Lisa Cesario_Sarah Jarvis_Eric Scott

ZS Associates | 847.492.3600 | www.zsassociates.com
Industry-Wide Collaboration to Support Field-
Based Medical Professionals (MSLs):
A Successful Case Study in Canada
Lisa Cesario, B.Sc. Phm. Director, Medical Liaisons Oncology,
HOFFMANN-LA ROCHE LIMITED
Sarah Jarvis, Manager, Medical Affairs Lead, ZS ASSOCIATES
Eric Scott, Manager, ZS ASSOCIATES
ExL Pharma MASS West: September 18, 2014

CanadianMSLForum_Day2at1215_for ExLPharma© 2014 ZS Associates
Disclaimer
 The information presented by Lisa Cesario is representative of the
opinions of the Canadian MSL Forum and not those of Hoffmann-La
Roche Ltd.
- 2 -

Agenda
1
2
3
4
Who: Canadian MSL Leaders Forum
How: Conducting a Survey in Canada
What: So What Did We Do?
Next Steps
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Agenda
1
2
3
4
Next Steps
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Evolution of the Canadian Field Based Forum in Support
of MSL Role
1970 ̶ 2000
Field Medical Function develops,
reporting to Marketing
2008
90% of Field Medical report
to a Medical function
2009
Canadian Field Based
Medical & Scientific
Communications Forum
established
2010
Canadian Field Medical
Guiding Principles created
2012
Guiding Principles aligned
with Rx&D Code of Ethical
Practices
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Canadian Guiding Principles for MSLs – Current as of July 2012
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 The Field-Based Medical and
Scientific Communications role is a
non-promotional role that must report
to a non-promotional function
 Provide peer-to-peer (collegial),
in-depth, scientific exchange according
to HCP needs in a particular (disease)
area of interest
 Communication is non-promotional in
nature as dictated by legal statutes,
regulatory guidelines and policies
 Continuity in developing a long
term association with HCP’s,
primarily with thought leaders
and the academic community

Canadian Guiding Principles for MSLs – Current as of July 2012
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 Fair balanced communication
of current, peer-reviewed data
on therapeutic area including
specific products
 Communicating the evidence in a
balanced and unbiased way without
expressing opinions, taking positions,
or making recommendations
 Through interactions with HCPs
Field-Based Medical and Scientific
Communications personnel may
support and or facilitate research
activities as dictated by legal statutes,
regulatory guidelines and policies

Why a MSL Forum for Member Companies?
Provide a forum for the open exchange of ideas and
information of a non-confidential nature related to Field Medical
between participating companies
Promote closer professional, non-competitive relationships
amongst Field Medical Personnel
Continuously monitor the industry and the external environment
for trends in the area of Field Medical
Act as a reference to associations that interface with regulatory
agencies or other governing bodies related to operating
standards & guiding principles of Field Medical
Create a platform for training and professional development
of Field Medical Personnel
- 8 -

The Three Core Pillars of the Forum
 Provide an opportunity
for the refinement of the
MSL function across
ALL companies with an
MSL function (even
non-Rx&D and Biotech
Canada).
 In the setting of a
professional forum
members can learn, as
appropriate, from each
other resulting in a more
robust, consistent
function long-term.
Consistency
 Focus on professional
development and
leading/best practice
through the
development of training
and symposia in
partnership with
Universities and other
like-minded groups or
associations.
Development
 Provide input or
expertise, when
needed, to Rx&D when
matters involving MSL
operation are raised.
Beyond the MSL
Guiding Principles,
matters of policy will not
be a focus of the Forum
as policy is the domain
of Rx&D.
Governance
- 9 -

Forum Members & Ground Rules
Participation
 This Forum is composed primarily of individuals from research-based
pharmaceutical and Biotech companies. It may also include from time to
time, dependent on meeting topics, consultants and contract organizations.
It does not however include individuals from generic companies.
Mode of Operation / Ground Rules
 Being respective of member company’s competitive intelligence concerns/
confidentiality constraints
 Collaborative and transparent environment
 Open and voluntary participation of companies
 Shared and rotating responsibilities for hosting the Forum
 An annual assigned Chair to construct agenda and facilitate meetings
- 10 -

Currently 28 Canadian Companies Are Active Members
- 11 -

of MSL Role
1970 ̶ 2000
2008
2009
established
2010
2013
Conducted an Industry-
wide Research on the
Value of the MSL
2012
Practices
- 12 -

17/28 Member Companies Agreed to Participate in the Survey
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Agenda
1
2
3
4
Next Steps
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Why Was a Survey Needed?
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 The role of the MSL has been a role that has undergone significant evolution
from its first inception within the industry
 Very limited data exists that defines the value of the MSL role in the eyes
of HCPs
 No data exists within Canada
 Establishing a baseline within the Industry will help guide the future priorities
of the Forum
 A survey will establish its first benchmark for the role of the MSL in Canada
Objectives of the Forum to Conduct an Industry Wide Survey
 To understand what HCPs and MSLs are saying about MSLs in Canada
 To gain insight on the value that is being provided/ not provided
 To identify the gaps that exist
 To help the forum build a plan on what to Start, Stop & Continue

