It’s been 53 years since the term “MSL” was introduced to the pharmaceutical industry. Upjohn Pharmaceuticals recognized that sales representatives with a high scientific acumen had significantly longer face time with doctors, resulting in higher sales numbers than those representatives who were “non-science” trained. Upjohn trademarked the term “MSL” and defined the function as those employees responsible for “education services,” specifically the initiation of drug studies in laboratory and clinical settings, development of workshops, symposia, seminars for physicians, medical societies, specialty organizations, academicians, concerned with drug related medical topics”.
While several aspects of the MSL responsibilities have remained the same over time, much of the role has evolved over the last half-century due to the ever changing landscape of the US healthcare system.
While building and maintaining relationships with key opinion leaders continues to be paramount, MSLs are increasingly tasked with working as the scientific/medical interface to a variety of customer segments. The shift in the healthcare industry has continually been defocusing the fee-for-service healthcare model in favor of more evidenced-based approaches and value-based pricing. This shift in landscape has led to the creation of a new type of “Liaison” focused entirely on communicating with payer organizations: the Health Outcomes Liaison (HOL).
The role of a HOL is newer and less established and recognized than that of an MSL. A 2018 study shows that about 56% of the pharmaceutical companies have a dedicated HOL team with almost 80% being among the top 20 companies.
The roles and responsibilities of an HOL are oftentimes still met with confusion, especially around the question of where exactly the role of MSLs ends and that of HOLs begins. The two roles have much in common regarding responsibilities as well as approach with customers. Like their MSL colleagues, HOLs are subject matter experts committed to presenting accurate data that is free of commercial bias and not focused or incentivized by commercial outcomes. For this reason, the majority of HOLs are, like their MSL counterparts, members of a medical affairs umbrella within the industry.
HOLs generally tend to have a comprehensive understanding of their field of expertise rather than a narrow focus on their portfolio, are able to provide information that extends beyond product-specific data and provide the most value to payers. Since HOLs are a “recent” addition to the Medical Affairs department, their teams are generally smaller than their MSL counterparts and therefore HOLs tend to be generalists rather than specialists.
So, what exactly are the responsibilities of a health outcomes liaison? Just like their MSL colleagues, HOLs serve as trusted experts, but while MSLs focus on communicating scientific and medical information about a product, an HOL’s focus is on communicating a product’s value proposition and health outcome data to payers. Presenting pharmaco-economic data is therefore one of the key responsibilities of HOLs.
Other key responsibilities include:
- Understanding the payers and the overall payer landscape and staying up to date on changes and reforms.
- Conducting discussions and answering information requests from key opinion leaders in the payer community.
- Planning and conducting health outcomes research and studies as well as publishing and presenting those data.
- Providing internal information and training on health outcomes issues to internal stakeholders, specifically MSLs and the account management teams.
- Working with internal stakeholders such as the market access, HEOR and Medical Science Liaison teams and to provide information and training on health outcomes issues.
The role of health outcomes liaison is fairly new and the responsibilities of this function will undergo changes as the role matures. Given the changes in the healthcare system towards value-based models, HOLs are likely to see their importance increase as they move from providing cost-benefit analysis for a specific drug to analyzing the healthcare environment more holistically to come up with recommendations that lead to better patient outcomes while simultaneously reducing cost. As Payers struggle to balance quality and cost of care, demonstration of product value is increasingly material to the competitive evaluation, placement, and reimbursement of different treatments.
Bio-pharmaceutical organizations have turned to Health Outcomes Liaisons to serve as a scientific bridge with payer organizations, thought leaders, and other important decision makers. Moving forward, it is important that organizations understand how to fully leverage the relatively new field-based HOL function in order to better inform decision-making about pricing, reimbursement, inclusion of drugs on formularies and treatment guidelines. Face-to-face visits will remain the most important mechanism to build working relationships and credibility with payers and thought leaders. Although payer groups are traditionally targeted, it is critical that HOLs deliver a strong value proposition to both customer segments in order to synergize with the efforts of their MSL colleagues.
- McKinsy & Company: Insights into Pharmaceuticals and Medical Products: A vision for Medical Affairs in 2025. 2019.
- Wamble, D., Brogan, A. A Critical Assessment of the Role of Health Outcomes Liaisons: Today and the Future. RTI Health Solutions, Research Triangle Park, NC, United States
- Benchmarking the Roles and Responsibilities for U.S.-Based Field Medical Team Interactions with Managed Care Customers. Best Practices Strategic Benchmarking Research & Analysis.
Mahesh Tawney joined Alnylam Pharmaceuticals in June 2018 as a Medical Outcomes Science Liaison (MOSL). Prior to joining Alnylam, Mahesh spent three years at Eli Lilly, and seven years at Daiichi-Sankyo, and three years at The Medicines Company. Mahesh received his Doctor of Pharmacy degree from the University of Maryland School of Pharmacy and subsequently completed a post-doctoral fellowship in Medical and Scientific Affairs at Sankyo. In addition, he has a Master’s in Applied Pharmacoeconomics from the University of Florida and Masters’ of Business Administration from Stetson University.
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