Pharma Sessions is hosted by Jonathan Kaskey
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Pharma Sessions is hosted by Jonathan Kaskey
Follow along on LinkedIn: https://www.linkedin.com/in/jonkaskey/
Or join the Pharma Sessions Substack:
www.pharmasessions.substack.com
Hello? Hello. I spoke with Eddie power, vice president, north America, medical affairs of the hospital business unit at Pfizer. And the focus of our conversation was digital. There's some gems in here talking about the double-edged sword as digital expands the universe, but also creates this world of unlimited options. Talk about information as value and how to think about different channels. And then we end with some practical advice for those who may be sitting in the MSL role or MSL management or even medical. Uh, directors. As always the views and opinions in this podcast are of Eddie and myself alone. And do not necessarily reflect the official policy or positions of Pfizer or my employer. Enjoy. So tell me what drew you to medical affairs? How did we get here? Well, I've always had a, a passion like for learning and for teaching and, and for communication. And I've always been fascinated by science and medicine. Um, and I always felt that there's, there was a gap between, you know, re really useful information, uh, and how that was communicated in a way. That different parties could understand it. Uh, you know, and, and it may not be the same type of communication, uh, you know, just depending on your stakeholder of a physician might be very different to a patient, might be very different to a caregiver. And always felt that that medical affairs was ideally positioned, you know, to bridge that gap between, you know, data rich, you know, and data heavy communications and somehow, Transform and synthesize that into bite size pieces of information, uh, you know, simple language that, that different stakeholders could understand. Mm-hmm. And it's something that I've always, that I've always been, uh, you know, been, been drawn to. I mean, you can have the best data from the. But if you can't communicate that in a manner that's understandable, uh, and and digestible, you might as well have no data at all. That's so interesting. So I listen to NPR every morning as I'm doing the dishes, and they often will have scientists come on talking about heady topics and. One of the biggest variables it seems between one, how much I understand it and how interesting it is, is the language they use. And I'm curious, is this something that is formally taught? Is it something that is now formally taught and wasn't? Or is this something that kind of comes through effort and through learned experience? I think it's a little bit of a mix of both. I mean, in medical schools these days, you know, there's this course around how to communicate with patients. Um, but I don't think it's taught formally within, say, a pharmaceutical industry mm-hmm. environment. I, you know, kinda learned the hard way, uh, when I first started in a faculty. Uh, and had to lecture these 300 medical and dental students on microbiology. And I walked in and, you know, was spewing out all these Latin names as Faria Coli, M R s A, right. Uh, and you know, very soon I tell the story. I saw the first paper airplane up here from the back of the lecture hall. and you know, within seconds the whole place was chaos. And, you know, went back and talked to my professor and said, you know, what's wrong? I said, I thought I had a brilliant, you know, set of slides of information. And he pointed out, he said, you know, most of them are interested in microbiology or infectious disease. You know, they want to be surgeons, they want to be dentists, they need to know enough mm-hmm. and how it applies to them and. They're planning to practice. And that kind of, you know, led me to self-reflect, right? And, and think, well how do I, how do I phrase this for them? How do I make it something that adds value to what they need to know on what they need to learn? Uh, and to this day, I keep a paper airplane on my desk, just to remind me that, you know, when we have information to communi. It needs to be relevant to the audience, right? And it's the audience in a way that determines what is relevant to them and what format it's relevant to them. It's so funny, I'm smiling because what the kind of the message of consumer focused perspective is something like I'm in the on the business development side, so I'm in the sales and marketing meetings all the time, and it's something that we're always talking about, which is like they don't care. How about your fancy widget? They just want to do what they need to do and it's just funny the similarities between that and what you're describing as you're training. You know, future health healthcare practitioners, it really is about delivering, make, delivering the point in the simplest terms that solve the need and cutting out a lot of extraneous stuff. Absolutely. Absolutely. Yeah. And it, and it may be a