Bridging Science and Practice
Introduction
The treatment of a disease to improve patient health while preserving well-being is constantly evolving. This evolution is driven not only by the emergence of new therapeutic products and treatments but also by real-life medical practice, which provides new data and unexpected positive or negative results. Although extensive studies and clinical trials are conducted during the pre-commercialization phase of a product, they usually do not cover the entire population with its comorbidities and idiosyncrasies, nor the full spectrum of diverse human beings.
More importantly, the commercialization of a medicine or device is approved for use based on its demonstrated effectiveness in clinical studies (on-label use). However, healthcare practitioners or prescribers sometimes slightly modify the administration or combine it with other products to adapt to the unique health situations of their patients. Sometimes, it is the patients themselves who change the dosage or method of taking the medicine and then inform their healthcare practitioners about it.
For this reason, it is of utmost importance for companies supplying these products to keep the medical community updated with the latest scientific data about their products to ensure their safety and efficacy. At the same time, companies must gather all field information to craft scientific and medical strategies. To facilitate this important scientific exchange, companies create a specific role: the Medical Scientific Liaison (MSL).
The MSL, or equivalent titles within a company, is a professional within medical affairs teams who engages with key opinion leaders (KOLs) to maintain this scientific exchange. KOLs are individuals whom healthcare professionals (HCPs) and researchers look to for credible medical information. During these engagements, the MSL works to develop an ethical peer-to-peer relationship with KOLs in healthcare, academia, payer, and government organizations to disseminate scientific information, gather insights, and evaluate KOLs’ expert opinions.
The MSL is expected to be a trusted scientific point of contact within the company, providing scientific information that guides the evolution of medical care. MSLs must maintain their scientific integrity by fostering truthful medical and scientific communications that are non-promotional and not misleading. The roles of MSLs and Key Account Managers or other commercial professionals need to be clearly distinct within the company; they are separated into different departments and have different KPIs. MSLs' performance metrics are never linked to the prescription rate or sales metrics of the product.
Practice Case
Ready to get a taste of what the work of a medical scientific liaison could look like?
Try the REBECA Practice Case for field application specialist. Remember, this practice case does not prepare you to become a field application specialist, it only aids you to better decide if this is your type of profession.
After completing the case, please do the reflection exercises; it will help you to clarify what you have experienced and take decisions about your career.
Requisites to perform this practice case
Biomedical or medical academic background is needed to perform this task.
Who are you?
You are a field medical scientific liaison working for a pharmaceutical company.
You have started in a new company, and you need to understand the company policies for engagement with medical and scientific community in order to operate accordance to them.
ACTION: Read the values of your company policy
NOTE: Apart from compliance with national and regional legislation on pharmaceutical activities in the public and medical professionals’ engagement, pharmaceutical companies al endorse Code of Conducts of Societies and associations that usually covers non-regulated or standardized areas and usually provides a more clear framework for the activities.
You have been assigned a new medicine into your portfolio: Semaglutide. You have been given access to the electronic folder of the product, where you can find information on the product, the medical strategy, educational material for KOLs, and scientific and clinical updates. It is in this electronic folder, where you will file relevant information that you gather in your communication exchange activities with health care practitioners and KOLs. The first documents that you need to read to understand the product are: the product sheet, and the medical strategy of your product.
ACTION: read the product sheet of Semaglutide (page 1-20): what disease is approved to treat, which population is approved to be prescribed or dispensed, which doses is approved to be administered and its side effects. Also read the (fictitious) medical strategy, and the titles of the current clinical studies (interventional and observational), to understand your product.
NOTE: Diseases, populations, and doses not specified in the product sheet are considered off-label use. This means regulatory bodies have not approved the use of your medicine for other diseases, targeted populations, or different doses. As an MSL, you are allowed to provide information proactively only for the on-label uses of your product.
NOTE 2: In real life, this documentation will be more extensive, and you will have enough time to go through it all. Moreover, MSLs are given thorough training on the products of their portfolio.
You have also been provided with the list of KOLs. Your team has decided to expand this list to 4 more KOLs in your regional covered area (around 500km) that you will need to engage with for scientific exchange, and plan your territory efforts. For this purpose, you are not allowed to use account-level or individual KOL prescribing information. Your prioritization should be based on solely scientific objectives and never commercial potential.
ACTION: Identify relevant KOLs for your product within your territory and indicate the reason to engage with the KOLs. You can use Google search, institution websites, publication author, list of faculties of medical societies, speakers of conference, etc
NOTE: First contact with KOLs can happen in several ways: encounter in a meeting and brief introduction, proactive email introduce yourself, or introduction by a commercial college. These introductory meetings are brief aiming at introducing yourself and your role, but not providing unsolicited information of your product. In case, it happens accompany with commercial colleagues, you should not be presented in the room if a commercial conversation starts happening.
During a Obesity Medical Association conference, Dr Walter (one of your KOLs) approached you and asked about the data presented by Prof Smith in a session regarding the use of Semaglutide for the alcoholism treatment, a non-interventional study publication that your company supported. You have arranged a meeting with him to inform him about this data.
ACTION: check in your internal documents, the information regarding this study that the clinical team has provided you with. Write the main message to prepare the presentation.
