Key Account Managers (KAMs) and Medical Science Liaisons (MSLs): The present and future of Pharma.

First, let’s look at WHY we think Key Account Managers (KAM) and Medical Science Liaisons (MSL) are critical to the success in Pharma (Healthcare industry)? 

Both these functions have been around for many years in Pharma.  That’s not news.  Like many other roles, the two have significantly evolved, and now need to be an even more significant part of the key strategies for development.  There are a number of reasons for this.  But before we get there, it is important to recognize that Pharma is a business and as such, strategies should always aim to optimal profitability while prioritizing the benefits to patients.  After all, patient centricity has been at the heart of Pharma’s efforts for many years.

KAMs, depending on their scope from one company to the other, are able to conduct the orchestra of stakeholders for the benefit of HCPs.  There are many versions of KAMs.  In this short article (and the following), we define KAMs as individuals that are responsible to identify customer’s needs in a wide variety of areas, help  develop solutions to meet those needs, and orchestrate the work of a number of stakeholders for the solutions to materialize.   The projects KAM manage or help create are often innovative, unique or essential to the advancement of the whole business model.  Very often, initiatives are not directly targeting prescription, or advocacy, or immediately measurable returns for all stakeholders.  Rather, they bring perspective, options and actions that foster an environment for better care, or effort allocation.  As an example, KAMs have led initiatives to better standardize the evaluation of people suffering from depression, increase the precision of the diagnosis and better orient treatment choices.  The initiative was created in concert with HCPs and eventually, led by the HCPs.  KAMs simply facilitated the discussions and brought resources together.  They are project managers and, hopefully, concentrate their actions where both industry and HCPs gain, for the ultimate benefit of patients.  We will explain WHY they are critical.

MSLs are scientific and clinical experts.  They are often physicians, nurses, pharmacists and PhDs.  Because of their formal training and role, they are able to discuss clinical aspects that commercial teams cannot, or will not.  MSLs also have the specific role to review the mountain of data in given clinical areas.  In oncology for example, some of the MSLs I know are so globally knowledgeable that HCPs count them as a part of their team, their brain power.  While it may be argued that MSLs may not always be neutral in their perspective, after all they do work for Pharma or Medical Devices companies, their training, and often their oaths to their profession (MDs, PharmDs, PhDs, etc.) more often than not counter the possibility to stray to unreasonable levels of partiality.  Not reporting to commercial groups and not receiving commercial incentives also help.  Yet, MSLs are able to guide HCPs in directions that better serve patients. 

So WHY are those two function so critical?

Both KAMs and MSLs have the ability and respectability to influence HCPs in optimal directions.  As I look back at the Principles for Persuasion by Cialdini, KAMs and MSLs can more easily (than others) leverage each of the principles.  Because of their superior knowledge they have Authority.  Their ability to relate and remain balanced in their approach makes then Likeable and inspire Reciprocity.  The capacity for KAMs and MSLs to be Consistent and bring fair perspective help their influence on Social Proof (people follow the lead of similar others).  Finally, when they are highly competent, and because there are far less of them at that level, they appeal to Scarcity (people want more of what they can have less of).  

KAMs and MSLs are able to generate more value for HCPs.  Commercial teams also have that ability, but they are significantly limited because of numerous factors.  KAMs can create solutions that go far beyond the treatment of single individuals and the “traditional” process.  The example I gave earlier with depression illustrates this.  KAMs can work on projects that help large clinics or treatment groups be more effective.  In the case of diabetes, projects have gathered a number of specialties to truly optimize the treatment approach and disease management.  This has produced significant cost savings for all stakeholders.  Helping HCPs make better choices will likely contribute to the profitability of project sponsors.   But this will not come via a distorted view of treatment options.  It will hopefully be generated by a rational approach, ensuring that the best option is selected for the right patient.  Think of the current opioid crisis.  Most of those drugs are necessary for patients that need pain management.  It can be argued that a part of the crisis is the result of incomplete understanding of pain management, and possibly an approach that did not involve a sufficient number of specialties.  While some companies have greatly benefited financially, the end result is extremely detrimental to reputations, credibility, HCPs that aim to do the right thing, patients and society in general.  KAMs can contribute to projects for which profitability will likely be established on actual best practices and ensure the viability of efforts.  As products are used more rationally, the results will improve for all stakeholders.   Increase in fairness, better results and fewer negative impacts will likely generate more synergy between stakeholders as opposed to acrimony and suspicion.  That is in part, WHY KAMs are a critical part of the future.