different, uh, message, right, or, or communication, just depending on, on the audience and what their interests. Yeah, so this is, I think, a great segue into what the, the bulk of our conversation, which will be today, which is kind of digital strategy and medical affairs. You know, we're currently recording this on January 18th, so I'd imagine there's a lot of medical affairs teams looking at revising their 2023 plans and. Digital. One of the benefits of it is you almost get that feedback of somebody throwing a paper airplane in your class, but it's not a paper airplane. It's, you look at your video and it's shut off after 10 seconds. Um, so I'm curious, what's your, we'll start at a high level and then maybe get a little specific, but what's your take on digital broadly and it's, it's sort of potential for medical affairs, uh, best practices, things to avoid, all, all of that. If you could start at a high. I think the, the biggest advantage opportunity that I, that I see for digital is that it, it expands, you know, the universe, um, of your audience and, you know, whereas in the past much was probably predicated on one-on-one interactions through, uh, medical science liaison or one to 10 interactions in an advisory board setting. Uh, you know, what digital affords us is, is this platform. Just to reach potentially every single, you know, healthcare professional, every single patient, every single caregiver mm-hmm. um, you know, in, in a manner that we have never had. You know, in the, in the past, and I, and I look at things like social media platforms and just, just the explosion mm-hmm. there of, of audiences, you know, followers, you know, whatever, whatever metric or measure, um, that, that you use. It's just a different order of magnitude, you know, compared to what we've experienced Right. In the not, not that distant past. Yeah. It's amazing. There's so much of it that is. Like mind blowing. But I saw at one point a chart of, you know, timeline to a million users and the telephone was like, you know, 50 years and TV was 40 years and Facebook was five years. And TikTok is like, you know, a couple, a couple weeks, right. Um, so absolutely. The, the scale is amazing, and I think that a lot of it, particularly if you're trying to reach some of these higher value audiences like HCPs, there's a little bit of a double-edged sword element to it where it's now you're, now you can go to anybody. So how do you look at, how do you prioritize who you're, you're? Talking to, and then as you were saying earlier, you know, you have different constituencies and even amongst doctors, right? There might be somebody who treats a different set of patients than, than another, or somebody who's more academic and somebody who's more of a community physicians. How do you go about, you know, looking at this massive universe and, and segmenting it and, and parsing out the message, uh, appropriate. ideally first you would start with a sense of how, uh, those different audience stakeholders would like to receive information. You know? Cause I, I think that that kind of gives you a, a, a baseline setting mm-hmm. and it won't be a, a a one size, you know, fits all. Yeah. Um, and you know, one of the pitfalls that I'm always, that very cognizant of and aware of is that, You shouldn't lead with the digital platform because it's, it's, you know, a novel approach or it's a novel technology. It's the information that really right, thrives the value, uh, for the, for the, for the listener, right, for the, for the reader. Um, If, if you don't get beyond the value of your information, you can have all the bells and whistles that you like, uh, but you won't have a captive, you won't have a captive audience. Um, but you know, if you start with that baseline, the, the way I think I think about it is, is if you can identify, you know, healthcare professionals, um, healthcare organizations, You know, that, that treat a certain number of patients, you know, you would probably focus your medical science liaisons, uh, on those individuals that treat the largest number of patients. Mm-hmm. because then you have, uh, I guess a more, uh, effective deployment of, of that resource, uh, with those healthcare professionals. Mm-hmm. you know, for the broader sways, uh, of healthcare professionals or patients or caregivers where. They may only be responsible for a handful of patients. Mm-hmm. then lightly the digital approach, uh, is, is more effective and more efficient. Mm-hmm. um, And you know, within those constructs though, there are different, there are different approaches. Mm-hmm. Mm-hmm. if you're doing an in-person or if you're doing a one-on-one, it could be in-person, it could be virtual. Mm-hmm. Um, it could be through a webcam or platform like we're talking today through Zoom. Mm-hmm. it could be old school technology like the. mm-hmm. Right. But the, the preference drives that interaction sim similarly with digital. Mm-hmm. you know, there, there's all sorts of, um, formats and channels. It could be Twitter, whereas's, just