NOTE: remember the code of conduct of your company. You should provide with balanced, research evidence, and non-promotional information. You should avoid the omission of key information and conclusive statements
During the Obesity Medical Association conference, Dr Walter (one of your KOLs) approached you and asked about the data presented by Prof Smith in a session regarding the use of Semaglutide for the alcoholism treatment, a non-interventional study publication that your company supported. You have arranged a meeting with him to inform him about this data.
ACTION: check in your internal documents, the information regarding this study that the clinical team has provided you with[EG1] . Write the main message to prepare the presentation.
NOTE: remember the code of conduct of your company. You should provide with balanced, research evidence, and non-promotional information. You should avoid the omission of key information and conclusive statements.
You have received the following email from Dra. Sanchez.
Dear MSL,
I am currently prescribing Semaglutide for patients with an IBM over 27 kg/m2. As you know, the frequency of obese patients diagnosed with non-alcoholic fatty acids liver disease (NAFLD) is high. Are there any data on the safety and efficacy of semaglutide for NAFLD treatment?
ACTION: Check in the information provided by your company if you have data to answer this inquiry. Otherwise, write and email to the medical information department to provide you with literature to answer this question.
NOTE: not all companies have a medical information department, in this case, MSL must search the information.
Your team has provided you with the following review. You have arranged a meeting to visit Dra Sanchez and update her in the safety and efficacy of your medicine in NAFLD patients.
ACTION: read the main results of the paper that your team has provided you with, and write an email with main message to the health care practitioner to answer her question.
NOTE: there are questions that are recurrent. Prepared information is ready to answer this question at any time.
TIP FROM THE EXPERT: clear, scientific, relevant, and non-biased information is key to create rapport with KOL. Your purpose is not selling your product is to keep KOL informed about the product. You do not have sales KIPs.
During the International Congress on Obesity, the Principal Investigator of the clinical trial “Effect and Safety of Semaglutide 2.4 mg Once Weekly on Weight Management in Adolescents With Overweight or Obesity ” has presented the result of this clinical trial that your company supported. You noticed that Dr Yuan, one of your KOLs, was not able to attend the meeting. You consider important that Dr Yuan, and specialist on obesity treatment for teenagers, keeps upated on the last results of the use of your product in these population. Global team of your company has given you the slides with the information . You would like to brief Dr Yuan about this update.
ACTION: check the presentation and extract the most important information. Write an email to Dr Yuan offering a visit from you to update him with this new information.
NOTE: when you present this data, do not alter the information presented remember not minimize the results on safety in comparison to the results on efficacy. You should be a trusted source of information to build rapport with KOLs.
During a conversation with Dra. Attanema, she said to you that several patients declare themselves very thirsty when receiving Semaglutide treatment. You know that GLP1 is expressed in areas the hypothalamus that control thirst. Based on this, you consider that this information relevant for your company and you want to gather further details that it can be of use for your company.
ACTION: write a few questions that you would ask to Dra. Attanema to obtain a relevant and useful insight. After this, report this insight according to your SOPs to your the company.
NOTE: Insights can vary in form; they could be comments to data presented in a meeting, questions asked, or other observations. Decide what information is an insight or not will depend on the medical strategy and the scientific knowledge of the product or disease. Sometimes is information of unpleasant feelings (non-adverse effects), flavour, confusing labelling or esthethical aspects of the device…anything that can be of use for the medical strategy, but also to the branding/marketing strategy. You must report insight in a timely manner and should reflect the conversation as it happens.
Medical affair department is organizing a meeting about your product with 10 health professionals, and he has contacted you to present the new finding of the agonist of GLP1 mechanism of action on water intake. Your college has asked you proposed one of your KOLs that could provide with an overview of the state-of-the art on GLP1 role in feeding reward behaviours.
ACTION: find a relevant KOLs that can give an introductory presentation on the subject and write an email with the invitation.
The end of Q3 of the year is approaching, and you need to prepare the next annual planning for relevant conferences for you to attend. In these scientific events, KOLs are attending and may present data of your company supported studies.
ACTION: check the list of scientific meetings that you have gathered after a quick search. Decide the 4 more relevant and write them down in your KOLs plan for next year..
NOTE: planning does not stop here, arrange the travel internally and arranging your own agenda is also part of the job
Acknowledgments
This practice case has been created thanks to the input of these clinical research associate:
- Julio Pozueta, Senior Medical Scientific Liaison at Bayer
- Brian Molloy Galiana, Medical Scientific Liaison at MSD
- Alba Jimenez Segovia, Medical Scientific Liaison at IQVIA
They also validated this case after its development.
Guided reflections
After this experience, we suggest you reflect on the following questions:
- Did you find the practice case easy or difficult to accomplish?
- What was the most engaging task for you? Was it difficult or easy?
- What was the most challenging task for you? Did you enjoy performing it? Would you see yourself getting better at it?
- Have you found something new about this profession? What was it? Did it surprise you? Did you like it or dislike it?
- Do you feel like contacting a scientific journalist in your network and research a little bit about the profession? Where would you find it?
Further information
If you want to know more on the profession, or specialised training information, check the:
You can also follow some of our recommendations to explore careers beyond academia.