How Did the Forum Move Forward?
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2013: Q1
 Forum members were able to submit
potential vendors for consideration
 Forum created a scope of work for
vendors to submit a RFP
Q3
 A total of 17/28 member companies
agreed to participate
 The vendor liaised with each member
company to establish a contract
according to each company’s
individual requirements
Q4
Survey and interviews fielded
October to November 2013
Q2
Potential Vendors presented
their proposal to the Forum
f2f in April 2013
One vendor was selected to
complete the survey on
behalf of all forum members
that volunteered to participate
Costs were shared equally by
each participating company
based on the scope of work
for the project
2014: Q1
Executive Leadership Forum
held in Toronto in January
Participation of 17 companies

Benefits of Working with a Third Party Vendor
Allowed each participating company to maintain their:
 Confidentiality requirements
 Competitive intelligence requirements
 Promoted collaboration
 Allowed for voluntary participation
Vendor would be able to remain neutral and ensure the needs
of the forum were met
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Agenda
1
2
3
4
Next Steps
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The Forum Has Commissioned a Unique and Groundbreaking Study,
Confirming That the Role Should Be Shaped by Those Within It
- 19 -
Internal
359 respondents
from 17 organizations
completed a 30-minute
quantitative study on the
value of MSLs to their
organization
External - Deep
32 Scientific Experts
(SEs, KOLs) across
16 specialties were
recruited for a 45-minute
qualitative interview on
their perceptions of MSLs
External - Broad
87 Scientific Experts
across 16 specialties
were recruited for a 30 min
online survey to rate the
value of MSLs from 30
different organizations

The MSL Attributes Most Correlated with an MSL’s Value According
to Scientific Experts Include Both Scientific Knowledge and Softer Skills
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MSL training should focus on both scientific/therapeutic information and softer skills
MSL drivers most valued by Scientific Experts (SEs)
Cost of EntryNon-differentiating Drivers
Very ImportantHidden Drivers
Highly correlated drivers of MSL Value
1. Understanding of
needs & preferences
2. Thought provoking
4. Therapeutic Area
knowledge
5. Scientific expert of
company portfolio6. Scientific expert of
competitor products
7. Communicating relevant,
meaningful and unbiased
information
8. Raising awareness of
opportunities (clinical trials
& grants)
9. Accurate and meaningful
interpretation of scientific
data
10. Supporting trials with
available company resources
11. Business acumen
12. Connecting the SE to
other TA leaders
13. Responsiveness
14. Supportive in research
15. Patient focused
Derivedimportance
Stated importance

While MSLs Comprise Approximately 26% of the Time SEs Spend with Pharma
Field Personnel Today, SEs Would Prefer to Spend Almost 50% More Time
with MSLs – at the Expense of Time with Sales Reps
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S1Q10. What is the split for your time spent with industry representatives over the past year?
S4Q5. In the future, what percentage of time would you prefer to spend with the following types of pharmaceutical personnel in a given year?
N-Sizes: Top tier SEs (7); Low tier SEs (80)
Average distribution of time spent
with Pharma personnel
14%
Other
26%
MSL
59%
Sales
Rep.
SEs would prefer to spend
approximately 40% of their time
with MSLs, and slightly less time
with sales reps, compared to today
Top Tier SEs:
 Spend more time
with MSLs than
average (35%
vs. 26%)
 Generally find
interactions with
sales reps less
valuable
“If we had to keep one or the other,
I would obviously keep the MSL.”
— Med Onc
"MSLs are the most valuable
person from the company.”
— Card
"I do not spend too much with the
reps because I typically know about
their drugs better than themselves.”
— Neuro
25%
Other
35%
MSL
41%
Sales
Rep.

While Almost All Scientific Experts Are Open to Seeing MSL Visits, a Small
Number of Younger SE’s Are Minimizing MSL Activity in Their Practice
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S1Q11. How would you characterize your personal policy towards pharmaceutical company Medical Science Liaisons (MSLs)?
S1Q13. Please rate your level of reception and openness to the following pharmaceutical personnel.
N-Sizes: Younger SEs (25); Older SEs (26)
Percentage of SEs that are open to
MSL visits and find them useful
3%
44%
53%
 I am very open to receiving visits and find the
interactions extremely useful
Older SEs:
Are generally more open to receiving visits and are more
likely to have an “open policy” towards their MSLs
 I am open to receiving visits and find the
interactions to be somewhat useful
 I try to minimize the number of visits because I do
not find the interactions to drive any value
58%
42%
0%
48% 48%
4%
I am very open to
receiving visits and
find the interactions
extremely useful
I am open to receiving
visits and find the
interactions to be
somewhat useful
I try to minimize the
number of visits
because I do not find
the interactions to
drive any value
Old Young
“I do not find the majority of my scientific
discussions with MSLs useful.”
— Medical Oncologist (7 years in practice)

