When You Shouldn’t Start a MSL Team

The logic behind the need for a sales force is simple: we have a product, and we need someone to sell it. The logic behind the need for a medical science liaison team is less clear. The symptom of poorly-defined logic for why we need medical liaisons prevails today: medical liaisons are touring the dinner program circuit, medical liaisons are focusing primarily or only on sales support, medical liaisons are taking on the CRA (clinical research associate) role.

The fact that medical liaisons can do all these things well – or be trained to do these competently – is what makes creating a liaison team so alluring. I just think these are very expensive and inefficient means to achieve business objectives. Would you hire a team of engineers to design a car or to assemble it? I see many companies hiring medical liaisons to perform “car assembly” when a well-trained technician can do a stellar job. Here are the top three reasons why companies shouldn’t start a medical liaison team.

1. Everyone else is doing it
Some time ago, a news magazine did a segment on adolescent peer pressure. Peer acceptance in some adolescent circles is contingent upon designer clothing. Concerned parents are maxing out credit cards and enabling this behavior in the process. Since even fledgling companies have medical liaisons now, starting a medical liaison team must be right, right? If you keep doing what your competition is doing, you’ll always be one step behind, and the competition usually doesn’t have the right idea to begin with anyway. How do you know that the competition is not doing what it thinks YOU’RE doing? Peer pressure is a powerful influence, the price to pay can be very expensive, and the returns can be minimal.

2. Short term gain or “We need to make our numbers this quarter.”
Medical liaisons can appear to be a panacea for many ills, especially poorly trained sales representatives. Liaison teams sometimes enter cycles of promotional behavior and act primarily as sales support. Medical liaisons absolutely should generate business results for the organization, one of which is creating a capacity for appropriate drug utilization. This is distinct from product promotion, which falls into the realm of sales tactics. Some directors believe that the medical liaisons exist solely as a support function. I believe that medical liaisons have an independent function within a pharmaceutical organization, and can serve a secondary support function to sales and marketing. What this independent function is will depend on an organization’s strategic direction.

3. Maximizing sales with off-label use
There are executives who incorporate off-label product usage into sales projections. Some executives have installed medical liaison teams specifically to encourage off-label use of their companies’ drugs. There are sales representatives and sales managers who erroneously believe that medical liaisons are protected by safe harbor and can initiate off-label discussions. Promoting drugs for off-label use is illegal, no matter who is promoting it (reps, MSLs, company CEO). More importantly, companies frequently have not maximized the on-label utilization of their products before looking to a direction that generates more liability than dollars.

The best time to create a medical liaison team is when you know exactly where liaisons fit into your product’s brand-plan, what liaisons will contribute to the organization, and how this will affect your hiring choices.

Proper “care and feeding” of medical liaisons are independent from a product’s novelty status. Success with a medical liaison team can be built with a novel product or with a “me-too” brand. If a product is novel (enough), there is a need to discuss new mechanisms of actions or delivery systems. There is a widespread need for increasing awareness in the medical community. Novel products require scientific comprehension and competency to verbalize concepts, thus medical liaisons may naturally be the “educators of choice”.

Are medical liaisons less valuable for “me-too” products? No. In fact, liaisons are often most valuable in a “me-too” market. Very few sales representatives will have the opportunity or the capacity to discuss intricate molecular differences between “me-too” drugs. These differences account for nuances in efficacy, safety, and population-specific responses. These nuances can make a world of difference to patients who may respond poorly to one drug yet respond well to a “me-too” drug within the same class.

However your company chooses to deploy medical liaisons, you absolutely must communicate roles and expectations clearly to your liaisons. Companies often use medical liaisons as a means to a short-term end, and then wonder why they have problems retaining or attracting the best talent. Executives should only execute a strategy that involves medical science liaisons when resources are available to fuel both the plan and the development of their medical science liaisons. Otherwise, companies will continue to fan cynicism of their claims to develop their people, perpetuate confusion about the medical liaison role in their organizations, and disrupt their most important thought leader relationships.

Jane Chin