a really brief bite size piece of information that, that the audience wants to consume. It could be a more formal webinar that you access and sit through. It could be self-service where you have a number of materials that may be dynamic. Interactive, they may be infographic based, some may prefer just to download a good old scientific paper, you know, and, and read through that. Yeah. Um, and, and it's really just thinking of the, the, the broad, you know, swath mm-hmm. of formats and channels. Um, you know, that, that, that you can deploy and you don't have to do everything at. Right. You can always start, start with one, expand to two, go on to three. Uh, but you know, I, I think back, we, we've always had virtual interactions. We've had email, we've had phones. We. Had faxes, if people remember those we had, uh, beepers in hospital settings. Right? There are all forms of communication that are, that are virtual, but we kind of forget, uh, you know, because of the technology. Yeah. Uh, to me that is a hundred percent the approach, which is. As you said, the information is the value, right? It starts with your scientific platform and understanding what it is you're actually bringing, and then the channel and all of the digital intelligence, you're looking at two factors, which is, uh, like simplistically reach and effectiveness. Um, and. The, I think the, you know, as most people do, the MSLs go to the top treaters make sense. They're the most expensive and, and time consuming part of the organization. Um, but I think then the, some of the segmented messaging that you were talking about earlier, um, the. If you keep that mindset that you have of digital is, we're just talking about channels, right? It might be a fax, it might be a telephone Show me, which is gonna get me the most people and be the most effective at communicating my message and then make decisions from there. Um, so I think that what, what I've seen working for health. Care technology companies for, uh, I don't know, the last 15 or 20, 20 years now is a lot of times people get focused on the channel itself. That's right. And attracted to, oh, I need a mobile strategy, I need a social strategy. When it's, it's like what you need is a comprehensive strategy that covers both live and digital and optimize. Each part for what it's best at. Absolutely. Absolutely. Absolutely. So when you, as you're exploring this, and this is the other thing, right? We're now living in a post covid world where it used to be that in-person meetings were a reliable way that you could at least annually get in touch with most of the most important people you want to talk to. That's no longer the case. How have things changed over the past three or four years? I think for, for me, the, the, the biggest change is in, is in the way that we communicate data, or even even more basic than that, on, on how we think of data. Uh, you know, and, and it's, it's not only within pharma industry, but it's also within the, the healthcare community. You know, we, mm-hmm. were always used to, You know, PowerPoint presentations that were data heavy tables, you know, with reams of numbers and digits on them. Um, and that was kind of the standard. You know, what we've seen, I think, is a shift that I think still has to be fully embraced by, by the medical community that, you know, you can have a graphic or an infographic, or you can have a little video. Those, that those are still data that are being communicated. Mm-hmm. it's just not in the form of a table. Mm-hmm. you know, images can be more powerful sometimes than, than digits uh, or numbers, you know, we, we have examples of that in medical practice, like pain scales where they use Right. You know, facial expressions. Yeah. And. There, there's no reason why you can't adopt, you know, that kind of approach to data or how we think about data. Mm-hmm. and communicate. Right. Communicate accordingly. Have you played around, uh, at all with any of these new AI tools like the chat, G P T or any of this? Any of this, these type of things, even outside of the the pharma. I haven't tried chat G p T, but I, you know, I do, uh, teach for, uh, for a couple of colleges where it's a concern because chat G p t in particular right seems, seems to generate these essays that are very hard to distinguish from, from a human. It is. And I think there's a lot of focus right now on using it for content creation and some of the concerns about, you know, plagiarism and, and all of that. And even with the AI image generation, a lot of it, they're kind of like stealing images from other people and reskinning'em. But what I'm really interested in is using, is looking at those types of tools for decision making. Um, and I've been playing around, I, I am planning a trip with my family to Iceland this summer, and I was, Plan me a 10 day trip with no more than two hours of driving each day. Give me an activity every day and give me a good restaurant to eat in every, every night. The itinerary that it spit out