Jane Chin, Ph.D.

Special to PharmCertify

One of the trickiest areas for MSL professionals to navigate is the “scientific exchange.” What can you, the medical science liaison professional, discuss? Should you initiate any and all discussions? Can you, the MSL, boldly talk where no sales reps can ever talk before? (Or at least, those sales reps who follow the rules of compliance and company policies).

MSLs will often express resistance at being told what they can talk about, and how they should talk about it, when meeting with key opinion leaders (KOLs). Experienced MSLs, who have worked in the field for 10 years and have strong relationships with their thought leaders may feel like they have a proven track record of knowing what to say and how to say it. They may not appreciate being told by a company policy (or the company’s compliance officer) “how” they should do their jobs. They may say, “They hired us because we’re professionals, they should trust that we know what’s appropriate.

They have a point. In general, MSLs are aware of the landmines around off-label promotion, and the last thing they want to risk is being mistaken as a sales rep who is promoting off-label. On the other hand, the company has a point in wanting to control clinical conversations. It is also aware of the landmines around off-label promotion. The last thing the company wants to risk is giving MSLs free rein over how clinical discussions should be conducted, especially when questions about off-label use can arise over the course of the discussion!

Some companies have begun requiring KOLs to submit a written request to see a medical science liaison before that meeting can take place. In other words, MSLs in these positions have now become responsive entities, no longer capable of proactive engagement. Some fear that this is a harbinger of doom for the existence of the MSL role. I suggest that this does not eliminate the need for MSLs, but certainly sets up the possibility of a significant number of MSL positions being downsized. MSLs would essentially become a group of field-based “medical/drug information” professionals, dispatched in response to a formal written request from a KOL.

So bigger questions arise: what should differentiate the MSL role from the sales role in therapeutic areas that are highly specialized? What can MSLs initiate in a scientific exchange without a formal request?

MSLs can answer very broadly, “We will discuss disease state.” That leads to the question of “what” about the disease state? Should all MSLs in the team begin the disease state discussion the same way? Can’t specialty sales representatives also talk about disease states?

The complexities of scientific exchange that today’s MSLs must navigate have increased. This requires companies with field-sales and field-medical teams to draw clear distinctions both for thought leaders and for themselves between these two functions. Companies need to differentiate the roles of their field-medical teams from their field-sales teams especially when the sales representative and MSL may interact with the same thought leader. Only then can companies preserve the sanctity of these two field-based roles.