MSLs: The Superheroes of Pharma?
MSLs are pharma’s elite, with the knowledge and interpersonal skills to engage and collaborate with customers. But is pharma asking too much of its scientific superheroes?
The Medical Science Liaison (MSL) has come a long way in a short time. While pharma never stands still for long, the need for scientifically credible partners to help customers understand the growing complexity of new medicines and navigate the choppy waters of real-world evidence and health outcomes, has seen the MSL come to the fore in ways few might have imagined.
While the core competencies of the MSL remain unchanged, new capabilities will be needed – both for MSLs and MSL leaders – to meet the demands of the changing roles. But what does the modern MSL look like and what skills will they need now and in the near future?
For Cesar Sanz Rodriguez, Associate VP, Medical Affairs Lead Mid-Europe Region, at MSD, the MSL should be a medical resource for the scientific leader and add value by being able to “explain what the treatment means to the patient, what it means in terms of adherence and quality of life — and eventually what value it brings to the patient, the physician and the healthcare system.”
“Healthcare landscapes are changing so quickly, and the roles in the different landscapes are changing to keep up,” says Walter Sheloff, Customer Facing Medical Excellence Lead, Europe, Pfizer. “But it’s going to vary by healthcare market. Countries are evolving at different speeds and rates.”
He points to how MSLs in countries like Sweden or the UK are potentially engaging different customers than MSLs in, for example, Spain or Russia. “In some countries, decisions on which medicines to use are made by HCPs, which in others it may be government, HTA groups and payers, and Medical Affairs has adapted its role to meet these changing and differing needs.”
Despite this variation, Sheloff sees a few clear capabilities that MSLs will need to navigate around today’s health landscape. These include:
- Scientific and technical – “critical for success”
- Stakeholder management, with “proactivity and developing solutions for stakeholders' challenges” as key attributes
- Excellent interpersonal and communication skills is “another crucial success factor”
Building on this, Helen Kane, Managing Director of consultancy Pivot MSL, sees four core competencies for today’s MSLs. “Five years ago, only the first two – scientific knowledge and communication skills – were considered strictly necessary for an MSL but now they also need scientific expertise and business acumen,” she says. “Now, with the contribution of the MSL manager to insight and strategic planning, there has been a shift in the view of the MSL as a partner. Emotional intelligence should be pretty high on the list too.”
Kane draws a distinction between scientific knowledge (in which she includes understanding the therapy area, drugs, clinical data, competitor data, key patient groups, reimbursement models and healthcare systems) and ‘expertise’ (in which she includes medical writing and the ability to critically analyze papers).
Communication skills are vital when it comes to delivering an impactful presentation or explaining complex – or even flawed – data, while also generating insight. The key for Pfizer’s Sheloff is tailoring the information to the needs of the customer. “It’s about identifying the landscape and having common goals or shared agendas with stakeholders, for instance, around doing research on a population of patients in a given country to understand how a medicine might fit into a particular group.”
Trust me, I’m an MSL
For Sanz Rodriguez, MSLs must play a leading role in building trust between doctors and industry. “Excellence in MSL activities becomes an opportunity to create a true bidirectional relationship; we need partnership between pharma companies and scientific leaders based on their need for informed dialogue more than ever,” he says.
MSLs must balance scientific exchange and medical information. “The value is not in the data but in the insights the MSL contributes to the discussion, which translate into value for physicians and their patients. The MSL must ask the right questions and listen to the answers; they need to maintain, and be seen to be maintaining, their credo of unbiased, peer-to-peer scientific exchange.”
Interpersonal and communication skills are essential is MSLs are to create value for stakeholders and help companies to “separate the signal from the noise”. Those who create and capitalize on interpersonal networks, both within and across organizations, are valued. “This is where MSL managers feel their teams are less effective and there is greatest room for improvement,” says Sanz Rodriguez.
Yet, MSLs are also representatives of their company and must have a rounded view, says Kane. “If a doctor wants to have a moan about the cost of drugs, it doesn’t matter what role you have, it’s important that you understand the story of your company. You need to respond with some level of credibility. You are the face of the company.”
Finding people with this long list of capabilities is a challenging task, says Sanz Rodriguez. “With the need for a range of skills beyond simply a scientific background, people are scarce in the market. Hence, there is a pressing need to develop or enhance these skills through effective training programs.”
“There is also an increasing need for training on health economics, for example,” he says “As scientific leaders become increasingly involved in managing care and integrated delivery systems, they are increasingly asking questions of the MSL. Digital skills will also become increasingly important.”
Unsurprisingly, Kane says there has been a drive to attract those from near the top of the academic tree. “More organizations are looking for individuals with post-doctoral degrees, the ‘D Club’,” she says. “Yet, people brought into the industry from academia need to understand how pharma works.”
Training and support resources are also often scarce. “What can happen is that there is a huge recruitment drive to bring in people with, say, a PhD in oncology, but companies don’t have the infrastructure to support them. They become confused about what they are meant to be doing.”
Sanz Rodriguez agrees that MSLs generally expect more training from their employers, while Sheloff says that Medical “hasn’t necessarily given the time to training that Commercial and Sales & Marketing colleagues give”. It is vital, he adds, that anybody who has customer-facing responsibility has initial ‘onboarding’ training whether they are new to the company or not.
For Rodriguez, investment in training is the best retention strategy, given the high level of competition among pharma companies for the best MSLs.
Lead from the front
With MSL leaders, Sheloff sees on-the-job guidance and the ability to coach others as essential, while Sanz Rodriguez highlights the need for the MSL leader to evolve beyond the manager role and set a vision for the team (and lead that change).
MSL leaders who have not been MSLs themselves may struggle, says Kane. “MSL leaders need to understand exactly who the MSL is – the role and value of the function,” she insists.
MSL leaders could advocate for the role better, says, Sheloff. “Commercial functions do well in demonstrating the benefit of their activities. MSL functions have to be clear about communicating their successes and understanding their value. There is room for improvement here – are they aligned with the business as a core part, or are they a bolt-on, supporting existing strategies? This will be increasingly important going forward.”
The MSL role has evolved beyond recognition in recent years but what does the future hold? For Sheloff, the term ‘MSL’ may even disappear altogether as all those who work in Medical Affairs take on the characteristics now associated with the role. “This could lead to a more over-arching Medical Affairs approach. This makes sense from a resource perspective as there’s barely a Medical Affairs role now that doesn’t involve seeing customers.”
Assuming MSLs have a future as a distinct entity, Kane believes that standards of excellence are required to ensure independence. “Some organizations will employ individuals they define as MSLs but who are really representatives in disguise,” she warns. “It only takes a few companies to muddy the waters to damage the trust we’ve built between physicians and pharma.”
Sanz Rodriguez adds: “I hope the approach different pharma companies take to the MSL role becomes more consistent, as there is risk if the perception builds that the MSL profession today is driven by internal pressure not the true needs of scientific leaders.”
This article appeared in the most recent edition of our specialist publication, Trends in Medical Affairs. Click to download a copy.