on a difficult agent is character-building, and unless you are considering frequent geographic relocation in your future, you will likely see ALL of these KOLs again. This is the perfect setting to establish your reputation as a credible, trusted medical partner even when the chips are down. •
- Whatever your role, do be sure that you and your Medical Affairs team have done the work of cross-functional communication internally. Have a playbook. Make sure you’ve heard the compliance messaging. Have your backup documentation plan. Have your contacts and apps updated on your phone; be sure you’ve booked international cell phone use if needed. Pack light.
7. First, Do No Harm
- And by this, I mean, WEAR COMFORTABLE SHOES.
Jane (JC) Cramer Varian, MSN NP
Jane is a Senior Field Medical Director at BeiGene, USA. After a hospital bedside nursing career, Jane began her pharmaceutical work over 20 years ago with Pharmacia and Upjohn. She has since served on oncology and hematology field medical teams with Sanofi, Pfizer, Bayer, Astellas, and others. Jane’s primary focus is on both New York’s academic physician-scientists and the cancer patients and families they serve. As a Family Nurse Practitioner, she holds advanced nursing degrees from Clemson University and Mount Saint Mary College.
Jane lives in Saratoga Springs, New York with her family, where she serves as the Vice President of the Board of Directors for the Saratoga Shredders, a non-profit girls’ mountain biking organization. Jane also is an Advisory Board member for Alucio, a pharmaceutical software company. For correspondence, Jane can be reached at firstname.lastname@example.org.