Key takeaways

• Measure medical affairs impact through changes in healthcare professionals’ knowledge, clinical behavior and patient outcomes, not prescription volume
• Combine leading and lagging indicators to guide near-term decisions while tracking changes in clinical practice over time
• Start with a proof of concept and the data you have instead of waiting to measure everything
• Build collaboration among medical, analytics, legal and compliance teams, with leadership buy-in, to sustain measurement

Medical affairs teams are moving beyond tracking activities to measuring changes in what healthcare professionals (HCPs) understand, how they practice and what they deliver for patients. That shift raises three questions: What should teams measure, how should they measure it and what should they do with the results?

Those questions were the focus of a conversation between Jon Gonzales, associate principal at ZS, and Remy Friedman, medical lead, ZAIDYN® Medical, at ZS. They explored how to choose measures that align with medical objectives, use data to inform strategy and build the cross-functional collaboration needed to sustain measurement over time.

They also discussed how predictive analytics could help teams assess future investments, as well as near-term indicators, attribution and investment in measurement capabilities.

Jon Gonzales (JG): What are the biggest questions medical affairs leaders face about medical affairs impact measurement?

Remy Friedman (RF): There are three big challenges that we hear from most of our industry partners.

First, what should be measured?

Medical as a nonpromotional function should not, and can not, be measuring script volume. Sometimes this is posed as a challenge, but I think of it as an opportunity. Our aim as a medical affairs organization is not to drive script volume; it’s to engage in scientific exchange and to advance the science. Our measures should reflect that and not reflect what our commercial counterparts are designed to do.

Second, how do we measure it?

Which sources should we be using, and how can we trust the results? Particularly if there are discrepancies from what we hear from our HCPs and what we see in their practice patterns. Which do we rely on more to help our decision-making?

There are so many modalities that we can use. We have market research, social media listening and customer relationship management (CRM) systems that track activities, claims data and electronic health record (EHR) data.

And third, once we have the results, what do we do with them?

This anchors back to how we set our medical objectives, and once we do, how does this data inform what we’re trying to accomplish and maybe change the way that we’re thinking about it moving forward? How do we tell our story internally to leadership, to our cross-functional colleagues and even externally to the physicians, patients and payers that we’re looking to engage with and partner with over time?

It’s not measuring for the sake of measurement. It’s measuring for the sake of action.

JG: What have been the biggest shifts in medical affairs impact measurement over the last few years?

RF: Most have accepted that outcome measures are the gold standard. The conversation has shifted from “I think we should get there“ to “We’re going there.” The shift is in using new tools; AI is embedded in a lot of this, and it really has helped to revolutionize the way that industry is thinking about analytics and gathering qualitative information from the quantitative data that they’re presented with over time.

JG: What do you say to those who agree with the shift but don’t know where to start?

RF: Organizations should start wherever they are going to have the data or be able to acquire the data to make those decisions.

In an ideal state, we’d measure everything. But we operate in a world of constrained resources, from a people, data and a tech perspective. It’s challenging to do all of this and certainly not all of it at the same time.

Where I would focus is on the upstream side of that—understanding how your physician base is thinking. That is likely the most accessible and cost-efficient piece of information when you start. Soon after, most organizations have real-world data in-house. You can get to that HCP behavior, pairing the data to inform how folks are thinking.

Start somewhere. Use the data to help you make decisions, to help you assess how you’re achieving—or not—your medical objectives.

JG: What separates organizations that make progress in medical affairs impact measurement from those whose efforts fizzle out?

RF: The biggest thing is cross-functional collaboration. So much of what we do in industry is operated in silos. Many of the organizations that we work with are starting to break these down, but it’s even more critical when we think about medical impact.

The medical affairs, business and capabilities teams need to understand how you’re progressing toward medical objectives for a particular therapeutic area or business unit.

You need to partner closely with the medical analytics team that can inform what data exists and what analysis can be done. This extends to your legal and compliance teams, too. Medical is by definition a nonpromotional function, and so there is risk associated with impact measurement in this space. Ensuring that your compliance and legal teams are on board from the outset is going to be critical.

The last piece is your medical leadership, even within the medical organization, your chief medical officer extending to the CEO. What do these chief executives want to see? What do they expect from a medical team? If you don’t have the buy-in from all levels of the organization, then the impact measurement is likely going to fizzle out. You need to provide value based on this cross-functional collaboration to the folks who are ultimately going to see this data at its highest level.

JG: I’d add the commitment to do this over the long term as well. This can’t change month to month, even year to year.

