Pierre Fabre

Dr. Sarah Tregenza

Since joining the Pharmaceutical Industry (a.k.a. “Pharma”) in 2014, I have held several medical affairs roles across 3 global companies, GSK, Novartis, and currently Pierre Fabre. During this period, I have seen firsthand the shift that is, and has been occurring for many years now, toward medical affairs moving more and more to the centre stage within the pharmaceutical Industry.

“What exactly is medical affairs?” you ask. “How much time do you have?” I ask. To me, there is not one function within Pharma which doesn’t interact with, and which cannot benefit from the collaboration with medical affairs. Let’s start with one of the most well-known roles in medical affairs─ the Medical Science Liaison (MSL).

The MSL role was first created in 1967 by Upjohn Pharmaceuticals. The role addressed a gap in the industry due to its unique ability to meet healthcare practitioner(HCP)’s needs by being able to interact with them at the level of a peer, as well as being able to reactively discuss both the company’s registered products and indications (“on-label”) and the company’s pipeline (future planned products and indications – “off-label”) in a reactive manner.

Like the sales representative, the MSL is a customer facing role. However, as a medical function, this role cannot be tied to sales targets and should also not be tied to call number targets. This is due to the reactive nature of the role, i.e. you cannot plan how many HCPs may have off-label requests within a given period, only track/monitor this over time. It is also due to the focus of the role which is on the quality of the services and projects provided (qualitative as opposed to quantitative measures). Unlike sales representatives, MSLs are also typically required to have a high-level science degree such as PharmD, PhD, and/or even an MD. This is to ensure they have the solid depth of scientific knowledge required for them to address HCPs’ questions and have discussions at a peer level. It also ensures they can bring the required value to the company by being able to drive relevant and mutually beneficial scientific projects for the company and HCPs in collaboration with these external experts, as well as bringing valuable scientific insights back to the company to inform strategy.

Medical Advisors (MAs) and Medical Directors (MDs) are two other common roles within Pharmaceutical Medical Affairs. These roles typically require the same minimum qualifications as the MSL role (PharmD, PhD and/or MD), but reflect a greater level of experience within medical affairs, as well as leadership and people management skills (may not be necessary for MA role). The MA role can also be seen as an equal partner to the MSL, in that their role is no more or less senior but differentiated by a Key Performance Indicator (KPI) of developing and driving strategic medical projects for the company and serving as the internal company therapeutic area expert. Whereas the MSLs KPIs are more towards being externally customer facing “in field”, and executing the medical projects with the HCPs, as well as bringing back relevant insights to the MA to inform the strategic medical projects they should develop to meet both the HCPs and company’s needs.

The base depth of scientific/medical training required for medical affairs roles also allows a pharma company to be agile and adapt quickly to an increasingly flooded and evolving market.

A medical affairs team can quickly decipher new data and changes in the treatment landscape and its impact to your company’s portfolio, leading internal training for other functions, as well as likely being the first function within the company to be able to find unique opportunities based off their insights from the external changes to optimise your current in-market products and pipeline.

They can also provide valuable input to your business development strategy by analysis of the potential benefit of different partnerships and/or acquisitions based on current gaps in the market and synergy with your company’s current and pipeline portfolio. The fact that Medical Affairs roles do not report to sales or marketing functions can further add to their credibility with, and hence ability to interact with, HCPs who may understandably be less receptive to discussing data and working on projects with functions who they know are driven by a KPI to increase use of a specific product/s.

As the importance of medical affairs within pharma increases, and with varying company size across the industry, we can see numerous variations or deviations on all 3 roles (MSL, MAs, MDs). Variations include prefixes to help further distinguish the level of experience/skill/seniority, e.g. ‘Associate’ or ‘Senior’ are often added to MA and MD roles and ‘Senior’ can also be added to the MSL role. Other deviations to these more traditional Medical Affairs roles seen recently seen in pharma include; Patient Journey Partner (PJP), PJP Scientific Exchange, Field Medical Advisor –which could all be seen as a sort of merger between the MSL and MA roles and in some instance like the PJP roles, replaced sales representative roles. Medical Communications and Medical Compliance roles have also started to appear. These roles can more specifically address the need to for compliant non-HCP directed communication, traditional HCP promotional and non-promotional material review, as well as navigating complex compliance requirements and increasing public communication required with the move towards more omnichannel and virtual external engagement by pharma.

With advances in technology and increasing move towards digital/online in all fields, information has never been more readily available to anyone who is interested to learn, HCPs and patients alike. It then becomes harder for Pharma to add value to time-poor HCPs who are increasingly able to access the information they need around various products/treatments from independent sources they trust. Patients are also becoming more empowered with ready access to their disease specific information as it is released in the public domain, which HCPs who treat across a range of diseases may actually not be as on top of with the constant advancements across all disease states. I believe medical affairs is uniquely positioned as one of the key roles in pharma to ensure your company can continue to interact with and meet the needs of both HCPs and Patients.