Reflecting on the past 21 years in the pharmaceutical industry

By Dr David Williams

In June this year, I passed a milestone. No, not a wedding anniversary or a special birthday (although I should probably make a note of those). For me, June marked my 21st year in the pharmaceutical industry. For a lot of us ‘21’ means a party. A ‘key to the door’. The symbolism of a key conjures up the notion of a rite of passage, the opportunity to unlock the future and take a step towards independence. But what does this rite of passage mean for the world of Medical Affairs?

Pharma doesn’t get out of bed for less than $2 billion

When I first joined the industry as a medical advisor, blockbuster mentality reigned supreme with big budgets and lavish hospitality in abundance. Marketing and sales teams ruled the conversation and sales frequency was king. But what of the science and Medical Affairs departments? They were usually buried under a mountain of paperwork, tangled in the contorted language of the ABPI code, with Medical Science Liaisons often found having conversations with marketing managers about why something couldn’t be said, why the weight of available evidence did not support whatever message was being pushed.

In those days, the sales representative was the conduit to the customer and payer focus was limited and ineffectual. Selling was seen as the only way to achieve commercial goals, with call rate being all-important. Twenty-one years ago, no one had heard of Market Access or Health Technology Assessments, and the thought of medical teams out in the field was a completely alien one. Some outdated notions have persisted for years, with countless organisations, especially in the US, abiding by the mantra that success is achieved through call rate and frequency, a mindset still present 21 years on!

Following the science; the future of Medical Affairs

One of the lessons we painfully learned during the pandemic was the importance of following the science. This concept was understood far too late by our politicians. It is by following the science that better decisions are made in public health and it is the same in medicine. The organisations that practice patient-focused, evidence-based principles generate better outcomes, which is better for patients and society.

So as Medical Affairs becomes a strategic partner with other company departments, what is the future?

For Medical Affairs to prosper, and become more impactful, there needs to be understanding of the science and marriage of that science with skills such as planning, project management and budgeting. More importantly, Medical Affairs teams need to understand that by getting closer to both the healthcare practitioner (HCP) and the patient they can gather more information and match their science with the needs and wants of these key stakeholders, thus becoming customer-centric.

Whether through physical face-to-face interactions or virtual meetings, modern Medical Affairs teams must communicate with the right people, at the right time, with the right messaging. Medical Affairs teams should wave goodbye to the still prevailing call frequency mindset, and embrace the opportunities offered to them through a Scientific Relationship Management™ (SRM™) system which allows teams to have meaningful conversations with the appropriate HCPs and gather real-time insights about the science and practice.

The industry has tried and failed to effectively use customer relationship marketing within its sales team functions, often pushing out impersonal sales messages to the masses. What we all need to appreciate is that in the modern healthcare system, payors and physicians have much more control and need to be truly convinced that the solution you have developed will make a tangible difference to patient outcomes, making each interaction so much more valuable.

The solution

The solution is knowledge. And according to IBM, with the expansion of the 'Internet of Things', the doubling of knowledge now occurs every 12 hours.1

Looking at that in context, in 1900 human knowledge doubled approximately every 100 years. By the end of 1945, the rate was every 25 years. The 'Knowledge Doubling Curve', as it's commonly known, was created by Buckminster Fuller in 1981.2

What is clear now is that as medical knowledge grows, and guidelines and patient empowerment become more widespread, Medical Affairs teams need to understand the scientific environment fully before progressing with their interactions. By gathering the scientific evidence and being fully informed, the team can lay the foundation of trust and belief. The more knowledgeable the team is, the more capable they are of having meaningful conversations with HCPs. It is this demonstration of science, with analytical approaches and real-time knowledge, that is the biggest differentiator for Medical Affairs teams.

Discover the latest science in your therapy area and patient needs. Define the key opinion leaders and HCPs. Understand their individual specialisms and how they like to be contacted. And build all that into an SRM™ platform. Better still, use one that allows insights to be shared across the organisation for the wider benefit of all.

Although everything feels like it has been turned on its head over the last year, the fundamentals of healthcare have not changed. The patient remains at the centre of it all. We need to empower HCPs with the most up-to-date knowledge, in a way most comfortable for them, to allow them to make better decisions for their patients. We should never forget our traditions, but we must also move on to embrace science and relationships in a new way.


  1. Chamberlain P. Design for Health 2020;4:org/10.1080/24735132.2020.1731203.
  2. Fuller R1981. Critical Path. New York: St. Martin’s Press.
Blog author(s)

Dr David Williams

Chief Medical Officer