Silent (R)evolution in Medical Affairs Through the Power of Partnerships and Collaborations

Who holds the key to drive meaningful change in the practice of medicine, influences healthcare policy and makes a lasting impact on the well-being of patients and society in the constantly evolving healthcare landscape?  The answer may surprise you. Even in the short time since the publication of our previous article, entitled “Medical Affairs’ Search for Meaning: Leading the Pharmaceutical Industry into the Future”,¹ Medical Affairs has risen like a phoenix to propel the patient voice into the decision-making halls of our industry. One could argue that it is finally where it should have always been. In companies that allow the function to thrive, Medical Affairs (MA) is no longer sitting at the kids’ table. In this privileged position, MA is leading from the front and is providing a collaborative anchor point across other functions like Government Affairs, Business Development, Commercial, and Research & Development (R&D). By driving common agendas and understanding that innovation no longer occurs within our own four walls, MA is leading the industry to ensure we are offering an outward looking differential value, based on the needs of the patients.

A recent report from McKinsey & Company² confirms that science and data are becoming the foundation for pharmaceutical companies to serve its stakeholders with the ultimate goal of improving patient outcomes. MA professionals with their medical and/or scientific credentials, scientific know-how, and credibility among stakeholders, are best placed to own the scientific knowledge and data within the organization and across the lifecycle of a medicine. With this, MA is transitioning to a new and fundamental strategic role within a pharmaceutical company, alongside R&D, Commercial, and Government Affairs.

We will describe in this article how MA can step up to own this new strategic role within a pharmaceutical company, particularly within emerging markets.

Patients and physicians need more than only the right medicine. It is key that we as MA professionals understand the patient and physician experiences in a way that we have not done before. The patient experience starts long before a diagnosis is made, when the patient is not a patient yet, and should continue until the end of life. We need to understand their real needs, their mindsets, and their emotional behaviors from pre-diagnosis through to treatment, post-treatment, and beyond. This requires us to look further than simply offering ad-hoc solutions for a specific vulnerability or pain point in the patient experience. We need to plan and execute along the entire experience and to be able to do this, we need to develop capabilities that are not currently part of the Medical Affairs’ curriculum. Digital innovation and digital solutions are key as they will help us to collect new insights along the entire patient experience, delivering longitudinal data from a variety of data sources and ways to perform data analytics. There are plenty of examples including the benefit of Artificial Intelligence (AI) in clinical studies, Real-World Evidence (RWE), and our interactions and communication with our stakeholders (physicians, patients and care givers, payers). Digital is transforming patient and physician experiences, and we as MA are ideally placed as the trusted partner between the industry, physicians, and patients, to respond to these new trends. But we cannot and should not do this alone; we need to develop partnerships and collaborations with third parties who have this expertise and infrastructure. We will provide some examples of how we were able to establish such partnerships in the emerging markets later in this article.

MA is central to partnership and collaboration, both internally and externally. Internally, we are uniquely placed within a pharmaceutical company between R&D and Commercial and Government Affairs, moving to the forefront as the new strategic partner; and externally, we continuously engage with our stakeholders. In today’s rapidly changing environment, we need to be agile to adapt, take advantage of the new data sources, and identify opportunities that will respond to the vulnerabilities or pain points in the patient and physician experiences. Only then will MA be able to generate value for our patients, other stakeholders, and the business. In the International Region at AstraZeneca, which consists mainly of emerging markets, we have developed a concept called iDREAM.³ We will describe in more detail how iDREAM has helped us position and deliver against our new strategic role.                                            

The landscape of healthcare is evolving quickly and in many exciting directions. Innovations in life sciences, health technology, and communication are opening up new realities of care provision that will improve accessibility, mobilize actionable intelligence, and propel patient empowerment, which will fundamentally change how we prevent, diagnose, and cure diseases.⁴ Reimagining healthcare requires a new way of thinking about new approaches and resources. For example, emerging markets have the potential to shift their role from the world’s back office to being at the epicenter of innovation.

A revolution has happened already. Unfortunately and mistakenly, pharmaceutical companies, with some exceptions, continue to associate emerging markets with manufacturing and commercialization, rather than with innovation and R&D. Taking into account that many emerging economies are placing innovation at the top of their national agendas, by creating forward-looking education and talent development policies, providing financial support to large-scale initiatives, and acquiring new assets in the form of intellectual capital and infrastructure, there is a whole new universe of advanced innovation opportunities opening up for healthcare globally in the emerging markets.⁵

Disruptive innovation in healthcare can come from anywhere around the world and there are strong signs that emerging markets may deliver sustained innovation in the future like that produced by established hubs in the United States or Europe, such as Boston, San Francisco or Cambridge.⁶ Pharmaceutical companies have an important role to play in partnering with emerging economies to help build capabilities that deliver their life sciences innovation agenda. This partnership includes supporting the advancement of local R&D, mentoring of scientists and researchers, and stimulating a network of leading biomedical ecosystems comprising academia, entrepreneurs, industry, medical professionals, governmental partners, and venture capitalists. Importantly, pharmaceutical companies can help these emerging markets share their life sciences innovations more broadly.