MSLs are able to put in perspective the mountain of data available.  They can speak to the present as well as the future.  Their interactions with leaders in their fields (clinicians, scientists, developers), and the fact that understanding data and trends is their main role, makes them moderators.  As such, they are able to calm down certain undue cravings for unruly usage of the new and improved.  MSLs have foreseen the opioid crisis.  MSLs are therefore better equipped to highlight dangerous paths and promote a balanced usage of all the worthy solutions.  Because of their credibility and balanced approach, MSLs have the ability to address situations in a manner that will bring a more universally advantageous approach to treating patients.  Just like KAMs, in their own way, MSLs can produce an increase in fairness, better results and fewer negative impacts to generate more synergy between stakeholders as opposed to acrimony and suspicion.  That is in part, WHY MSLs are a critical part of the future.

I mentioned Cialdini earlier.  Let me link his principles of persuasion to the intrinsic value of KAMs and MSLs in Pharma.  At the moment, some of the most acute problems faced by Pharma and Medical Devices companies are access to their customers, credibility, the perception of value (other than a treatment of quality), the impression that they don’t truly contribute to the overall healthcare environment (product focus instead of health focus), and the conviction that all that counts is industry progress as opposed to the development of the complete environment.  While it is not universal or unanimous, HCPs may see the industry as a taker rather than a contributor.  That’s where KAMs and MSLs contribute to change that reality.

Access.  While it has been advocated for years now that sales representatives need to “up their game” and bring more global knowledge and skills to their customers, regulations can significantly limit their ability to use such capabilities.  However one feels about the changes implemented in Pharma’s commercial practices, there have been both positive and negative impacts associated to new rules of engagement.  When we amalgamate those limitations to a persistently volatile perception of their value, the potential positive impact that teams can have, often remains torpedoed compared to their true capabilities.  This directly impacts access.

When time is precious, we tend to choose with more discernment where we invest it.  In most cases, HCPs will choose to invest where there is a potential return.  This is WHY KAMs and MSLs have more attraction and increased access.

Credibility.  Not directly promoting any specific product, in spite of being employed by a corporation, contributes to the credibility of KAMs and MSLs.  With the incredible amount of information available to HCPs, it is particularly critical to decipher the wheat from the chaff.  KAMs and MSLs both have that capability, which turns into an advantage.  Credibility breeds confidence which in turn, promotes loyalty.  Loyal customers are critical to profitability.  This explains WHY KAMs and MSLs need to be more strategically integrated.

Value. KAMs and MSLs bring ideas and perspectives contributing to the evolution of HCPs.  As such, they help enhance the reputation, productivity, precision of treatment, time management and resource allocation of HCPs.  It is rather easy to translate any of this into added value.  When someone has value to us, we tend to treat them well, and we care for their perspective.

Contribution.  As mentioned earlier, KAMs and MSLs are often able to become partners or consultants for HCPs. Projects such as the one I briefly mentioned with depression, help HCPs enhance their ability to perform at a higher level.   KAMs and MSLs that are able to contribute to HCPs’ scope gain significant impact.  Another reason WHY they are critical.

Progress.  Let’s face it, with the amount of new data generated these days, it is almost impossible as an individual or a specialized group to fully integrate what is available.  Humans are notorious for finding a level of comfort in their daily activities and cruise.  KAMs and MSLs will help HCPs shake their habits, inspire them to dare new avenues.  The generated progress will benefit the therapeutic areas and patients.  Who doesn’t want to be a part of that?

 Hopefully, this has provided an illustration for WHY KAMs and MSLs are so critical for the future of Healthcare efforts.  The next article in this series will address HOW to best integrate and develop KAMs and MSLs in the industry.

But wait.  As much as this text supports the continued development of KAMs and MSLs, bestowing upon them a strategic importance, it should also be an indicator for the orientation of commercial teams in the Healthcare industry.  Commercial teams can still play a strategic role and remain of critical value.  Knowledgeable individuals that are not solely dominated by their personal performance or metrics, that care about a balanced approach supported by evidence, and working to look at possibilities and valid options are arguably the most profitable sales people imaginable.

For a few immediate ideas on the HOW, please visit