Which metrics are you using to show impact of MSLs/Medical Advisors on medical practices?

1af9e88672b031f9641f434915a80cfbQuantifying performance and measuring results are no longer the attributions of sales organizations. Though not all non profit organizations as Medical Affairs need to measure impact – this depends on how leaders determine relationship between actions and their impacts. Organization’s rationale is supposed to explain, that actions should ultimately lead to the achievement of its goals and mission. To determine how you are performing against your business objectives, metrics are used. The goal of MSL/Medical Advisor metrics is to drive the desired MSL behaviors and also to demonstrate the value of the organization. Such metrics are still debatable in pharma companies. Since strategic role of MSL/Medical Advisor teams is to address unmet medical needs through credible communication of scientific information to thought leaders to ensure safe and appropriate use of therapies, are there ways to capture their impact on medical practices?

For me the best metric set should contain both quantitative and qualitative metrics with emphasis on the qualitative measures or outcomes – like feedback from customers on the services MSLs provide to external customers. A number of quatitative metrics reflecting engagement in the field with the customers should be small. A good way to capture feedback from customers is continuously asking them about their satisfaction (current status) and expectations (future). Both can be collected with a thought leader surveys. This tool has already become a standard means of performance measurement across the pharmaceutical industry. Currently, 58% of all companies surveyed by Cutting Edge Info conduct thought leader feedback surveys to assess MSL performance. Customer feedback is perhaps the final key measure of the perceived MSL value from the perspective of not only customers, but pharma company itself.


MSL Activities and Performance Measurement: Harnessing KOL Relationships for Optimal Clinical Support” (

Written by Dr. Alexander Tolmachev,


Effective questioning as a critical skill of tomorrow MSLs

6a00d8341bf7cb53ef013488dba177970c-piPharma’s engagement with thought leaders and advisory boards is significantly transforming under intense public observation and demands transparency. This makes Medical Affairs teams enhance patient access to optimal medical treatment through clearly demonstrating value to physicians. In order to understand and clearly demonstrate value, Medical Affairs have to strengthen understanding of local medical practices and patient needs, deriver relevant insights from this and utilize those insights to ensure that brand strategy maximizes the medical benefits for patients and physicians.

The first critical element of this chain is understanding local medical practices and patient needs. Both require an MSL skill of effective questioning. Effective questions will help MSLs to connect with thought leaders in a more meaningful way and better and fully understand their needs and problems.

An analogy might be the trainer who asks a lot of questions, mostly irrelevant,  slips off topic, unable to get to the essence of the training. At the end of the training when little progress was made, the attendees are left wondering what they learned. Like a trainer is responsible for the progress of the trainees, MSLs are the corporate owners of thought leaders engagement and education.
Asking good questions is not an abstract idea. There are concrete steps one can take to acquire this skill.

1. Have a specific goal. Decide in advance what you want to achieve with your questions to a thought leader. Focusing will help you eliminate unnecessary questions.

2. Do your homework. Write out the questions you want to ask, in advance. Make sure every question relates to the idea or topic on which you are focusing. Put these questions in a logical sequence. Even if you end up deviating at times your list will give you a road map to follow.

3. Ask open-ended questions. Avoid questions that can be answered by “yes” or “no.” To do this, ask questions beginning with: Who, what, when, where, why and how. For example, instead of asking, “Will the current guidelines fit to respond to these clinical challenges?”, ask “What is it about the current guidelines that will make them a response to the new challenges?”

4. Ask only one question at a time. Otherwise, you risk to cause confusion or receiving a partial response. For example, instead of asking “Why do you say that product A is more efficacious than B and what was wrong with B and how do you think the patients should be treated instead of B?” ask, “Why do you think product A is more efficacious than B?”, “Why do you think product B failed?”,“How do you think the patients who fail on B should be treated further?”

5. Ask empowering questions. As I said earlier, most people like to talk about themselves and the work  they do. So ask questions that allow them to reflect on their experience and share it with you. For example,“May I ask for your advice?”, “Based on your experience, what are your recommendations?”

Behind effective questioning is also the ability to listen to the answer and suspend judgment. This means being willing on understanding what the person who is talking is really saying. What is behind their words? Good listening is a part of effective questioning. Though sometimes a desire to keep control of the conversation and demonstrate intelligence and skills may prevent us from listening or asking good questions.

As a conclusion, development of effective questioning skills in MSL teams may lead to gathering better information, do more solution oriented problem solving and eventually reduce mistakes. Also good questions may help to persuade thought leaders in smooth and trustful manner.

1. Pharma Medical Affairs 2020 and beyond – McKinsey & Company Report.

2.The Art of Effective Questioning: Asking the right question for the desired result.

Written by Dr. Alexander Tolmachev,


How MSLs Can Improve Thought Leader Management Through Ranking Their Stakeholders?