is amazing, like it's, but I'm just really interested for when somebody hooks it up to. You know, IQ V I a data or, uh, data around, uh, academic publications. I feel like there's so much, um, there's so much just on the very near horizon about what can, where we can use these tools to assist decision making rather than the content it's itself, which I think is, has more to go before it can be created that. I think that that's absolutely right. You know, and I, I, I see, and I think we're still in infancy where we're using artificial intelligence or, you know, it's derived as machine learning, natural language processing. Yeah. You know, to begin to mine write that, that plethora of data that, that, that are out there. Yeah. Yep. Um, you know, one, one of the things I think where we've had to adapt, uh, as medical affairs in particular, was. With digital and social media is, is that the platform for healthcare professionals to articulate an opinion is much broader? Mm-hmm. you know, in the past you basically had a funnel that was called scientific publication, um, that was peer reviewed, um, and. You know, by, just by the nature of that process, the, the number of people who had a platform was small, right? Compared to the broader mm-hmm. healthcare community. But now, you know, you're moving to, um, you know, public platforms, online platforms where you can publish papers, you can have blogs, right? You can have opinions, uh, and, and. The scope or or breadth of the medical community that now voices that opinion is much broader. Yeah. And, and that's where I see the application of artificial intelligence, for example, in, in mining, like gathering, synthesizing all that information to give us a sense of. What insights, where trends, where trends moving? Um, because, uh, you know, I think what it starts beginning to do, uh, and for me, like in a medical affairs profession, it starts not only to predict where things are going. It starts you, you're not always reacting to the environment and producing information in a reactive basis. Now, now you begin to be able to predict, you know, where are trends going, what's of interest, what's topical? What do we see happening in the next three months? And then you can create that information, write of content in order, you know, to address those kind of future needs, which is a. See change in, in, in how we've typically approached, um, information sharing. Sure. And so thinking about it from an insights gathering perspective, which is a huge part of what Meta Affairs does, has that type of sort of social media monitoring or combination of. Various input monitoring advanced enough that that can be a standalone channel? Or do you think of it more as I'm using this to identify who my digital opinion leaders are, and then I'm gonna go talk to them, uh, in a virtual or a live way? Yeah, I think at the moment we're probably more in the latter. Mm-hmm. Right. Um, and, and it's more just identifying, you know, who those healthcare professionals. um, be beyond the digital opinion leaders, you know, with all, with all the data that we have. You mentioned like a q before, with claims, databases, you know, we, we can increasingly identify those healthcare professionals that are at the patient interface. And I'm managing patients directly and the majority of those have probably never spoken at a conference. Have never published. Right. Right. Have never been on a pharmaceutical advisory board. Mm-hmm. Uh, but yet they're the ones who probably have some of the most valuable insights, you know, relative to a more academic thought leader or, or, or digital opinion leader. And I think what it's afforded. As, as an industry as a whole is, is to really be able to be more strategic Yeah. You know, about whom we engage with and, and how, and how we, we engage with them. Um, and it, and it tends to be, I call it applied medical affairs. Where, where then you start beginning to identify, um, those healthcare professionals who influence a, a patient. Right. Or patient management. Um, you know, a prescriber's information needs may be very different to a pharmacist's information needs or a, a nurse's information needs. Right. Or a social worker's information needs. And when we think now of how integrated healthcare delivery is from the moment, a patient, for example, and as a hospital, then all the way through discharge and back to the primary care. It, it, it just gives us, I think, so, so much more insight as to where we see gaps and where we can add value, right? As, as a medical organization, uh, you know, to meet those gaps. I did a previous podcast with a woman named Amber Spear, who, uh, she was in charge of, I think, patient advocacy at Novartis for a while and is now at e Qrx. And she talked a lot about understanding the patient journey. Um, and it's really interesting when you think of that holistically, like there are a number of places that can go wrong for a patient where they don't end up getting the medication that they need, particularly