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The Medicalization of Customer Engagement and the role of Medical Affairs

Christian Wilkens | Partner, Strategy& Germany
December 8, 2021

As the traditional share-of-voice approach gives way to customer-led partnerships around science and innovation, the role of Medical Affairs is becoming more strategically important

The medicalization of customer engagement

The way that pharma companies engage with customers is changing: increasingly, models are beginning to shift away from the traditional share-of-voice approach toward a more holistic, customized and value-based model of interaction and knowledge support.

There are a number of drivers behind this change. Modern drug innovation is giving rise to increased product complexity, precision medicine, and more complex ecosystems (resulting from digitalization and increased connectivity) through which pharma companies need to convey their messages. At the same time, the majority (79%) of physicians are questioning the value of traditional pharma engagement formats, stating a preference for more scientific and medical content from the industry1. The kinds of supporting content needed today are highly personalized, medically involved and, where relevant, product-agnostic.

Pharma leaders and tech disruptors are already starting to address this, for example by developing data-driven clinical decision support systems – often in partnerships with other ecosystem players.

For traditional pharma, new engagement models are likely to involve an elevated role for Medical Affairs. Although it would be a leap to suggest that medical experts must take the lead in all customer interactions, demand for scientific knowledge and insights is growing, and pharma field teams today need a more holistic outlook as they engage with healthcare stakeholders.

As part of this rethink, the Medical Affairs function needs to look afresh at its entire operating model and its exchanges and knowledge sharing with other functions.

1 SERMO poll on physician social media (N=120), April 2021

Early signs of realignment

While it is still early days, we are seeing different approaches emerge from leading pharma companies that are keen to move with the times.
In one scenario, adopted by a major global pharma company, the change has been quite radical, involving the replacement of all existing field sales roles with new medically led single points of contact. A more incremental approach to change, on the other hand, as embodied by another major global pharma leader, looks to improve on the existing structures. (The two approaches are discussed in more detail below.)

What’s important here is that forward-thinking pharma companies have recognized the need to approach customers in a different way. For busy physicians, each interaction with pharma companies must count – whether in the form of face-to-face meetings with highly specialized reps or medical science liaisons (MSLs) who can bring to bear the right intelligence, evidence and insights, or via targeted digital channels.

From enabler to holistic ecosystem partner

Up to now, Medical Affairs’ involvement in customer engagement has typically been as an enabler, providing the latest information and supporting medical projects. However, as pharma companies strive to get closer to customers and their evolving needs, Medical Affairs teams are being called to take on a role of ‘holistic ecosystem partner’ – both supporting customers in their strategic choices and feeding back their needs and insights to the business toward the development of better solutions.

Medical Affairs professionals must be able to adapt their approach for each target customer group – on the basis that there is now a broader range of stakeholders they must engage, each with different priorities and requirements. The identifiable customer groups are physicians, patients, healthcare providers, payers, and key opinion leaders.

Below we will look at a bold approach to the shift in customer engagement, and then a gentler and more gradual evolution, drawing on two real transformation examples.

The bold change: a new, holistic medical role

In this example, the multinational pharma company has completely moved away from having traditional full-time field drug representatives, and created new, agnostic, medically skilled customer engagement roles.

Accelerated by Covid-19 and a broader internal transformation project, the organization has completely changed its go-to-market approach. Its aim is to structure customer engagement by allocating one point of contact for each target audience, which identifies opportunities and needs, and co-creates innovative customer solutions.

The new model has product-agnostic roles – a ‘Disease management partner’ and a ‘Health Systems Partner’ – in place of the traditional/functional roles of sales reps, MSLs and field access. The new roles have no sales incentives and follow a new compliance framework designed to support the new approach (of integrating medical and commercial knowledge and insights without blurring ethical boundaries).

The new consolidated points of contact are seen as scientific partners of the healthcare, instead of representatives of a commercial machine. New structures are being created to nurture deep scientific expertise and facilitate cross-organizational pockets of expertise.

The idea is that companies do not promote an individual product, but rather, by moving the whole disease management forward, optimize medication use and improve patient outcomes. Thus, this model would work well for pharma companies that are market leaders in their chosen therapy areas, or for those that are in the process of building a strong presence in a particular therapeutic area and have leadership ambitions.

A more incremental approach to change

In the case of another major global pharma organization, the chosen approach has been to enhance rather than replace existing models - by creating a single medical point of contact for top customers and the scientific community.

