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Field-Based Medical Programs and Medical Thought Leader Advocacy Service Offerings List Scientific Commercialization LLC's Position Statement and Value Proposition Regarding Field-Based Medical Programs and Medical Thought Leader Advocacy Scientific Commercialization LLC is dedicated to providing expert consulting services that will allow field-based medical programs to optimize the planning, execution, and evaluation of their business. This includes working with our customers to help define, build, and enable a Medical Science Liaison team. The principles that Scientific Commercialization LLC applies to these tasks are transparent, credible and valid, allowing the data to be communicated and utilized within the team as well as with key stakeholders in our customer's organization. SCIENTIFIC COMMERCIALIZATION LLC POINT OF VIEW ON FIELD-BASED MEDICAL PROGRAMS The genesis of field-based medical programs was the result of pioneering work at Upjohn in the late 1960's. Although different companies assign different job titles to these roles, they are generally regarded as liaisons between the company and important academic and practicing thought leaders. Approximately half of the industry's field-based medical teams have a reporting structure within Medical Affairs and the other half within Commercial. In general, the groups reporting within Medical Affairs have strong, sometimes formal, linkages with Commercial. The majority of field-based medical scientists have advanced academic training and professional experience in a scientific discipline. The core activities of the field-based medical scientist are geared toward achieving the 'gold standard' peer-level relationship with thought leaders. These activities include knowledge exchange around complex scientific issues, clinical trial support, research support, presentation support and many others. The most effective and well-regarded field-based medical programs have acquired the competence to leverage these relationships to support the products, therapeutic areas and disease states that are corporate priorities. In addition to their activities with external customers, the field-based medical scientist has significant responsibilities within the company. These vary from active participation in the development and registration process to training local sales representatives on disease state, therapeutic area and product knowledge. They may also be engaged in the business and account planning processes. As field-based medical programs continue to evolve and the perceived value of field-based medical scientist activities increase, a significant capacity problem begins to emerge. There are simply not enough field-based medical scientists available in the right location, trained to the highest level, and with the necessary product life cycle expertise to manage all of the demands from key stakeholders (both external and internal). This breadth of perceived value, while admirable, eventually leads to the situation where the ad-hoc workload interferes with their ability to effectively maintain and leverage the desired peer-level relationships. Today there are nearly 3,000 field-based medical scientists working within the biopharmaceutical and pharmaceutical sectors. Over the past 5 years the popularity of these programs has markedly increased. This popularity is evidenced by the number of companies initiating these programs increasing by more than 50% and existing programs expanding their teams by >80%. This growth is due to the perceived value of these groups within their company as described above and the convergence of the following trends in the pharmaceutical industry: decreasing access to physicians and an increasing need to stay abreast of current therapeutic advances. Currently there exists unsustainable growth of sales representatives. The number of pharmaceutical sales representatives has grown from approximately 36,000 to 80,000 over the past five years. Pharmaceutical companies are spending approximately $22 billion per annum on traditional detailing. Physicians (both thought leader and practitioner) are allowing less time for meeting with pharmaceutical representatives. Nearly 50% of physicians have decreased the number of representatives they see and reduced the time allowed for each interaction. Physicians are also requiring that the time they do spend with a representative have significantly greater knowledge transfer than was previously expected. The result is significantly more representatives competing for a continually shrinking amount of time with key physicians. As for the representatives who gain access, many are not prepared to engage in meaningful knowledge exchange. The field-based medical scientist is one potential solution to this growing problem. The perceived value of these groups by thought leaders has been well publicized within the academic community and to key commercial and development leaders within the pharmaceutical industry. These individuals clearly have the scientific knowledge that thought leader physicians and practitioners desire. The interaction time between the field-based medical scientist and thought leader physicians is on the order of minutes to hours rather than seconds to minutes for sales representatives. It has been documented that the duration of the interaction is a better predictor of impact than simply the frequency of interaction. The ability to gain access and engage in meaningful knowledge exchange is essential to achieving the 'gold standard' peer-level relationship. In order to create and maintain the high level of scientific knowledge and business acumen that enables the field-based medical scientist to create and leverage peer-level relationships with medical thought leaders, industry-leading teams have dedicated