I. I've done a lot of work with rare people in rare disease and it's like, that might be years of misdiagnosis before you get to something where there might actually be a be a treatment. Um, so that, I love the concept of, you know, in the past you essentially were reliant on who was publishing because that was your single source of. Who's at the leading edge of this stuff. Yes. And now it's very different. And having those conversations with all of those different constituents, it's just, it leads to an outcome that's kind of like, you're almost following the patient journey with who you're, who you're talking to. Almost I, that that's absolutely right. You know, and the other change, I think, John, that that's happened with that is, is that now we have the ability to, to, to really act on, on information that's much more real. Right. In the past with publications, there's a lag between submission and, and actual publication. So you were kind of six months behind. Yeah. The eight doors, so to speak. Um, same with the Congress. Even if it was data that was in progress, you were still relied on that fixed point in time where you could. See, write those, those data or that information. And now, you know, people post write on online journals without peer review or they communicate, like we were talking before with bot, with blogs or even within professional medical societies, you know, where they have, you know, the, the closed, um, systems and communicate by Twitter, for example, and discuss you. Treatment paradigms, you know, treatment, algorithms, patient pathways, and it, and it's all there, um, like now, right. I it's a, it's a very, it's a very different way I think of working and thinking. Yeah. Right. About, about how, how, how we communicate it. It's fascinating. And I was, there was a medical device company I was talking to who had a wearable, uh, temperature monitor essentially. And so, They're at the point where you don't even need to wait for the test to be ordered. If a, if it's post-surgery and a, a patient spikes a fever red flag, it's like the, the notice goes out digitally and action can happen literally right away. Um, and I, I don't wanna misquote their numbers, but it was a lot faster than, um, than than previous. Um, It's all of that. And that's particularly like everybody, all the doctors had to go to E H R, I don't know, five or 10, 10 years ago. So now there's, there's opinion data, but there's also data, data about, you know, I ordered this test and this was the result, and, and then I ordered this test. And that could, I feel like that is a, another natural kind of machine learning application, um, that could be plugged in. But let me, let me ask you a couple questions. This in the last time we have, we have left. We'll do two if you do an m Ms L first and then a medical director. But if you were an M S L today, January eight, 18th, 2023, what would you, how would you be thinking about digital and what would you be trying to incorporate in your day-to-day that would help you do your job better? Yeah. So I would start thinking, you know, very broadly about, about the, the opportunity, you know, to, to reach a far wider audience than, than before. And I think there's always gonna be a place for like your one-on-one interactions, I think, and one-on-one, uh, you know, re relationships, but, Stop thinking about the role more as, as facilitators. Mm-hmm. uh, of, of information and where information can be found that adds value to the audience rather than perhaps a more traditional, uh, you know, push model of communication where, You know, you had your fixed set of approved slides Yeah. And you interacted with, with somebody or with a group, and you delivered that information regardless of whether they wanted all of that information or not. And I, I think now there's such a wide opportunity where you can be a facilitator and say, Hey look, I can reach out and I've got this information that's on our website, or, you know, we've got this, this medical Twitter handle that you can follow. And we put out information we're offering these webinars. Um, you know, and, and to my mind it's more, it's more neighbor in a. You know, to, to really cast a wide net. And it may not all necessarily be one-on-one, which is fine. Uh, because there will be a number of healthcare professionals who want more of a transactional relationship. I need this information and where can I find it? Right? Um, I want to do it self-service. You can, you know, direct and that channel right towards that particular healthcare professional. Some may say. I'm gonna go and look at it, and then if I have any questions, I may want to call you back. And, you know, it, it, it's a little bit of a change. I think it's a behavioral change. Mm-hmm. As well. Um, you know, I'm sure that, that there may be concern, right? Or anxiety in certain parts of the broader M S L community where they may be thinking, you know, I'm gonna be undervalued relative to. What I did in the past, but I kind of see