Um dos maiores desafios para executivos farmacêuticos sempre foi decidir como alocar recursos comerciais ao longo do ciclo de vida de marcas individuais, para se conectar a profissionais médicos e maximizar a maximidade. (Ver Marca renascimento: cinco maneiras de ganhar comercialmente nos mercados farmacêuticos , BCG Focus, dezembro de 2011.) Esse desafio é mais agudo agora do que nunca: praticamente toda área terapêutica se tornou cada vez mais competitiva, e os profissionais médicos têm uma necessidade cada vez maior das informações que podem ajudá-los a tomar decisões clínicas melhor informadas. Apesar disso, descobrimos que os executivos farmacêuticos, na maioria das vezes, não estão aproveitando a oportunidade efetivamente de criar pontes -chave com profissionais médicos, e nem a farmacêutica nem o lado do médico são satisfeitos.
A função que historicamente constrói esta ponte para empresas farmacêuticas é a equipe de assuntos médicos. (O papel dos assuntos médicos varia um pouco em toda a indústria farmacêutica dos EUA, mas concentramos essa discussão em seu papel no compartilhamento de informações médicas com os profissionais de saúde.) O trabalho dos assuntos médicos se tornou cada vez mais importante à medida que as necessidades de informações médicas dos médicos cresceram e se tornaram mais complexos. (Consulte Anexo 1.) Em nossa experiência, praticamente todas as empresas farmacêuticas estão lutando para determinar a melhor forma de responder ao ambiente em mudança e investir e adaptar o modelo de assuntos médicos para se tornar um diferencial e uma fonte de vantagem competitiva sustentável.
Repensando os assuntos médicos
Identificamos três fatores críticos de sucesso para empresas farmacêuticas que se esforçam para diferenciar seus assuntos médicos que oferecem uma demanda, além de apoiar os profissionais médicos em relação aos recursos do paciente. O tempo para entender as necessidades de informações mais prementes dos profissionais médicos para um estado de doença específico ou área terapêutica-e desenvolver uma oferta que atenda a essas necessidades
- Investing disproportionate resources in products that generate the greatest demand for medical information
- Investing the time to understand medical professionals’ most pressing information needs for a specific disease state or therapeutic area—and developing an offering that meets these needs
- Aligning the medical affairs organization with the mission of earning the trust of medical professionals
Investing Resources in the Right Places
Pharma companies typically invest in commercial activities on the basis of a product’s revenue potential, competitive context, and life-cycle stage. Although the precise formula can vary, the principles for resource investment are clear. However, applying that same approach to medical affairs will not deliver the best results.
In order to determine the appropriate allocation of resources to medical affairs for a particular product, companies must focus on answering two core questions:
- How much information do medical professionals need? In general, the products that generate the greatest need for information have a novel attribute (for example, a new “mechanism of action” or a biochemical interaction produced by a drug), employ a more complex clinical protocol, and are used by specialists who have access to an increasing array of products for treating different types of patients. In addition, doctors usually need less information about products that are approaching the end of their life cycle than about those that are newly launched.
- How much help do medical professionals need to distill and interpret the medical information that is most relevant? The number and complexity of available products—the level of “noise” in the information landscape—drives the answer to this question. For example, our research indicates that oncologists, like many other specialists, seek extensive information on the products they use. Most oncologists, focused on a broad range of cancers with many possible treatment options, are inundated with data and visits from medical science liaisons (MSLs)—representatives from pharma-company field medical teams—on a regular basis. Oncologists are more likely than other specialists to demand that MSLs be adept at sifting through the available data to produce a set of customized information that is especially relevant for them and their patients.
Understanding the Needs of Medical Professionals
Most of the medical affairs teams we have worked with have a wealth of institutional knowledge but lack a deep, objective understanding of the specific information needs of the medical professionals they serve. They also tend not to differentiate among the needs of various stakeholders who make or influence treatment decisions, including key opinion leaders, other physicians who specialize in a specific disease and treat a large volume of patients, and nonspecialists. This lack of differentiation likely explains why physicians’ satisfaction with the medical-information offerings of most pharma companies is far from high.
Many of our clients know that their strategies could be more progressive and that their tactics could have more impact. When we work with these clients, we recommend a three-step approach.
Descubra o que é necessário. As empresas farmacêuticas devem identificar os "ecossistemas" distintos e os tipos de profissionais médicos que tratam pacientes com um produto específico e devem entender como as necessidades dos profissionais variam do ecossistema para o ecossistema. As empresas também precisam avaliar o quão bem os assuntos médicos estão atendendo às necessidades de cada ecossistema. The first step is to conduct comprehensive qualitative and quantitative research with medical professionals in order to better understand their medical-information needs. Pharma companies must identify the distinct “ecosystems” and practice types of medical professionals who treat patients with a specific product, and they must understand how the needs of these professionals’ vary from ecosystem to ecosystem. Companies also have to assess how well medical affairs is meeting the needs of each ecosystem.