RF: Changing beliefs and changing practice patterns is inherently something that’s going to take time. Being committed to assessing impact over that lag time is critical. That’s not to say that we don’t have methods to figure out earlier what leading indicators may be. Your activities and knowledge can all be part of the equation.

But if we’re driving toward behavior and patient outcomes, it’s critical to have that medium-to-long-term view that remains business-aligned, and that commitment to measurement over the long term.

JG: What does the future hold for measuring medical affairs impact?

RF: We’ve just scratched the surface of impact measurement, and much of what we’ve spoken about is retrospective. We’ve done activities, produced evidence and spoken to physicians about how they’ve changed their practice over the past year.

Even if we’re looking prospectively and designing an experiment, we choose the metrics today and look forward a year. In a year’s time, we’ll understand what changed.

The analytics we have today unlock an element of prediction in this. Medical impact measurement is going to shift from looking only at what has happened to asking what we can do in the future.

I’ll give you an example. As we’re designing field medical teams, suppose we want to add three medical science liaisons (MSLs), which would increase our reach by 12%. As a leader, I would ask, “What would that investment lead to in terms of changes in physician behavior or how physicians are thinking?” Today, we don’t know. We can estimate, but we don’t know.

Once you build up this index of data and model that information, you can explore those strategic decisions to find out where to make your investments for the biggest impact down the road.

JG: The impact feeds back into the strategy. Once you’re measuring that impact, are you calibrating your strategy, activities and experts?

RF: We’ve used voice of customer analysis to inform our strategy forever. The question now is how do we bolster that? I think using this data is the next step we as an industry have to take.

JG: How do you define medical affairs key performance indicators (KPIs) that guide near-term decisions while measuring long-term impact?

RF: We’ve seen leading and lagging indicators work well. Ultimately, you want to measure patient outcomes, but something like overall survival isn’t really feasible to measure in a business context. It’s more of a research context.

For a physician to change their practice pattern—ordering a particular diagnostic, for example—that may take about a year. The earlier you can align your measurements and KPIs with business strategy, the better.

Changes in knowledge and beliefs can happen in three to six months. Understanding those changes can help inform how you and your organization think about impact measurement.

The correlation between your activities, HCP knowledge and beliefs and HCP behavior change is also critical. This is where prediction may come in. Today, what decision can I make based on the information I have? Tomorrow, predictive thinking can help make that information more actionable.

JG: How can organizations determine whether medical affairs drove the observed impact rather than other factors?

RF: Within your own organization, how can we distinguish the impact driven by medical affairs from that driven by our commercial counterparts? Commercial may launch an unbranded disease awareness campaign, and that may show up in some of the measures that medical is thinking about.

One way to approach this is to say we’re one collective organization. We’re looking to move the needle on a particular scientific concept, so it’s less important to me whether this is medical or commercial. On the commercial side, a prescription or sale is likely not driven only by commercial.

A physician needs to understand the science before prescribing a particular drug. Yet medical is not promotional. Our aim is not to drive prescriptions. Commercial’s role is to increase sales, so that’s what they measure as their KPI.

Medical is looking to advance the science. I would argue that our KPIs should be about scientific knowledge progression and changes in clinical behavior, perhaps at a class or guideline level, to optimize care.

The second question we hear is, “What if a major competitor had a launch?” Or, “What if two organizations are running a similar campaign? How do we know it’s us and not our competitor driving this shift?”

There, we can lean on analytical modeling to regress out some of these confounders. It’s not perfect. We cannot get to 100% certainty that our medical affairs organization or our MSL is driving the shift. But directionally, to help inform your decisions, I would argue that it’s good enough.

JG: What do organizations consistently overinvest in and underinvest in when building medical affairs impact measurement capabilities?

RF: I’ll start with the underinvestment. Bringing everybody together around a common goal is often overlooked.

We dive heavily into data and technology, yet it takes a large effort to help people understand the impact measures and get the cross-functional team fully involved. Investing time in bringing people along so everybody has a shared objective is critical.

For overinvestment, I’m less certain. I think most organizations are investing the appropriate amount. I don’t often see organizations going above and beyond in their investment in medical impact or medical capabilities.

I’d reframe that as trying to do everything at once. When organizations say they’re going to start on day one with every therapeutic area that can lead to friction challenges and disillusionment when they don’t succeed right away.

There’s likely a stepwise framework. Invest in a proof of concept, invest in something to get started rather than waiting for perfection.

JG: Thanks, Remy, for this insightful conversation and for sharing your perspective on how medical affairs teams can make impact more measurable.

RF: Thanks for having me, Jon.

Watch the full discussion