Medical: Pharma’s New North Star
Already growing in importance, Medical Affairs will become a key differentiator for pharma campanies prepared to adapt and invest in the function
One the biggest shifts that we have seen in pharma in recent years is the rise of Medical. So much so, that we’re dedicating a keynote track to the function at our flagship events in Philadelphia and Barcelona.
The transatlantic story is one of an increasingly strategic medical function, which has gobbled up responsibilities from both commercial and R&D, while positioning to lead in emerging areas such as RWE and value-based care.
So why has this happened, and where it will it lead us?
Rob Scott, the outgoing Chief Medical Officer at AbbVie, sets out the case that the fundamental driver behind the growth in size and importance of medical begins at the level of portfolio strategy.
Market conditions and fierce competition have driven pharma away from prevalent, chronic disease. High pricing and high prevalence makes a worrisome combination for payers, which has led to aggressive pushback for new product in this arena. Scott points to the recent launch of Repatha as a case study example. Forecast to be a multi-billion dollar drug, the product has underwhelmed expectations.
This has led manufacturers to depart from prevalent chronic disease. It has become the dominant industry strategy to concentrate on oncology and orphan drugs, where niche populations present less of a budget impact to payers, yet still offer high pricing potential.
Why are we talking about all of this and what does this have to do with Medical?
The shift to specialized therapeutic areas isn’t just a different business model for pharma, it is a different operating model too. With smaller patient populations, commercial teams have become leaner and targeted.
Sales has become a more complex process as well, Scott notes, “You [now] have to communicate more complex data, explain to payers where this will fit, as well as the possible role of companion diagnostics. Typically this approach will be better with a science-based conversation and this has driven a switch to beefing up medical affairs”
Customer Evolution Drives Strategic Scientific Engagement
On the customer side, the world hasn’t stood still either. Several developments have accentuated this shift in the nature of the Medical function.
Eddie Power, Vice President, North America Medical Affairs, Hospital Business at Pfizer, speaks to this, stating, “We have changing stakeholders. While medical affairs traditionally focused on academic kep opinion leaders (KOLs), [the] group [function] has broadened significantly to include ‘practicing’ HCPs who might not be publishing research. This group has also grown outside of physicians to include advocacy, and payers.”
The transition to value-based care, in its myriad forms, is the primary driver behind this evolution, says Power. Stakeholders now need a deep understanding of how a new product will add value. In the case of health systems, it isn’t just about comparative effectiveness, it is about looking more broadly at health system outcomes and determining whether a product contributes a net gain, or loss.
This is a trend which isn’t going away. Across stakeholders of all shapes and sizes, institutions are increasingly allocating resource to determine the benefit of medicines.
The New Medical Model
As industry-customer dialogue becomes increasingly strategic, it has grown beyond the capacities of a traditional sales function. The strategic medical capability has become essential to the modern pharma model.
In a certain sense, nothing is actually new here. What we are really talking about is a change in the size and importance of the function, rather than a radical redefinition of the job. As Scott notes, “Pfizer was an early adopter with using MSLs, even in the early noughties we were using them for dual roles in clinical trials and customer engagement. What has happened now is just wider adoption… people who only had a medical director… they now have a medical affairs organization.”
It is a sentiment echoed by Rachele Berria, Vice President, Head of Medical at AstraZeneca, who states: “Medical used to be a nice to have small function. But more and more it has become a must have independent function, able to convert the science into a message for patients, payers and providers.”
With growth in Medical is heavily slanted towards increased customer engagement, success in this role certainly requires a degree of business acumen. This has led some to raise concerns that the rush to use Medical to rebuild customer trust could be self-defeating. If medical engagements start to ‘absorb’ commercial tactics, integrity could be undermined.
Scott offers a cautiously positive take, stating, “Anytime a person in medical affairs puts across a point of view that isn’t patient driven or scientific driven…then they are failing to fulfill the objective of the function.”
Physicians who are hired into Medical roles remain physicians first and employees second. A high level of integrity ultimately translates to good business.
For Scott, the ability of a field function has more to do with scientific nous than acumen. This is why he argues that new Medical Affairs talent should ideally come with hands-on exposure to clinical development. Deep knowledge can only come from direct involvement with the pipeline, which will give those in customer engagement roles the ability to communicate the data with authority.
In the rush to enhance and staff expanding medical functions, this may be a Learning and Development strategy that is too expensive and may amount to overkill for many companies, particularly alongside competing priorities, such as the need to advance a digital strategy that works for medical.
However, as customers continue to consolidate and access declines, each individual engagement will grow in strategic importance for pharma. Customer experience through quality, science-driven engagement could become a key differentiator. But as we come to expect more from our MSLs, they will require training to be ready to deliver.
With new strategic areas in customer partnerships, patient engagement and RWE strategy on the horizon, savvy leaders should invest in Medical talent today.
To learn more on how the growth of Medical could revitalize pharma check out the 2020 program our flagship events in Barcelona and Philadelphia here.