COVID-19 will cause acute strain on medical affairs in the short term, but longer-term planning is also needed to ensure that teams can remain in the more visible role that customers are demanding, writes Sarah Jarvis.
With the coronavirus now a pandemic, medical affairs leaders are being asked to increase support of patients, physicians and other groups within their own companies. While the role of medical teams in most companies has expanded significantly over the past five to 10 years, this pandemic will put additional critical responsibilities on key roles within medical affairs. In some cases, responsibilities are more numerous, in others they’re new and unique. While in the short term this may cause acute strain, longer-term planning is desperately needed across most of the industry to ensure that medical teams can remain in the more visible role that customers are increasingly demanding. Here are the three areas that can provide the most help.
If your company hasn’t already felt the additional strain on its medical info call center, it’s likely coming soon. In a recent global survey of patients and physicians from the market research company M3, keeping people informed is cited as the most effective way to contain the spread of the virus.1 From patients to caregivers to physicians and payers, medical information groups are called on to respond to all sorts of inquiries, whether on- or off-label, to educate customers (rather than promoting to them). Companies involved in the response to COVID-19 have likely already experienced a significant increase in inquiries and are in close contact with their corporate communications teams. For many others, the uptick in inquiries has probably just begun. They’re fielding questions about access to medicines and off-label uses because of delayed or missed medication. Such interruptions could be caused by supply chain issues, limited access to physicians’ offices or, in some cases, concerns about immunosuppression. For example, should cancer or other immunosuppressed patients go into infusion centers for treatment?
In the short term, companies need to ensure that they have enough qualified people to answer questions quickly and effectively. In times of crisis, a delayed response is not acceptable, and the standards for what’s considered “delayed” are much stricter. To prepare, consider these key questions:
1. Do you have enough people to respond to inquiries?
2. What’s your response time? Typical 24- to 48-hour response times are not likely acceptable now.
3. Do those on the front lines know how to respond? With patients or caregivers, this may take some additional guidance and training, but even beyond fostering a more empathetic approach there will likely be new questions that aren’t part of current FAQs: for example, “If I’m on drugs A and B but B isn’t available, what should I do?” or “My patient is at high risk for contracting COVID-19, so should I delay, decrease or stop his medication?”
4. Can others help fill current gaps? Bringing field medical MSL roles in for on-call support, especially as their in-person presence is limited right now, could be a win-win situation. Medical directors and other internal roles can help in real time or in preparation by developing new FAQs or standard response letters around hypothesized and real questions. For certain medicines, companies may even consider outreach to FDA, EMA or governmental bodies to create more standardized outreach to physicians and patients with specific guidance.
5. Are there other groups, like corporate communications, patient advocacy or patient access groups-that should centralize responses through medical information teams?
Longer-term, medical affairs groups should rethink how customer engagement works within their organizations. Some organizations have centralized customer engagement roles-such as field medical and medical information teams-under the same leadership, but most don’t. We believe that the COVID-19 worldwide response to telemedicine2 will be the catalyst that changes how many consumers approach education and information consumption for good. Medical teams that adapt with new ways of working will succeed. Whether this is with medical information and field medical teams working hand in hand or under the same leadership, it will be vital for these groups to change together to meet customer needs.
Companies across the globe are shifting to non-personal engagements. Field medical engagements are inherently different from customer conversations with commercial sales reps. MSLs will schedule 25- to 30-minute meetings with HCPs while reps drop by for less than two minutes on average. We don’t yet have data on the impact of COVID-19 and the result on MSL vs. sales rep access. Almost no one is continuing in-person outreach, and there will be decreased access. This will likely be felt disproportionately on the commercial side. We’ve already seen this play out in recent years3 with sales rep to MSL ratios lowering from 10:1 in 2014 to 8:1 in 2018.
In the short term, MSLs will likely have more time on their hands. How should they best spend that time?
• Support other functions where their expertise can be used. For example, this could include medical information teams, as noted above.
• Shift coverage to support other therapeutic area MSLs. While some therapeutic areas might be called upon less in the short term, others-like MSLs in respiratory-may need much more support. This is a great time to cross-train and upskill across companies with multiple therapy areas.
• Train for soft skills and business acumen. This is a lingering to-do item on the lists of most field medical leaders, but it’s always deprioritized because of customer demand. Now might be the time to revisit this goal. How to operate virtually has long been a training need for medical teams. While we’re all getting a crash course, it would be smart to invest in how to do it well.
In the long term, find new ways for medical information and field medical teams (along with other non-medical roles) to work together and meet customer needs. Doing so in the ways that customers demand will involve lots of work by a diverse set of cross-functional groups from within medical teams, commercial teams, IT and many others.
Upcoming meetings that have been central to medical and clinical data dissemination and engagement are also being delayed or cancelled. More than 50 national or regional meetings4 have been cancelled or postponed, or they’ll go virtual. As a result, companies are taking a hard look at new options for disseminating scientific information.
In the short term, most companies are going to struggle. Few are set up to ensure easy access to new data outside of one-on-one engagement or through conference venues. We need to act quickly to prioritize outreach during escalating asks on the physician community. This will require coordinated efforts. We’ll need to ask some tough questions about scientific exchange that will challenge metrics and goals that were put in place before this new reality.
In the long term, companies should rethink their data dissemination strategies on a broader scale. This will require thinking beyond traditional medical communication and publication roles and, ideally, pulling in experts in social media and adult education. Some companies have already started investing in this type of expertise in productive, if non-traditional, ways.
These are just three examples of where medical teams may be asked to quickly step up in the coming weeks. There will be many functions that medical teams will be called on to contribute to, like clinical trial support, advisory boards, etc. Medical teams should take a leadership role in this crisis. They can shape the short-term response that will ensure longer-term requests for more or different resources. Medical teams rising to this occasion will have an incredible impact on customers, caregivers and patients in this difficult time.
Sarah Jarvis is a principal at ZS and global lead on medical affairs consulting.
Notes
1. https://m3globalresearch.blog/2020/03/14/corona-virus-physician-patient-perspectives/
2. info.zs.com/activeingredient/is-coronavirus-the-spark-that-telehealth-needs
3. www.zs.com/publications/whitepapers/analysis-of-field-medical-growth-and-industry-trends
4. www.medscape.com/viewarticle/926359#vp_3
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