We believe that holistic, beyond-the-pill, patient-centric solutions are on the horizon, and that by working cross-geographically and cross-industry together, the future of healthcare can be improved. MA is well placed to drive this value creation and generate innovation. Taking into account that innovation does not happen in isolation, we need to partner with talented researchers, entrepreneurs, government entities and leading R&D institutions from all over the world and not limit ourselves to the usual suspects in the developed economies. Only by doing this will we enable scientific innovation to cross boundaries, accelerating the dissemination of new ideas into innovative patient-centric solutions.

This approach embodies our iDREAM hubs project (see Figure 1) which aims to develop an integrated open science platform in emerging markets and embed it as a leading ecosystem in a global innovation framework. The iDREAM initiative, which we started in 2018, is designed to foster partnerships between pharmaceutical companies, researchers, entrepreneurs, government entities, and R&D institutions within the emerging life sciences clusters. iDREAM supports biomedical innovation, irrespective of geographic location by breaking down some of the barriers that face institutions, researchers, and young entrepreneurs, like lack of understanding of (clinical) development processes. iDREAM connects these stakeholders to each other and to established R&D hubs, providing guidance when it is most needed-be this at the initial proof-of-concept stage, securing investment, navigating the licensing process, or moving towards commercialization.

Figure 1. iDREAM* hubs concept: open science ecosystem (*International Drug Research and Development, Education and Government Affairs Hubs Project)

Click image to enlarge.

In 2018, we launched iDREAM hubs in Russia, Brazil, and Taiwan; and in 2019 we started hubs in China, Argentina, and India. Each of the hubs have different objectives, guided by regional differences and needs, but the main focus is on innovation that delivers improved patient outcomes. We’ll provide one example of how we initiated the iDREAM hubs in Russia.

Finding the right partner who shares your values and has similar objectives is a key to success in partnerships and collaborations. For the iDREAM initiative in Russia, we chose one of the biggest innovation centers in Russia-a government-led innovation ecosystem, which supports and incubates biotech start-ups and biomedical companies, that are developing potential patient-centric solutions to an identified pain point in the patient experience and helps them to scale up. MA, together with this center, launched a Start-up Challenge competition in 2018, a program aimed to identify best-in-class biomedical projects in Russia and uplift local R&D capabilities to support Russian biotech entrepreneurs. Start-up winners passed through a comprehensive three-month acceleration period, which included tailored mentoring support from our R&D top experts and a business capabilities development program. The success of the 2018 program, where we identified two companies for further collaboration at a local and global level, became the base for the 2019 program. In addition to joint research activities, we partner with one of the youngest modern Institutes of Science and Technology in Russia, with a focus on students and young talent mentoring, assessing scientific projects and internship programs for students at our premises.

In addition, one of the key outcome of iDREAM is an internal mindset shift; that MA can play and win in a new field of disruptive healthcare innovation, bringing value back to patients and to the organization in a new non-traditional way.

By leading in bringing company global expertise to the local market, by carefully listening to local needs and understanding healthcare trends, MA has started building a trust and a bridge between a pharmaceutical company and healthcare government authorities. The final beneficiary of this new way of partnering and collaboration is not politics or the pharmaceutical company, but patients and their families.

To uncover these new and underestimated opportunities, MA must work with a wide range of internal stakeholders, where Government Affairs and the business units play a crucial role. The traditional paradigm of the MA role and place in the company is now changed-we are equal partners who can lead and guide cross-functional colleagues in a changing external healthcare environment and a volatile, uncertain, complex, and ambiguous (VUCA) world of healthcare innovation.

There is a substantial opportunity to improve patient outcomes by partnership and collaboration with governments, academia, and research organizations. Within a pharmaceutical company, MA professionals with their medical and/or scientific credentials, scientific know-how, and credibility among stakeholders, are ideally placed to lead this (r)evolution.

References

• http://www.pharmexec.com/medical-affairs-search-meaning

• Mc Kinsey & Company: A vision for Medical Affairs in 2025

• https://www.astrazeneca.com/Partnering/partnering-case-studies/idream.html

• https://thefutureishere.economist.com/healthcare/

• J.Kao. Big Picture – Tapping the World’s Innovation Hot Spots. HBR, 2009; March: 109-114

• A. Gautam et al. Market watch: A framework for biomedical innovation in emerging markets. Nature Reviews Drug Discovery, 13(9), 646-647, 2014

Alexander Bedenkov, MD, PhD, AstraZeneca Medical, International Region; Carmen Moreno, PharmD, MBA, AstraZeneca Medical, International Region; Ryan Bate, BSc , AstraZeneca Medical, International Region; Andrey Ipatov, MD, AstraZeneca Medical, International Region; Filip Surmont, MD, AstraZeneca Global Biopharmaceutical Medical; Maarten Beekman, MD, AstraZeneca Medical, International Region.