Environment Transformation: The Power of Medical Affairs in Non-Traditional Stakeholder Engagements

Executive Insight facilitated a workshop titled “Environment Transformation: The Power of Medical Affairs in Non-Traditional Stakeholder Engagements” at the Medical Affairs Professional Society (MAPS) EMEA 2023 meeting on May 15^th in Lisbon. We share our key learnings and takeaways from the workshop.

1.    Environment Transformation: The power of Medical Affairs in non-traditional stakeholder engagements

The complexity of the interaction between patients and the healthcare system results in several direct and indirect treatment access barriers. Understanding the landscape and co-creating solutions to ease access barriers throughout the entire product lifecycle is now recognized as a key strategic component for commercial success. Specifically, the environment transformation approach brings together a broad stakeholder profile in a strategic co-creation partnership aiming to holistically optimize the care environment, and thus improve patient outcomes and deliver value-based care. 

Medical Affairs is perfectly positioned to help bridge engagement gaps between the pharmaceutical industry and non-traditional stakeholders incl. patients and payers. To empower Medical Affairs professionals in bridging these gaps, our workshop provided tangibles examples and a platform to brainstorm ideas to enhance non-traditional stakeholder engagements driven by Medical Affairs.

2.    Current situation: Non-traditional stakeholder engagements via Medical Affairs 

Fig. 1: Non-traditional stakeholder engagement via Medical Affairs professionals

We conducted a live attendee poll for Medical Affairs professionals to share their current level of engagement efforts with non-traditional stakeholders and associated challenges within their organizations (Fig 1). 

The poll showed that most patient engagement is currently limited to ‘isolated efforts’ (N=10). Whilst payer engagement is much more varied across organizations, most participants reported ‘regular effort’ (N=6) to ‘strategic priority’ (N=7). 

The top 3 challenges were firstly, limited workforce capabilities and resources to collaborate with cross-functional partners (44% of responses). Secondly, internal strategic misalignment on prioritized objectives is challenging (28% of responses). Thirdly, compliance issues and constraints from legal frameworks were commonly mentioned.

3.    Case studies: Successful cross-functional collaboration in non-traditional stakeholder engagements  

Invited Patient Affairs and Market Access industry professionals shared case studies of successful non-traditional stakeholder engagements in collaboration with Medical Affairs. We share our reflections and examples from the workshop. 

Patient engagement

• There is an increasing awareness of the value that patients provide starting from early R&D to regulatory and HTA processes. Patients have a unique perspective, given that they are experts of their own condition and the end user of pharma products
• Patient organizations expect a professional approach and collaboration when working with industry. Thus, there is a need for open and transparent partnerships with patient organizations, through the right capabilities and frameworks
• The pharmaceutical industry needs to invest in continuous capability building, following the latest developments and industry standards
• Medical Affairs, in collaboration with, or in the absence of Patient Affairs, is ideally positioned to compliantly collaborate with patient organizations

Payer engagement

• Leqvio (inclisiran), an innovative cholesterol drug, was made available to eligible patients through a population health management agreement between Novartis and the UK’s NHS – a deal that simultaneously addressed key cross-stakeholder needs incl. high-risk patient access, large-scale prevention trial, and a local manufacturing consortium
• Stakeholder collaboration was an essential part of achieving the deal. The underlying success factors for the engagement were identifying common grounds, breaking down the co-creation process into smaller steps, and iterating the action plan by listening to others first 

Employer engagement

• The identification of the right non-traditional stakeholder, which can help overcome patient access barriers, may not always be immediately obvious – as showcased by the success of the complimentary Migraine Care program available to Novartis’ employees in Switzerland
• Employers are increasingly becoming a key player when it comes to reimbursement in the private market by offering employee treatment and care support for chronic conditions with a high disease burden
• Doing things differently will inevitably come with internal and external pushback –building resilience to the initial, automatic “no” is essential in bringing a good idea to life and can pay off by significantly improving patient outcomes

4.    Workshop outcomes: Key recommendations for non-traditional stakeholder engagements

The identified engagement challenges (described in Fig 1) are highly interconnected. Successful engagements, as demonstrated by the case studies, can help overcome some challenges by focussing on what can be controlled by the team directly. We summarised the workshop discussion into 3 key recommendations (Fig 2).

Fig. 2: Key recommendations for Medical Affairs professionals

Our first recommendation is to address limitations in workforce capabilities and resources by embracing a beginner’s mind. Recognising that innovation is characterized by the unknown, helps to acknowledge the discomfort that different stakeholders may experience venturing into unfamiliar spaces. Although building relevant capabilities and securing internal resources is a key component in scaling approaches, for most of us it is out of our immediate control and may not be relevant during the “exploration and learning” phase. An open, flexible, and creative mindset is the driver – so embrace beginner’s mind and face the unknown!  

Secondly, we recommend to not take no for an answer when it comes to internal misalignment and pushback. Pitching a new idea takes courage, especially one that it is out of the norm. Taking the opportunity to truly understand the reasons behind an initial “no” will shed light on ways to improve and iterate the project goals and plan of action accordingly. Simultaneously, listening to and acting upon raised concerns will enable an open dialogue and understanding between everyone involved, leading the path towards cross-functional alignment, and securing buy-in.

Lastly, to address internal and external knowledge gaps, as well as siloed working, our recommendation is to invest early into stakeholder relationships. Building collaborative stakeholder partnerships that bring mutual value will take time – identifying key players, understanding their needs, developing the communication and ways of working will help set the right foundations. Good ideas are also always less obvious. Therefore, breaking down the engagement into small steps and leaving room for reflection, will pay off in the longer term.