both significant human and financial resources to training and development. Indeed, one leading program has dedicated more than $2 million per annum solely to the training and development of field-based medical scientists. Once trained and deployed there is a critical need for business measurement of these teams. Business measurement of field-based medical science liaison programs has been largely neglected since the inception of the field-based medical scientist role within the pharmaceutical industry. Historically the value of field-based medical programs has been based upon testimonials from medical thought leaders and corporate stakeholders. While these testimonials are a critical input to the measurement of field-based medical scientist value, they are subjective and potentially more influenced by personal bias than is desirable. In addition, subjective testimonials work well in times of corporate growth and prosperity but are often the first data set dismissed when companies are resource constrained. Over the past several years, field-based medical programs have come under increasing pressure from various stakeholders to define their value in more objective terms. This trend will certainly affect the emerging groups as well. There is a need for the development and implementation of objective, transparent and valid methods that allow quantification of the value that can be achieved as a result of the activities conducted by these groups. The data from these analyses can be used in many ways ranging from quantifying the specific return on the financial investment of the group to the ability of senior management to make more informed resource allocation decisions. These data are also a critical input to prospectively plan the activities of the team and to select the most important medical thought leaders with which to interact. In the final analysis, field-based medical programs urgently need to address two critical questions: What is the optimum number of field-based medical scientists for their individual organization? How do they translate the perceived value of their team into objective performance measures where the return on investment can be appropriately measured? THOUGHT LEADER ADVOCACY Thought leader advocacy is critical to the success of any product. The appropriate segmentation of advocates and effective alignment of their individual areas of influence, coupled with the development of a cadre of physicians at differing impact levels, produce an advocacy continuum that will contribute to maximizing brand performance. Thought leaders provide unique and valuable insight into unmet medical need, disease state treatment trends, competitive market intelligence, and competitive clinical trial intelligence. Indeed, recent benchmarking studies indicate that thought leader development is one of the most critical success factors that distinguish successful product launches from the average launch. Optimal use of the thought leaders' knowledge requires that they be engaged as early as the pre-clinical phase and continue to be engaged through to product launch and beyond. This puts the thought leader in a position to help optimize the initial indications, product positioning, clinical trial enrollment, publication and presentation of data, and ultimately the commercial awareness and uptake of the product. In order to build an effective advocacy structure, it is critical to segment physicians by the level of influence they can exert on their peers. There are five basic segments: advisors, national advocates, regional advocates, local advocates and prescribers. The main objective of the advocacy pyramid is to drive the first and second tier advocates on a national level to convince the other specialists (influence network) to use and gain experience (and in most cases product satisfaction) our customers' product(s) while using the third tier regional advisors to help identify and mold local specialists to help build the market by educating primary care physicians and other healthcare practitioners about the disease and the benefits of therapy. The advocacy process should be dynamic in nature with the intent being to identify effective advocates and drive them to expand their exposure. Due to the importance of optimally identifying, developing, and leveraging advocates and thought leaders, many companies are turning to a dedicated internal resource (i.e. Medical Science Liaison). In addition to aiding in the identification process, these liaisons work together with the headquarters-based medical and marketing personnel to prepare the advisors/advocates for their participation at the various meetings, work with them when attending meetings, debrief them after the meeting, and maintain the awareness and excitement of the product/company with the advisors between meetings. This activity ensures that the advisors/advocates are actively engaged with all aspects of the product's development and commercialization. The liaison also acts as a critical point of contact for communication between the advisors/advocates and the company. The liaison can triage the numerous requests from the various departments within the company (e.g. public affairs, marketing, professional relations etc.) in order to optimally utilize the advisors/advocates time on behalf of the company. SCIENTIFIC COMMERCIALIZATION LLC'S VALUE PROPOSITION Scientific Commercialization LLC possesses the most experienced and knowledgeable professionals in the global pharmaceutical industry regarding Field-Based Medical Programs. The partners of Scientific Commercialization LLC have proven track records in establishing and operating successful Field-Based Medical Programs. Establishing a dedicated Medical Science Liaison Organization within our customers' organizations:
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