Recentemente, ajudamos uma equipe de Assuntos Médicos com sede nos EUA otimizar sua oferta de informações para um produto especializado. Nossa pesquisa indicou que a equipe estava fazendo um trabalho eficaz de fornecer informações médicas para os principais líderes de opinião, que eram seu foco principal desde o lançamento do produto. No entanto, o desempenho da equipe em atender às necessidades de especialistas clínicos, que, como um grupo, trataram 45 % de todos os pacientes com a doença direcionada por este produto, estava atrasada para os concorrentes. Eles queriam informações práticas e atualizadas, mas tinham pouco tempo para analisar as últimas descobertas clínicas. Além disso, eles queriam ser visitados por MSLs com mais frequência do que os principais líderes de opinião - oferecendo resumos concisos de informação para que pudessem voltar aos pacientes e aplicar o que haviam aprendido. A equipe MSL do nosso cliente raramente visitava esse conjunto de médicos.
Digging further into the data, we determined that these specialists had deep expertise grounded in a significant amount of clinical experience. They wanted practical and up-to-date information, but they had little time to sift through the latest clinical findings. In addition, they wanted to be visited by MSLs even more frequently than did key opinion leaders—preferring concise summaries of information so they could get back to their patients and apply what they had learned. Our client’s MSL team rarely visited this set of physicians.
Com base nessas descobertas, o cliente implementou várias alterações. Ele expandiu sua equipe médica baseada em campo, criando um papel totalmente novo para atender às necessidades específicas desses especialistas clínicos. Os novos membros da equipe estão focados em fornecer a esses médicos interações mais frequentes e concisas. O cliente também está aumentando sua ênfase no treinamento, garantindo que cada membro da equipe de campo saiba a melhor forma de envolver os médicos e tenha o conhecimento e as ferramentas necessárias para servir a cada ecossistema com mais eficiência. Nossa pesquisa quantitativa de acompanhamento com médicos indicou que aqueles que haviam sido visitados pela equipe de campo expandidos ficaram significativamente mais satisfeitos com as informações médicas que haviam recebido do que aqueles que não haviam sido visitados. Os resultados foram resumidos em um "scorecard de métricas" atualizado que o cliente atualizará regularmente para acompanhar o progresso e informar a evolução de sua abordagem de assuntos médicos.
The client implemented the recommendations within a few months of our engagement, and we followed up a year later to track progress. Our follow-up quantitative research with physicians indicated that those who had been visited by the expanded field team were significantly more satisfied with the medical information they had received than those who had not been visited. The results were summarized in an updated “metrics scorecard” that the client will refresh on a regular basis to track progress and inform the evolution of its medical affairs approach.
Entenda como as necessidades evoluem. Descobrimos que, em muitos casos, as idéias geradas pelo MSLs no campo não são capturadas sistematicamente, compartilhadas internamente e traduzidas em ação. Mais frequentemente, os MSLs passam horas por semana inserindo o médico visitando estatísticas em um banco de dados, mas os aprendizados mais salientes de suas visitas não conseguem chegar aos diretores médicos que definem a agenda de pesquisa. Como resultado, a estratégia médica não evolui para atender plenamente às necessidades dos médicos, e os médicos pensam que suas vozes não estão sendo ouvidas-uma maneira segura de perder sua confiança. Em uma empresa farmacêutica, o MSLS transfere informações do campo para um banco de dados central, que é rotineiramente extraído para obter informações que são sintetizadas por um recurso interno dedicado. Esses insights são compartilhados regularmente em discussões de equipes médicas de campo, bem como com outras funções relevantes, como grupos de informações médicas. The second step in improving medical affairs strategies is to develop a process that routinely reassesses how medical-information needs evolve as established products mature and new products enter the market. We find that, in many cases, the insights generated by MSLs in the field are not systematically captured, shared internally, and translated into action. More often, MSLs spend hours each week inputting physician visit statistics into a database, but the most salient learnings from their visits fail to reach the medical directors who define the research agenda. As a result, the medical strategy does not evolve to fully meet physicians’ needs, and physicians think that their voices are not being heard—a sure-fire way to lose their trust.
The best solutions are simple—for example, a user-friendly knowledge-management tool and a process to guide its use—and they can deliver real impact. At one pharma company, MSLs transfer insights from the field into a central database, which is then routinely mined for information that is synthesized by a dedicated internal resource. These insights are regularly shared in field medical-team discussions, as well as with other relevant functions, such as medical-information groups.
