A common theme in my recent conversations with MSLs has been how companies can best organize the activities of medical teams and commercial teams in order build on departmental synergies, while respecting the specialities and boundaries of each team.
Morunda Asia conducted an online survey and a number of interviews around this topic, with a focus on the role of MSLs. All who took part were based in Singapore or Malaysia, and working in the pharmaceutical industry. The participants were of various levels of responsibility within Medical Affairs departments. This article gives a ‘broad-stroke’ overview of opinions in the region.
The opening question was “do you feel that the role of the MSL is clearly understood between medical and commercial colleagues”. It is notable that no-one felt it was “misunderstood” or “not understood”. Interestingly, only 16% said that the role was “clearly understood”.
The general consensus was that the “guiding principles” of an MSL were clearly understood; that MSLs are scientifically credible professionals who inform and guide HCPs using evidence. How these principles were translated into an operational role that worked effectively alongside other departments was where issues could arise.
Around 50% of participants felt that the role was “reasonably well understood”, and that most issues could be resolved through simply improving inter-departmental communication. For example, one Medical Advisor at a European MNC told me that the Medical Affairs team had faced questioning from the commercial team regarding KOL visits. The commercial team wanted Medical Representatives to be able to accompany MSLs on follow-up visits to KOLs. The commercial team’s thinking was that these would be opportunities for sales team members to get more, better quality time with thought leaders. The Medical Affairs leaders had to outline the necessity that MSLs are strictly ‘non-promotional’, and that this perception must be kept clear in the KOL’s mind. It was pointed out that opportunity actually arose from this distinction; the MSL has a broader remit in terms of discussion topics so they could foster a better understanding of the product’s value proposition. Once this was clearly explained, and the link between value proposition understanding and increased advocacy was established, then the commercial team could better appreciate why it wasn’t possible, and in fact was better not to have these joint visits
Within the second largest group of respondents (approx. 34%, who felt that the MSL role was understood “to some extent”), there was a little more frustration voiced. One Medical Director at an MNC mentioned that disagreement over the aims and means of the MSL role was still “frequent” despite “numerous meetings and discussions” between the relevant stakeholders. In some cases, this stemmed from an outdated concept of the MSL as a kind of “Super Medical Rep”, rather than being aware of the distinct functional advantages of the position. With such a conception of the role, MSLs would be tasked with a large number of hospital visits, and the company would expect to see a sales increase shortly afterwards. One Senior Manager pointed out that, from an operational perspective, this disconnect risked having a negative impact on the longevity of MSL services. If MSL counterparts at different organizations were perceived as having a clearer role, and ‘more respected’ status within the company, then they could be tempted to change to a “better” opportunity.
One MSL pointed out that, in their company, Marketing had always “called the shots”, so there was a degree of political interplay as departments jockeyed for influence. Those comments reflected a view held by MSLs at a number of companies that they and their Managers were almost “figuring out” the most effective role as they went along.
The solution to these frustrations, for one Regional Medical Director, was to have MSL deliverables clearly established. When KPIs were set out effectively, this would bring a number of benefits: (i) the activities of MSLs and how they related to improved commercial performance were better understood throughout the company, (ii) MSLs could be managed and developed more effectively through performance objectives, and (iii) the MSLs gained a greater sense of worth in their role.
Setting appropriate KPIs for MSLs is a broad area that will be covered in detail in a later article. However, one example that this Director gave was to have MSLs given measurable targets around formulary listings. The ability to convincingly present the product’s comprehensive value proposition to a team of e.g. Formulary Listing Heads would be an example of what an MSL could do, utilizing their specific scientific expertise to further commercial aims.
Overall, there was optimism amongst all participants. Healthcare practitioners expect increasing levels of scientific credibility in their interactions with pharmaceutical industry representatives. As long as the purpose and actions of an MSL can be agreed upon, then the MSL role can be at the forefront of this, engaging with stakeholders and sharing the insight needed to enable better health decisions for patients.
Written by James Oakes