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The New Order for Medical Science Liaisons (MSLs): From the Unicorn Helpdesk

unicornI was recently asked a ton of questions about the MSL role, in several different venues–including SXSW. Unicorn helpdesk to the rescue!

First, resources are already out there so you don’t go reinventing the wheel on the MSL:

MSL Book

MSL Career Primer – Online Course - this contains all my work on the MSL role in the past 10+ years.

Ok – next, if you’ve dove into these resources, here are my thoughts on questions I was asked recently about the MSL’s future, other roles tangential to it, and conferences on or for MSLs. (Opinions are mine and mine alone here…).

I believe that the MSL is here to stay. Pharma and biotech companies would be completely stupid to get rid of them. (Yes, I said stupid.) In this era of high dollar drugs, personalized medicine and specialty pharmacy exploding, MSLs are needed now more than ever, because every new drug is not necessarily right for every patient. Sometimes there’s a pharmacogenomic test or a clinical process/assessment a patient has to go through to even be considered for a therapy. Further complicating matters, it may be a subjective test by the clinician. It’s only become more sophisticated and complicated – that’s why the MSL has a great future, because they’re the clinicians and experts who can educate the practitioners on the drugs and the processes around those drugs before they get to the (right) patients. And while a few MSLs are PhDs, I generally feel that MSLs are better with a clinical background than a bench pre-clinical background (my opinion only). I’m also a fan of a mix of backgrounds on a team – but at the end of the day, the MSL should be talking to academic thought leaders who treat patients – not rats in a lab. That’s why having an appreciation for clinical practice is important to the MSL.

Second – there are other roles tangential to the MSL role that are also growing and probably here to stay. There are health economics and outcomes (HECON) MSLs, which also have a role with payers, and healthcare plans. They focus on outcomes data for the most part – and where I think they’ll be even more valuable over time is in the area of value based outcomes reimbursement. I just read the other day that apps will start being approved with molecules by FDA to track value based outcome payments and reimbursement for specialty drugs.

Yes, there will be an app for that.

There are managed care liaisons as well – which may be a hybrid of the two roles above, but their clients would be more of the payer decision makers. Back in the ‘olden’ days of MSLs – the MSLs did all the roles above, but now companies realize that different audiences require different types of professionals to call upon them, so bigger companies may have MSLs, HECON MSLs, and managed care MSLs. Smaller ones may not. But all roles are essential for a strong community understanding of a new drug or biologic.

Finally, there are in house medical affairs folks that work with the field based roles and sometimes work directly with medical information. Often, I’ve seen in house medical affairs people wind up out in the field as a promotion; rarely the other way around. Generally, calls centers for in-house medical affairs are a starting point for pharmacists new to the industry, and most (not all) don’t want to remain in a call center for the rest of their lives. So, one way to move up is to start in the call center, then move over to medical affairs as a MSL. (If your company has the forward-thinking culture to promote from within.) It will be interesting to see which drug companies pick up on the chat bot technology and employ it in their medical affairs teams in house. Chat bots won’t work for the MSL role, however, because true MSLs are or should be working with the science in ways that aren’t necessarily even tried in clinical trials just yet, like investigator-initiated trials.

Biggest challenges for MSLs today include time (it’s always a challenge) as well as pressure to be in more places at once. The sheer volume and size of most MSLs’ territories demands that they be in several places at once. Solid time management skills, self direction and self motivation are and always have been keys for successful MSLs. Also, MSLs have the constraints of doing more with less, just like all of us in healthcare these days. This also includes conference coverage and maximizing time at conferences. (My friend Kristin Eilenberg has this one covered, btw.)

I would also say that the other challenge for most competitive MSLs is career ennui. What I mean by that is–the MSL, if s/he wants to move up inside the company they work for, either must move, (to the home office), be a manager of MSLs (in the field), or just work as a MSL for another company or therapeutic area. MSLs generally are type A people who love a challenge, and get bored easily. So, career development is always a challenge for the best and brightest here. I’ve never seen a career progression conference here out of the MSL role – that might be something cool to explore. (I don’t personally have the capacity to develop this type of conference right now. If you’re a conference organizer – you’re welcome.)

As for useful conferences for MSLs – I track those here. And while this list is primarily pharmacy based, most MSLs are still pharmacists – so there is overlap. I’ve previously addressed some of my favorites in the MSL Guide I wrote above, and not much has changed in the conference world since then. For the most part, the same vendors are at it, with a few other newbies thrown in of late on top that I can’t comment on, since I’ve not been to their events.

Last, but certainly not least – I’d personally love to see the MSLs get more involved in a product’s launch these days, particularly if the drug is high dollar, has a pharmacogenomic test associated with it, and/or is a nightmare to bill, or has limited distribution. (One of the checkpoint inhibitors with your online billing guide = you’re doing it right. I won’t say which one…you’ll need to investigate that one on your own–as I’m not here to promote drugs.) Just finding an actual launch date for a drug can be a massive time vacuum – and these are all areas where the MSL can help.

That’s the latest thoughts on the MSL role. Again, smart companies fully realize their value, and I don’t see them going away any time soon.


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