Understanding the role of the MSL

Helen Kane surveyed more than 200 medical science liaisons to understand more about the role of the MSL and their current in-role reality. She gave Pf Magazine exclusive access to the results.

According to IQVIA’s White Paper Medical Science Liaisons: A key to driving patient access to new therapies:  ‘Medical Science Liaisons (MSLs) are therapeutic specialists with advanced scientific training. They are experts in communicating complex scientific and medical information to a variety of stakeholders. Their primary role is to build and foster strong relationships with key external experts in their shared therapeutic category. They provide a credible link to external stakeholders, helping bridge the communication between clinical development and commercial success. Additionally, MSLs are in a unique position to gather insights that inform business strategy in areas such as product development and market access.’

“MSLs play an important role in a drug’s lifecycle”

MSLs work to manage industry reputation through informed, non-persuasive conversations with healthcare professionals (HCPs). They require a breadth of medical skills and business acumen, plus a good network of contacts, making them a rare breed. This means that for those organisations which are seeking to build a best-in-class MSL function, it is important to support and nurture them.

MSLs in a changing market

Both industry and the health sector are facing increasing pressures from an ageing population with multi-morbidities, healthcare finance and increased scrutiny from payers and approvers. The doctor/patient relationship is also changing, with patients having a more powerful voice in decisions around their health. Added to this, perceived issues with lack of fair pricing and transparency in industry can affect relationships with HCPs.

MSLs are key members of medical affairs who sit between research and development, sales and marketing. This means they need to focus on communication, education and reputation, aligning their activities with the needs of HCPs. To do this, MSLs need to be the right people with solid foundations including proper governance, an embedded scientific engagement model and an aligned strategic direction to the wider business.

However, the role is not always clearly defined across industry, as Helen explained: “The MSL function is not necessarily universal. We are aware of at least 28 acronyms for the MSL function, meaning the role of MSLs can be confused amongst HCPs.

“What is universal, though, is that MSLs play an important role in a drug’s lifecycle. They are the external face of medical and will have been selected for their scientific and technical expertise, communication skills and business acumen. In pharmaceutical industry language, the MSL is defined as non-promotional.”

Although the role of the MSL is one of the fastest growing in industry, it is under scrutiny. Helen added: “To be effective in-role, the MSL needs to have the essential knowledge, skills and behaviours, to be recognised internally and externally as different to sales, as a conduit between the organisation and the healthcare community.”

MSLs have an opportunity to engage with HCPs from pre-approval through to post-approval. This is something that commercial and market access teams are unable to do. Helen continued: “MSLs with the right brief, training and direction can be the face of the organisation prior to a drug achieving approval. But they will need to know the company story, understand the vision, philosophy and values. However, according to our survey results, MSLs don’t always rate the need to know that information about their organisations as highly as their scientific knowledge. Both need to be understood.”

MSL Survey

Helen and her team at PIVOT MSL surveyed over 200 MSLs in 2018. Respondents were predominantly field-based or working in hybrid roles. They were split across large, medium and smaller organisations and 25 countries participated.

The survey identified some key data about MSLs and their place within organisations:

• Interestingly, five out of 10 respondents had been in their role for less than six months to a maximum of three years.
• Just over one in 10 didn’t have a job description or weren’t sure of their role, responsibilities, or competencies.
• Nearly half reported to an MSL Manager, and a similar number reported to a medical director or medical manager. However, an additional survey identified that nearly six out of 10 MSL managers did not receive any upskilling to support their transition into an MSL management role.
• Only 2% of MSLs surveyed said their activities included being a buddy or mentor to new-to-role MSLs.
• When it came to career progression, nearly six in 10 respondents said there wasn’t a defined career pathway for MSLs in their organisation.

Commenting on these figures, Helen said: “With the continued growth of the MSL function there is a lack of experienced MSLs to satisfy demand. So how do you find potential MSLs? Mainly through academia or healthcare. However, we need to recognise that these individuals are brought into a unique environment and expected to deliver with impact and value. To do so, they need to be supported throughout their professional development journey. However, it’s clear from some of these results that they are not receiving the essential support needed to succeed. Retention of MSLs is an ongoing challenge.”

Training

As a unique role which can be recruited from outside the industry, initial training is essential to bring the MSL up to speed. The survey found that the key onboarding topics expected by MSLs were: job description; drug scientific data; medical strategy; compliance; ongoing clinical programme; company procedures; therapy area (eg patient journey); competitor data; future clinical strategy; key external customers; key internal stakeholders; healthcare environment; brand strategy; and company story.

However, the survey found that less than two-thirds received role-specific onboarding.

Added to this, just over half of respondents had a knowledge review prior to going into the field. With nearly one in four not having a review, they had no opportunity to identify where they may have information needs or challenges.

Helen added: “Onboarding is critical to building a best-in-class MSL function. Our survey shows that it can range from two days to more than six months of training. MSLs require a huge amount of information and data to be able to do their job properly, I believe there needs to be consistent standards for MSL employment, training, onboarding and management.”

Skills

To perform their best, MSLs need specialist skills and the provision of support to teach them.

These skills include: managing relationships; engaging and presenting with impact; effective cross functional collaboration; exploring to gather insights; customer identification and profiling; emotional intelligence; planning for impactful customer engagement; planning for field medical success; defining field medical value and impact; supporting launch excellence; self-coaching for personal success; and navigating challenges with confidence.

However, the survey identified that one in five respondents said their organisation do not have dedicated MSL training and almost two-thirds received between zero and two coaching visits in 12 months.

Strategic, governance & value

Given the crucial role of the MSL, the survey identified a fairly even split between those MSLs who were involved in the medical strategic plan of their drug (55%) to those who weren’t (45%). The figures improved when it came to a formalised MSL plan which is aligned to the drug strategy, with two-thirds having such a plan.

On the subject of governance, three-quarters of respondents had MSL Standard Operating Procedures (SOP) or guidance documents. Of those with a SOP, 58% said it had a positive impact on their daily working.

As MSLs add value through their key role with HCPs, when it comes to assessing that value, there was a fairly even split of methods used with 30% using quantitative measures, 23% using qualitative measures and for 24% there were no formal metrics. Added to this, the value of MSLs isn’t always recognised company-wide. Nearly half said their value was recognised by medical and commercial leadership, nearly one in four by medical leadership only, and just over one in 10 said it wasn’t recognised at all by leadership in their organisation.

Work to do

There is some work to do to ensure that MSLs receive appropriate expert training and in-role guidance in order to be valued and have clear parameters within which to work. However, as an important and trusted link between HCPs and industry, it is essential that MSLs are fully supported to maximise their impact.

Helen concluded: “The value of MSLs is in their building of scientific partnerships. They bridge the gap between HCPs, the pharmaceutical industry and clinical research organisations. They are the external face and voice of medical. A good MSL also needs to be a good listener both inside and outside of their organisation, sharing information back and forth for the benefit of all.

“A good MSL is a valuable asset. They are bespoke, they need to have specific skills and knowledge that needs to be nurtured. And most of all, in order to retain them they need opportunities for career progression.”

Helen Kane is Managing Director of PIVOT MSL. Go to www.pivotmsl.com