Almost 90% of SEs Took a Proactive Next Step After Interacting with Their
Best MSL and All Actions Are Highly Correlated with the Overall Value an MSL
Can Deliver to the SE’s Practice
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11%
23%
30%
32%
35%
44%
51%
52%
0% 55%% of SEs
65%
24%
11%
0%
100%
%SEs
No Actions Taken
One Action Taken
>1 Actions Taken
Typical range
for percentage
of SEs who
took an action
following their
visit with MSLs
Actions taken following conversation
with the best MSL
89%
Requested follow-up
information from MSL
Utilized information provided by
the MSL responding to
questions in my practice
Gathered additional information on
my own in the topic area
introduced by the liaison
Utilized information provided by
the liaison in my own publications,
speaking, or teaching
Shared information provided by
MSL with a colleague
Participated in sponsored /
supported clinical trials
Submitted a study protocol on a
topic of interest
I did not take any action

Finally, internal stakeholders recognized the value of the MSL role, but
could benefit from increased coordination and communication
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Better coordination is
required between MSLs
and other field personnel
to enhance the overall
customer experience
that the SE has with
representatives of the
pharmaceutical company
As more emphasis is
placed on patient
outcomes and health
economics, it is crucial
for the MSL and
Public Affairs teams
to collaborate as
strategic partners
There is a clear need for
better visibility of the
MSL role and alignment
on the scope of activities
and responsibilities within
the organization
Internal stakeholders find
the MSL role highly
valuable and crucial to
future success

Internally, we
can start to
make changes
Clearly identify and define the role of an MSL
Communicate, internally and externally, what we can and cannot do
Collaborate and stay in contact with our field colleagues to bring value to
our shared customers
Our SEs have
different needs
Oncology & Niche Specialists: research & clinical involvement
Specialty & Mass Market: understanding data and therapeutic decisions
Younger SEs: different engagement model
Top SEs (Tier 1s): leadership & speaking activities
Survey Results – 3 Key Takeaways
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The MSL Role is
not just about
therapeutic
knowledge
Key drivers of MSL value are:
 Therapeutic knowledge
 Understanding needs
 Providing a high level of customer service
Our SEs are customers, too
Survey Results Established the Benchmark for
the Forum to Build a Strategic Plan

Agenda
1
2
3
4
Next Steps
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Using Study Insights, the Forum Has Identified Key Issues to Help Bridge
the Gap from Today’s Reality to Tomorrow’s Vision for MSLs in Canada
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Gaps identified through quantitative and qualitative research
Future
Vision
External Gaps
Internal Gaps
Current
State

Valuable role both internally
and externally
Value is highly correlated with:
 Proactive next steps by SEs
following MSL interactions
 “Softer” customer service skills
such as understanding needs
 Therapeutic area knowledge
Perceptions of MSL value &
engagement vary depending on:
 SE age
 Specialty type
 Research involvement
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External Gaps
Internal Gaps
Current
State
Future
Vision
Future
Vision

External gaps include
• Engagement with younger SEs
• Common Core competency model
for MSLs in Canada
• Skill building and overall stakeholder
awareness of roles and responsibilities
- 29 -
Internal gaps include
• Role clarity and definition
• Communication and collaboration
Future
Vision
Current
State
External Gaps
Internal Gaps

- 30 -
External Gaps
Internal Gaps
A collaborative role viewed across
the organization for expertise in
balanced market & therapeutic
area knowledge
 Role defined by SE needs, not
reactive compliance concerns
Ability to understand needs
of & tailor discussions to
different types of SEs
Providing responsive and
accessible service to Scientific
Experts
Current
State
Future
Vision
Current
State

of MSL Role
1970 ̶ 2000
2008
2009
established
2010
2013
Conducted an Industry-
wide Research on the
Value of the MSL
2014
Forum to build a 3-5 year
Strategic Plan with a 2015
Tactical Plan
2012
Practices
- 31 -

Building a Strategic Plan for the Forum
Subcommittee established in
July (8 members) to plan for a
strategic planning session
(including one year tactical plan)
for early November 2014
 A third party vendor will be
selected by the Forum
Target budget agreed to and
made reasonable across
participating companies
Subcommittee will review 3–5
request for proposals via webex
on behalf of the forum members
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 Plan & facilitate the strategic session
planning day to include:
 A situational analysis of the current
environment
 Interview forum members to understand
the current environment, issues
 Support the review and refinement of
the guiding principles
 Ensure the research findings are
incorporated into the future plan
 Produce a strategic plan with tactical
recommendations for the forum to
review and approve
Vendor’s scope of work will be:

Questions?
Lisa Cesario
Director, Medical Liaisons, Oncology
Hoffmann-La Roche Ltd., Canada
lisa.cesario@roche.com
Sarah Jarvis
Manager, Medical Affairs Lead
ZS Associates, San Mateo
sarah.jarvis@zsassociates.com
Eric Scott
Manager
ZS Associates, Toronto, Canada
eric.scott@zsassociates.com

Lisa Cesario_Sarah Jarvis_Eric Scott

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