The Rise of the MSL
Ironically, for many pharma companies, the best way to preserve the sort of access they've traditionally had with physicians
may be to turn away from the sales model and make more use of medical science liaisons. MSLs can't promote drugs, but they
can engage in scientific discussion with physicians on a level that most reps would be unable to sustain, even if they were
permitted to try. And in the new world of complex specialty drugs and biologics, that trade-off looks increasingly attractive.
Cisco's 2008 "Unifying the Prescriber Influence Network" report notes that physicians want to control when, where, and how
they get information. Furthermore, says Jan Malek, director of IBSG and co-leader of life sciences for Cisco, physicians want
to connect with experts. For example, an MSL would be appropriate for a first contact level with a physician followed by a
key opinion leader on second contact.
There is a debate about whether a rep has the ability to deliver value beyond the basic presentation of information. For example,
what happens when the physician has a specific medical question? "A rep has to call a doctor once per month or so. What will
they tell him or her after month six, seven, or eight? I don't think reps have learned anything new at those points," says
Malek. "They can keep pushing the drug, but if the doctor has a specific question, that is where the MSL comes in. They speak
the same language."
There are also difficulties associated with leveraging MSLs—chiefly the price tag and travel issues. However, the average
sales rep spends so much time traveling and sitting in waiting rooms that key interaction with doctors is lost. "MSLs who
are actually interacting with physicians via phone calls, chats, or online are spending a greater proportion of their time
talking to doctors than the sales rep. Even though they're more expensive, you get more return on that money," says Malek.
The Medical Affairs Company observed a trend in the growth of specialty MSLs in 2008. Company President Evan Demestihas, MD,
believes the best way to a physician is through an MSL. "You have to find a model that makes everyone happy, beginning with
the physician," he says. "Times are changing. The companies that jump on the bandwagon first will be miles ahead of the pack."
Training will be crucial. In an effort to provide their reps with advanced training in the cardiometabolic area, Solvay sends
its field force to a special academy. "When we spoke to customers in market research, all of them indicated that they want
a rep with a higher level of training—one who can fill in the ranks of a nurse practitioner or practiced medicine with a level
of understanding that goes beyond a typical sales rep," says Hastings.
The Future Forecast
Pharma is currently facing some challenging times. Between looming patent expirations, the recession, and a dearth of new
drugs in the pipeline, companies are forced to come up with new and innovative ways to sell drugs.
Drug firms that have taken the initiative and begun restructuring their sales force models are ahead of the game. Which sales
model will be the right fit or the best solution might not be an easy answer, but the paradigm shifts underway are proof that
pharma is willing to adapt to market trends.