the other way, right? It's so I can actually add more value now than, than I could in the past. So if you're an MSL leader, what kind of hurdles do you need to remove so that teams can operate with flexibility? I'm thinking from a compliance standpoint and, and what they're allowed to say and do. Yeah. So I, again, would, would move more towards the, the value proposition and, and try and lead it from what the medical community or the patient community, you know, it, you know, it is looking for, uh, it, it does mean a change, I think in the way, uh, that compliance and legal have thought about. you know, fair balance, um, you know, a and so forth. Um, but I think in, in today's day and age, that's where the Ms. L leader, I think, needs to really put that holistic picture. Mm-hmm. You know? Mm-hmm. perspective. Uh, and, and it's more of a, a modular right, or a bite size approach in terms of communicating information rather than a static. PowerPoint presentation that, that we used in, in the past. Now, you know, and we're seeing, I think some companies are beginning to embrace that more readily. Mm-hmm. I think, than others. Uh, you know, willing, willing to take more a thoughtful risk. Mm-hmm. uh, you know, in, in compliance terms, you know, but at the end of the day, you know, if there's, if there's a real unmet medical need, I think, I think morally and ethically as medical professionals, that that should be the, the, the guiding star. Right? And, and I always think, you know, there's probably areas where, uh, you can take your first steps a little bit more simply. For example, disease, state, therapeutic area. Without necess, without necessarily getting into any kind of product. Right. Details, right. Where more of that compliance risk or concern may arise. Um, you know, and then it becomes a, a little bit of a iterative process and you know, where, where that appetite for, for risk. Uh, six, it's, it's pretty interesting. I think over the last five years I worked. I don't know, 15 of the top 20 pharma companies and, uh, 20 or 30 different biotechs, and at least amongst the top 20, every time you have a compliance conversation, it starts out by them saying, I know everybody's conservative, but we're the most conservative and not everybody's right. Uh, there are two that I'll tell you about offline that, that are right. Um, but what's fa, what's fascinating to me about that is. There is, there are the rules and the guidance, and then there are the interpretation of, of the guidance from somebody's internal legal group, which may actually differ from oncology to, I don't know, immunology, depending. That's right. Who's looking at it. So making that strong, uh, case as to why this approach is worth any incremental risk. Um, to me it seems to be the way that people have been able to like to, to. Incremental change. Um, there, let me ask you the same, same question, um, but from a medical, you can take off your MSL hat, put on your medical director hat. I know this is essentially the gist of what we've talked about, but. If you're, if you're a medical director, how would you be thinking, what would be the thing that you would think about differently now than you did say this time last year, or this time, three years ago? As it, as it relates to digital engagement? I, I think the, the, the first would be, uh, around, around priority and, and focus. You know, I, I think medical professionals, both within pharma and and outside pharma, right. Always want to communicate everything. Yes. They know. Right? And it's, it's sometimes been a, a data dump or, or a knowledge dump. Um, and I think we're increasingly comfortable about saying, you know, here's the one or two key points that I, that I want to communi. I forget all the rest. You know, if I, if I really have something to communicate in five minutes, in 10 minutes, even less, right? Some of the attention spent for some videos is something like, two minutes. What am I gonna focus on that? I believe that's the most value, and I think that's been the biggest change. You don't have to share everything you know about a particular medicine or a particular device. With everybody, right. Every time, uh, you know, you, you can be selective, you can be more strategic, you can prioritize your audience, and those one or two key points might be different. Right. And, and it's also getting comfortable in not having to show a table of data. Mm-hmm. you know, it could be a dynamic visualization. Right. That just, just communicates that particular fact. Um, you know, and, and it, it obviously needs to, there needs to be some kind of trust for that to work, but I think, I think by and largely the broader medical communities, Mo is moving that way. I love that. I feel like it's full circle to the lessons you learned at the beginning when people were throwing paper airplanes, That's right. That's, that's right. In class. So, Eddie, I appreciate your time and, and let's leave it there. That's great, John. Thank you. Appreciate it. All right.