Pharmaceutical companies engage though leaders to consult for them, conduct clinical trials, give lectures, and make presentations on their behalf to targeted audiences. No need to say that industry allocates considerable time and money in cultivating thought leaders who are critical to a product’s ability to improve patient outcomes, from development through commercialization. However, thought leader identification is only half of the way – proper utilization, powerful content and ongoing compliance are all necessary for success. Profiling procedure can be vital in building of an engagement strategy of though leaders. MSL force as the owner of scientific thought leader engagement plans may utilize ranking opinion leaders in their database in order to justify resource allocation in their therapeutic fields. Classification and prioritising thought leaders will clarify which of them can have a significant impact on the success of the changes that MSLs are driving on the market.


Most common approach MSLs can undertake is ranking of thought leaders as per their regional influence (national, regional, local) and loyalty to company or brand (negative, neutral, advocate). This will lead to quick and rough estimation of engagement strategy that has to be implemented in this or that stakeholder segment. The strategies are “Manage Closely”, “Keep Satisfied”, “Keep Informed” and “Monitor”. At different phases of product life-cycle there might be different balance of stakeholder percentage who are belong to these categories, i.e. at launch phase “Manage Closely” probably should prevail, on plateau – “Keep Satisfied” or “Keep Informed”, etc.

Once MSLs have a good list of stakeholders, they then make judgements about how much and which kind of effort to put into dealing with their needs and what types of messages they should communicate.

Written by Dr. Alexander Tolmachev,


8 Steps Toward a Robust Medical Affairs Strategy

Strategy-Review1-290x220Today due to regulatory restrictions Medical Affairs teams take more responsibility with less resources. Medical Advisors have to coordinate and integrate different medical data and types of knowledge and achieve external recognition for providing credible and unbiased medical information. Development and leadership of the Medical Strategy for each product, including collaboration with Business and R&D and others will ensure the product’s cross-functional life-cycle strategy and planning. In some cases when Medical Affairs still position itself as reactive scientific support function for Commercial, there may be lack need in strategic plannig, value definition and impact measurement. Though the spreading changes in regulatory environment will make Medical Affairs build new capabilities and become equal to R&D and Business. Having cross-functionally aligned Medical Affairs Brand Strategies will ensure deeper engagement with medical stakeholders, creation of new evidence data and its dissemination.

1. Make sure you understand why you need a Medical Affairs strategy for your brand.

Strategy is a dynamic process of defining your direction and making decisions on allocation resources to implement the plans. In case your organization has separate budgeting from Commercial, you obviously need to justify the your costs and demonstrate the results. Strategic planning is a tool of cost and other resource allocation that you need to have to reach your goals. Even if your budget belongs to Commercial you still need to continuously review Medical activities costs, follow up with Marketing on how your strategy is being implemented, and perform a cross-functional annual strategic review to ensue a clear and valuable Medical contribution.

2. Understand the current situation.

In order to determine the Medical Strategy of the brand, it is necessary to understand the current position and the possible directions through which you can pursue a specific course of action. You have to challenge the status quo through addressing good open questions to internal and external stakeholders. Make sure you have clear answers on 3 key questions – What do you do? (what is your current tactics?) – For who do you do that? (what is the customer?) – How do you do that? (which steps you undertake).

3. Prioritize perceived unmet medical and clinical needs.

Unmet medical needs are identified based on the situational analysis that includes medical SWOT analysis of the competitor brand customer perception. The main goal of a SWOT analysis is to understand the environment. Each analysis should conclude in a number of medical and clinical unmet needs. The next step will be to prioritize them as high, medium and low priority.

4. Build up your Strategic Medical Imperatives.

Propose clear and short strategic actions addressing high priority needs. Each unmet need should be addressed with 1-2 corresponding actions (strategic imperatives).

5. Translate each Strategic Medical Imperative into specific, meaningful tactics.

Tactics should describe what must be achieved. Using the conventional and innovative tools as CME, Advisory Boards, Medical Publication, remote MSL visits, etc, prepare a specific activity plan linked with the Commercial plan and calculate the costs. Your plan should contain resources, responsible and time-lines.

6. Elaborate clear metrics for your activities.

You will need this not only to measure your progress, but also to demonstrate your impact value to the stakeholders. Lots of ideas for metrics seem good until you try to use them. One test of the quality of a metric is whether or not you can actually measure how you approach your goal. In addition, it’s important that all relevant parties agree that the metrics appropriately measure what they are intended to measure, so Commerial colleagues to certain extent may be involved into KPI elaboration process.

7. Make sure that your Medical Strategy is aligned with Commercial strategy, but is not promotional.

Medical Strategy has to be based on fulfilling medical gaps or needs revealed in the Business strategy. Tight collaboration and deep understanding of Marketing role will ensure best integration of Medical strategy with Marketing activities. Tactically best sequence of aligned Strategy elaboration is when Marketing first prepares their strategy keeping in mind that Medical strategy will follow and both have to be synergistically linked. In case Medical Affairs is a separate non-promotional department, make sure that your plan doesn’t contain promotional claims or statements that could potentially be misinterpreted as such.

8. Learn from execution and review the strategy regularly.

Strategy is a dynamic process of responding to environment changes and real life evidence. Your KPI dashboard may serve as a tool for internal and external strategy alignment.

by Dr. Alexander Tolmachev, Senior Manager for Medical and Regulatory Projects, Takeda