The aim is to develop new external partnership and networking models with healthcare providers and stakeholders, through new forms of scientific dialogue and knowledge transfer with an emphasis on:

  • Thought leadership
  • Peer-to-peer and network exchange
  • Data generation (e.g., real-world evidence) and co-development (e.g., digital therapeutics)
  • Tailored (digital) scientific information and education

The dedicated point-of-contact role coordinates and facilitates external engagement.

The model described here is more suitable for pharma companies that are active in specialized markets yet are not universal market leaders.

Supporting the new ways of working

Whatever the preferred path to transformation, companies will need strong supporting foundations which enable the new or evolved Medical Affairs roles to achieve their potential - and deliver what is expected by the various customer groups.

Here is how this might break down:

The increased complexity of medicines and health ecosystems generally requires deep scientific expertise that can no longer be siloed within individuals or teams. Rather, this expertise must be collated, nurtured and shared.

To enable this, companies need to think about innovative, AI-enabled platforms: interconnected systems that can enable transformed customer engagement based on real-time insights and medical thought leadership:

  • A knowledge platform, bringing together internal and external data and publications, integrating project findings and outcomes, and flagging any insight gaps. AI and natural language processing (NLP) enablement can facilitate simpler search, provide further read recommendations, include update alerts, and much more
  • A projects collaboration platform for coordinating work-in-progress initiatives and enabling regular exchange with customers (e.g., ad-boards, market research, data sub-analyses). Seamless links with knowledge platforms will further be able to increase productivity
  • Expert networks/social media, for networking and connecting people across the organization (and potentially beyond – for instance, with healthcare providers) to deliver the right information at the right time via the right channel to the right customer

In the new value-based partnership engagement model, Medical Affairs professionals need additional skills and attributes including a business mindset/entrepreneurial spirit; an aptitude for strategic thinking; the ability to network and build long-term relationships; and digital savviness.

An overarching strategy for communications and change management is important too, to de-emphasize product-specific focus and cultivate a more rounded set of skills.

Blurring lines between commercial and Medical Affairs responsibilities under new models could create an additional compliance risk. Companies need to determine what the reinvented function is permitted to do from a legal perspective in each market, and whether there are any grey areas to be navigated with care. There are 3 key considerations to effectively support the new Medical Affairs role from a compliance standpoint:

  • The need for and importance of compliance requirements must be recognized across the organization. As Medical Affairs function expands beyond its traditional engagement formats (e.g., Advisory Boards) and engages broadly with HCPs and patients, regulations become more complex and stricter and require awareness as well as incentives that foster proactive compliant behavior
  • Formats for communicative compliance guidelines must be adapted to simplify the navigation through complex risk and regulatory frameworks. Instead of lengthy SOPs, companies need to think about more innovative and user-friendly delivery methods, e.g., AI-supported decision trees, interactive scenarios or chatbots
  • Lastly, the evolution of the regulatory landscape (internally and externally) must be monitored closely. Since local requirements may change rapidly, staying on top of them is key for success

Finally, with new roles and responsibilities must come new performance metrics, geared to encouraging and measuring the behavior and resulting value now sought. In place of volumes of stakeholder interactions, the emphasis must shift to the strength of customer relationships developed and maintained, the number of stakeholder partnerships developed, improvements in patient outcomes, and rising overall customer satisfaction.

How to direct change

Given that the overriding goal for transformation is a value-based, customer-led partnership, the starting point must be the needs of the different stakeholder groups.

So, start by assessing what’s needed from the customer perspective. Consider:

  1. What exactly do our customers want?
  2. How do customers want to interact with the organization? What do they want or need, and how is that evolving and changing?
  3. What value could Medical Affairs bring to healthcare providers and other (new) stakeholders that has been lacking or inadequate up to now?
  4. How does the company want to be perceived by the customer in future, and what role should Medical Affairs have in connecting with the various different stakeholders in the new engagement model?

Framed in this context, it becomes easier to make tangible the specific operational changes now needed – such as ‘What interfaces to other functions need to change/evolve so that Medical Affairs can work more seamlessly with other parts of the internal organization?’; and ‘What new capabilities might be required within the reimagined Medical Affairs function?’

Ultimately, the objective is to build trust through partnership, by adding the desired value in the optimal way at the right time, to drive better patient outcomes. Achieve that, and any stakeholder relationship should flourish.

Ralf Schönfeld, Carla-Ines Cebulla, Alina Lack and Jana Tretter also contributed to this article.

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Christian Wilkens

Christian Wilkens

Partner, Strategy& Germany