When I speak with medical liaisons and managers of those people, I consistently hear that there is a need for better qualitative metrics for the function. So too, I hear this when I speak with executives who are making decisions regarding continuing to fund the function or even grow it. Well, perhaps those executives are not specifically asking for a qualitative metric but they are asking for better metrics overall. In the end, at the level of individual performance or assessment of the impact of a complete field medical organization, better metrics that provide insight into real value are needed.
There is a need to balance the quantitative metrics related to number of customers seen, days in the field and other metrics that show that the field team is in fact in the field and qualitative metrics that better measure the impact of that time in the field, the real value being generated through interactions by MSLs and their customers, both for the customers themselves and the companies employing the liaisons. When I say “balance”, I mean it. Pure quantitative metrics translate poorly into actual value and drive MSL behaviors that are not always productive, such as the drive-by interactions to check the boxes. Pure qualitative metrics without any quantitative thresholds can produce amazing efforts with select customers but overall small numbers of these, which may not be all that compelling to organizational decision makers deciding to fund the MSL function.
In the rapidly changing healthcare world, one attribute of MSL and broadly pharma customers that is evolving and becoming more challenging is access. Overall, it is shrinking for sales colleagues but also for medical affairs colleagues. The bottom-line is that many of the customers our industry used to call on are now employees of bigger organizations – organizations that may not see any value to allowing access by pharma employees. In many cases, pharma looks to the MSL as one of the functions that maintains good access, which is true and substantiated by at least some data and significant amounts of anecdotal experience.
Why not use access in conjunction with customer sphere of influence, coupled to overall interactions, to measure a key part of the value of the MSL function at either the individual level or the group level? Why not then use customer feedback as the final key measure of the perceived value from the perspective of the customer and perhaps customer feedback and contributions to pharma company efforts as the key measures of value to the pharma company itself?
This is actually pretty easy. The first step is to define who the MSL customers are or should be. If the focus is going to be opinion leaders and key decision makers, there are many companies out there who can identify and qualify those customers by sphere of influence to define a “universe” of MSL customers with the greatest impact on healthcare delivery within the given therapeutic area.
The second step is for the MSLs to engage these people, develop relationships with them, identify their needs and interests, learn from them and otherwise engage in scientific exchange. Through this process, they can establish a baseline of access, which could range from none to essentially unlimited. Further, the MSLs might find that some of the most important customers are very challenging to access but need to be accessed as they represent key perspectives of thought. The best MSLs persevere, look for appropriate ways to provide value to these hard-to-access customers and ultimately develop meaningful access and relationships so they can exchange information that allows those customers to best understand and use their therapies but also for both parties to exchange information that moves the level of care forward.
The third step is for the pharma company to survey those customers on a regular basis to gain feedback on the perceived value of the relationships with the MSLs, the likelihood of the customers referring colleagues to the MSLs for information, the preferred channel(s) for further engagement and such. This is the voice of the customer related to overall perceived benefit of the relationship with the MSL. It would be great if there was a third-party survey offering this insight for all companies without each having to go to a vendor for a survey or do such a survey alone but for now, such customer surveys are only done if driven by individual companies.
The fourth step is to define desired contributions from MSL customers and then track whether or not customers are contributing as such. This list of contributions could include speaking, sponsored clinical research, investigator-initiated research (MSLs and companies have little control over this but it is a significant contribution when it occurs), publishing, advisory board participation and such. One I’d like to see added, which often is not, is referred customers. If a MSL customer refers another customer to the MSL, I think that is a significant contribution, which should be captured.
Pulling all of this together, for each MSL, the first quantitative measure is whether or not the MSL is working with the top people in her territory. Whatever the size of the MSL panel, it’s likely smaller than the actual number of potential customers upon which the MSL could expend her time so the question to ask is whether or not the MSL is focusing on the most important ones. If this is met, you now have a quantitative measure with a tremendous qualitative aspect to it – most important customer is highly qualitative. Then you assess access by allowing the MSL to simply engage the full panel of customers for a period of time and use this as baseline access. This may take a year with a stable region, where the MSL is focusing on the top customers in the region and working to establish a baseline of access. From there, the goal of the MSL is to improve this access, using all appropriate channels so that an actual relationship can be established. This access will be directly coupled to the perceived value of the MSL to the customer; you can’t get access if you are destroying rather than creating value. Access alone becomes a significant qualitative measure and will correlate to the customer feedback survey results and likely to the contributions the customer will make.
Figure 1: A look at a balance of changing focus on customer panel and engagement of customers. For this example, the change from baseline to year 1 is 56
As seen in Figure 1, the change from baseline to year 1 is 56, which is driven by a combination of moving engagement to the right customers and then maximizing that engagement or access. Importantly, this type of change can be achieved in any region, even if there are few to no top influencers, by doing the best to move “up” the pyramid and then by improving access to the panel.
I recognize that this is not a perfect measure but interesting food for thought. If the goal of MSL metrics is to drive the desired MSL behaviors and also to demonstrate the value of the MSL organization, this set of measures in combination with customer survey results and a measure of contributions, could be the four measures that best drive wanted behaviors and make the strongest case for the value of the MSL group.