Mantenha um scorecard. Nos assuntos médicos, a maneira mais eficaz de medir o sucesso é através do feedback direto dos médicos. Isso pode ser compilado por meio de uma pesquisa concisa que se concentra nos aspectos das informações médicas mais críticas para os médicos e incluem comparações com concorrentes. Ajudamos os clientes a projetar e pesquisar pesquisas para estabelecer um scorecard de métricas de linha de base. (Consulte a Anexo 2.) Esta pesquisa pode ser uma lista de readminar regularmente e usada para informar refinamentos sobre a estratégia de informação médica ao longo do tempo. Os membros da equipe de assuntos médicos estão mais motivados porque podem ver suas idéias traduzidas em ação e impacto. Os médicos estão mais envolvidos e as informações médicas geradas e compartilhadas são muito mais eficazes para atender às suas necessidades. Como resultado, os médicos são capazes de tomar decisões de tratamento mais informadas, melhorando os resultados e aumentando a confiança dos médicos no produto farmacêutico e na empresa que o fornece. The last step is to track the organization’s progress in meeting the information needs of medical professionals. In medical affairs, the most effective way to measure success is through direct feedback from physicians. This can be compiled through a concise survey that focuses on the aspects of medical information that are most critical to physicians and includes comparisons with competitors. We have helped clients design and field surveys to establish a baseline metrics scorecard. (See Exhibit 2.) This survey can be readministered on a regular basis and used to inform refinements to the medical-information strategy over time.
When these three steps are implemented, a virtuous circle develops. Members of the medical affairs team are more motivated because they can see their insights translated into action and impact. Physicians are more engaged, and the medical information that is generated and shared is much more effective in meeting their needs. As a result, physicians are able to make more informed treatment decisions, improving outcomes and increasing physicians’ trust in the pharmaceutical product and the company that provides it.
Ganhando confiança
Tensions within a medical affairs organization over vision, strategy, and tactics can be resolved by aligning the team with a shared mission of building medical professionals’ trust. According to Bruce Henderson, The Boston Consulting Group’s founder, trust can be defined as the perception that a company, or an individual acting on behalf of a company, is subordinating personal interest, has no undisclosed motives, and has fully taken into account the values and consequences for all those affected by a decision. In other words, trust is generated when physicians believe that a pharmaceutical manufacturer’s interests are aligned with their own.
We have identified four primary ways that medical professionals come to trust a pharmaceutical product, as well as how each way can be influenced, directly or indirectly, by medical affairs:
- Medical professionals have more trust in a product if they can easily review the clinical data. In this regard, the job of medical affairs is clear: it can build trust by generating the data physicians need and sharing the information transparently. For example, developing a robust safety-communications strategy is critical. Do you proactively share safety data on an ongoing basis? If a crisis occurs, how will key stakeholders first be informed—by your medical team or by the media? Will MSLs take responsibility, or will they blame corporate headquarters for not keeping them in the loop?
- Physicians also come to trust a product through experience—their own and others’. Medical affairs organizations have more impact here than they might think. Although they cannot directly influence what happens once a physician prescribes a product, they can provide the information physicians need to improve the likelihood of a positive outcome. And they can take advantage of strong relationships with key opinion leaders in order to help build other physicians’ trust in the product.
- A good relationship between medical professionals and the pharmaceutical manufacturer can build trust in a product as well. This relationship can be fostered by high-quality MSL interactions. The important thing is for MSLs to maintain their focus on building trust and advancing patient care as end goals, with relationship building as an enabler. This focus can be disrupted if the mission is not clear. As one clinical specialist stated about MSLs, “Sometimes I get the sense they are out there in the parking lot, memorizing my kids’ names. But that’s not what I’m interested in… I don’t need another friend.”
- Finally, medical professionals will trust a product if they have a positive perception of the manufacturers’ reputation. Medical affairs can have a direct impact here, but this perception is also shaped by a much broader set of interactions between physicians and various representatives of a pharma company, including sales reps, key-account managers, and members of the field medical team. Ensuring that these interactions are coordinated and streamlined is critical to building trust.
Avaliando a saúde da sua estratégia de assuntos médicos
The medical affairs landscape is changing rapidly. The best organizations do not look backward at benchmarks and lagging indicators. Instead, they clarify their mission, focus their efforts, learn about the needs of the physicians they serve, and innovate to meet those needs.
When we work with medical affairs clients in preparing for a new-product launch, we administer a “health check” to assess organizational readiness. We invite you to consider a few of the questions we pose. Consider them in the context of your own products.
- Is the level of medical affairs investment commensurate with the importance of the new product to the company (as opposed to being distributed equally across all brands)?
- Is the medical affairs strategy customized to the new product and its defining characteristics?
- Is the mission of the medical affairs organization aligned internally, and does it help guide the actions of its personnel?
- A oferta de informação médica é adaptada para atender às necessidades dos ecossistemas específicos de profissionais médicos? executando em relação ao dos concorrentes?
- Are hiring and training plans for MSLs designed with an understanding of which MSL attributes (such as clinical acumen, active listening, and responsiveness) are most important to physicians?
- Is there an objective understanding of how your medical affairs organization is performing relative to that of competitors?
Se a resposta para qualquer uma dessas perguntas for "não", então há uma oportunidade de evoluir sua estratégia de assuntos médicos. Troy Andre
