July 24, 2017
Medical Science Liaisons (MSLs) have been around for about 50 years. Upjohn Pharmaceuticals first created this unique position in 1967, aimed at building relationships and research collaborations with Key Opinion Leaders (KOLs).[^1] The role of the MSL has since evolved. It has become an increasingly important resource for pharmaceutical and biotech companies as regulations and compliance demands have increased, and the market has shifted toward more specialty products, payer-driven treatment decisions, and greater patient-centricity. This evolution has resulted in a broader scope to the MSL role, but the derived value of the role continues to come from the scientific and clinical expertise possessed by the MSLs, which leads them to build strong science-based relationships with both external (primarily KOL) and cross-functional internal stakeholders.
MSLs play an important role in providing information to KOLs to help them keep abreast of advances in science. Furthermore, they also support KOL engagement in a company’s medical affairs activities and bring insights into the company that can be used to refine medical and/or commercial plans. It remains to be seen how the MSL role will continue to evolve in Canada given Health Canada’s recent initiative to publicly release previously unavailable clinical information concerning the safety and efficacy/effectiveness of drugs and medical devices included in drug submissions and medical device applications.[^2] The release of this clinical and research information may offer the MSL an expanded opportunity to interact with KOLs through the discussion of the additional scientific data.
Over the years, we’ve seen greater efforts to better describe and quantify the value of MSLs. It was over a decade ago the industry experienced a shift towards using a combination of both quantitative and qualitative metrics when communicating value to internal stakeholders.[^3] Despite much attention having been given to the matter, the heterogeneity in the MSL functions both across the industry and across a product’s lifecycle, as well as the changing environment and regulations, has resulted in widely varying performance metrics for MSLs. A 2010 survey describing MSL perceptions of their performance metrics suggests MSLs do not agree company-imposed metrics are a reflection of their true value to the organization; 50% of companies reported that their MSLs perceive current MSL metrics as only “somewhat reflective” of their value.[^4] Through speaking with Canadian Medical Affairs Leaders and CEOs, as well as previous personal experience as a leader of MSL activities in Canada, it is evident that defining and measuring MSL value remains a challenge.
A variety of quantitative, qualitative, and outcome performance measures for evaluating MSL value have been described in literature (see Table 1). [^3] [^4] [^5] [^6] [^7] [^8]
|Quantitative||Qualitative||Performance Outcomes (Combination of Quantitative/Qualitative)|
|Number of KOL interactions/day or month||Quality/depth of KOL interaction||"Thought leader identification"|
|KOL reach||Unsolicited/solicited KOL feedback||Competitive intelligence|
|Days in field||Internal cross-functional stakeholder feedback||Therapeutic landscape monitoring|
|Duration of KOL interaction||Internal management feedback||Clinical site investigator identification/evaluation|
|Number of maintained KOL relationships||Customers’ agreement with disease or product messages||Generate awareness of company new to therapeutic area|
|Number of new KOL relationships||KOL insights gathered (disease, product, competitors, medical strategy)||"Scientific representation at conferences"|
|Number of internal scientific presentations by MSLs||KOL engagement in company programs||Assistance with clinical education, training and advisory boards/number of advisory boards conducted|
|Number of external scientific presentations by MSLs||"Support of IIT* programs/number of IIT submitted"|
|Number of scientific presentations by KOLs||"Support patient registry"|
|Number of publications accepted|
* IIT- Investigator-initiated Trial
Quantitative metrics have the benefit of being generally much easier and faster to obtain and have been utilized as a performance indicator for some time. While “reach and frequency” metrics are generally well-accepted and utilized with field-sales activities, these activities are often tied to short-term outcomes such as revenue generation and market share change. Applicability of this metric to field-medical activities is less straightforward, and potentially complicated by a focus on long-term outcomes, by an MSL’s geography, and individual performance objectives. According to a 2010 US survey, reach and frequency measures can make up a significant percentage (41%) of how MSL programs across different companies assess effectiveness.[^4] Furthermore, forcing call quotas on MSLs may encourage more proactive promotional (versus reactive scientific) activities, but could also over-inflate the number of calls MSLs make, which could potentially result in decreased quality of the interaction.
Qualitative measures such as those related to competitive intelligence, landscape monitoring and product/disease insights collected during KOL interactions, can be quite valuable to an organization and its medical and commercial efforts. However, these measures are hard to gather, take more time, and may be judged to be insufficient from a business justification perspective. KOL engagement in company-wide activities while an important measure, is limited in that it is influenced by a number of factors, many of which may not be within an MSL’s control. One of the best qualitative measures currently available is KOL feedback – feedback that captures what MSLs are currently doing or need to start doing to support physicians’ efforts in improving patient care.
We are all well aware that “you get what you measure,” yet how to properly define and measure MSL value remains open to debate as there is no industry standard. While no one has yet identified the perfect set of quantitative and qualitative measures to accurately measure the overall value of the MSL function, perhaps what is required to navigate in the dynamic and evolving Canadian pharma environment and sustain the MSL role is to:
For more information, contact Tina Laister, PhD, at email@example.com.
[^1]: Morgan DK, Domann DE, Collins GE, et al: History and Evolution of Field-based Medical Programs. Drug Inf. J. 2000; 34: 1049–1542.
[^2]: Health Canada: Public Release of Clinical Information in Drug Submissions and Medical Device Applications (2017), https://www.canada.ca/en/health-canada/programs/public-release-clinical-information-drug-submissions-medical-device-applications.html Accessed March 18, 2017.
[^3]: Chin J: Measuring Performance of Field-medical Programmes: Medical Science Liaison Metrics Consensus. Journal of Commercial Biotechnology 2007; 13: 177 – 182.
[^4]: Medical Science Liaison Institute: Medical Science Liaison Metrics Research (Full Report) (2009). Accessed: March 7, 2017.
[^5]: Groebel R: Exploring the Changing Role of Modern Medical Science Liaisons (2015). Accessed March 7, 2017.
[^6]: McDonald O: Metrics and Performance Measurement within the MSL Role. Medical Science Liaison Association (2012). Accessed March 7, 2017.
[^7]: Dyer S: Aligning the Activities and Goals of Medical Science Liaison Teams for Strengthened Corporate Sustainability (2011). Accessed March 7, 2017.
[^8]: Medical Science Liaisons - A New Strategic Lever - Recommendations to Boost MSLs’ Performance. Smart Pharma Consulting (2016). Accessed March 7, 2017.