Operating at the speed of science: The new medical affairs playbook (Sponsored)

Introduction to Zayden

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Medical Affairs Challenges

0:53You're listening to a sponsored episode of The Top Line. You're listening to Top Line, brought to you by Fierce Pharma. I'm your host, Irina Lowell. Today's episode is sponsored by ZS. Medical Affairs is being asked to operate at a speed the ecosystem has never demanded before. The science is moving faster, HCPs are more informed than ever,

1:25and the bar for demonstrating real impact on clinical practice has never been higher. In today's conversation, we're going to be talking about a new medical affairs playbook and what that actually looks like. Joining me for this conversation are two guests. Josh Jay-Z Schwartz, who is currently the Vice President of North America Medical Affairs at B1 Medicine. Jay-Z has spent his career leading medical affairs through launches and field build-outs at large and gross stage companies.

1:58And Joppa Shah, a leader in the medical and evidence practice at ZS. Welcome both. Thanks for joining me today. Hello. Thanks for having us. So Jay-Z, when we're looking at this environment today, what feels fundamentally different about the role of medical affairs now versus even a few years ago? So I would say it's two things. One is the pace of the science. It's just moving faster and faster. And because of the pace of the science, it's really made medical affairs even more of a core business driver.

2:28When it's done well, medical affairs is the scientific voice of the company and the face of the company to the medical community. When you have the science moving that fast and then medical affairs, it makes it become a core business driver. And that's really, medical affairs kind of sits in between commercialization and R&D. And companies are starting to see medical affairs because of the pace of the science really becoming an important factor and more so probably than even a few years ago. And in your experience, how effectively does medical affairs demonstrate its value

3:01and what could be done differently? Yeah, so that's sort of an age-old problem. Medical affairs has this issue where you can't tie its success or benefits to sales or revenue. So you really have to sort of find surrogates for value. And, you know, I think we're getting better at that, but it's still not perfect. And one way is, you know, showing how medical interactions increase the pace of the clinical trials process and how they can actually increase

3:33how fast clinical trials not only get up and running, but enroll and read out data. And then the second is, you know, how you can show high-quality medical interactions, you know, equate to improving the success of the launches of drugs and the commercialization process. And Jalpa, you work across a range of pharma organizations to really address this. What are you seeing as the biggest challenges that's stopping medical affairs

Operating Model Shift

3:59from making that shift? Yeah, the biggest challenge is not a lack of data. It's really the assumption that more data is automatically going to lead to better decisions. So in reality, what we see across most organizations are three challenges. One is that they have fragmented ecosystems of data where insights are sitting across multiple different places, right? They sit across MSL notes, publications, your CRM systems, Congress coverage. The second challenge

4:31is the lack of visibility that goes back to the field. So you get all these insights from the field, but it's really coming out back to the field as direction. And the third is this non-linear nature of practice change for medical. Clinical behavior, it doesn't shift in a straight line. So this understanding that, you know, you're not going to expect change as you would do an activity and it would lead to change. So just this defaults organizations to start to measure activity rather than impact.

5:03And what we're seeing done differently by organizations that are leading in this area is they're making the shift to connect all these internal insights with external scientific and practice signals, like linking your MSL insights to shifts that are happening in physician understanding or confidence or, you know, what evidence gaps remain, or things like tracking the changes in diagnostic approaches, referral patterns, or testing behaviors as indicators of your evolving practice.

5:34What we're really seeing is when, in several disease areas, when evidence is widely available, we still do see a misalignment in how HCPs are interpreting, say, the mechanism of action or patient identification criteria. And early signals of change often is showing up in changes in the questions people are asking, that physicians are asking. So things like, what do I do with my borderline patients? Or how should I think

6:04about this subgroup of patients versus broader questions on what patients are appropriate or what does this disease mechanism look like? And so teams that are able to pick up on these signals, they identify where the clarification or additional evidence is needed and they adapt their scientific engagements to close those gaps more precisely. So to me, the shift isn't more data, it's really creating that connected, decision-ready view of how your scientific understanding

6:34and clinical thinking is evolving and so that medical teams can now start to act with confidence and credibility. Now, those are great points and thank you for laying out those challenges. Jay-Z, when we're talking about today's environment, we have to talk about AI. AI carries a lot of potential for medical affairs, but what has actually shifted in how your medical teams operate day-to-day because of that? And what is a real value you're seeing on the ground? We're obviously using AI like a lot of companies

7:05and a lot of industries to improve workflows and take administrative time out of core jobs. But then in addition to that, very specific to medical affairs, medical teams have always generated a lot of insights from their scientific engagement with clinicians and medical community. And so because of that large amount of data that comes in those insights, we're able to use AI now to much more quickly go through those insights and generate summaries of insights,

7:35trends and insights, and then use those insights to go back into how we develop our medical strategy, our commercialization strategy, our clinical development strategy. So really, that's been the first and best place I think we've used AI. We're also looking at potentially using AI in the future through the next best action of medical affairs. So you're taking all of the data that we have internally and externally to then generate

8:05a next best action for our customers with our field-facing teams. So that's an important area. And then the second piece is in addition to the next best action, it's what's the best content to deliver in that action. You know, medical affairs has a lot more potential material that can be used in scientific engagement than some of the other teams that are in the field, such as sales or marketing. And using AI to not only figure out, hey, this is the next thing you should do with this customer,

8:36but here's the tool or resource you should use in engaging that customer. You know, we have things that have helped us immediately and then things we're looking at to hopefully help us in the future when it comes to artificial intelligence. That's amazing. It really sounds like AI can really elevate the value medical affairs bring to the other teams. Joppa, if medical affairs needs to operate at the speed of science, what does the operating model that makes that possible look like? Yeah, so operating

9:06at the speed of science to me isn't about moving faster. It's really about reducing that time between the signal to the decision to the decision we need to make to the action we need to take. And that requires a fundamentally different operating model across, again, three dimensions here that I think about. The first is how data is being used, right? So we need to move from insights capture to intelligence orchestration. It's not about collecting more data here.

9:38It's about integrating your signals into a single decision-ready view. And leading teams here are layering together things like field insights, literature, and real-world evidence all together as they try to do this. The second is how the function is structured. And so here we need to move from an annual planning way of working to continuous prioritization. So annual plans, they just assume stability.

10:09But the science and external environment, especially today, are very dynamic. And so what we're seeing high-performing teams here do is they operate with a rolling prioritization model. So they adjust their focus based on real-time signals. And also you want to move away from siloed roles into more of a connected teams structure where you have shared visibility. So medical, field, analytics, they cannot operate in sequence anymore. They should be operating as

10:39one system. And then finally, it's how leadership is showing up. So ultimately, speed doesn't come from effort. It comes from alignment. Leaders who succeed in this model, they focus their organization on what is changing and where to act, not just during the planning cycles. And they drive real-time clarity. So they don't wait for the periodic direction, but there's real-time clarity. And we're starting to see this kind of shifts as they become

11:10accelerated when we have AI-based platforms like Zayden Medical, for example, where insights, data, external, in-signals, they all come together in one layer of intelligence. And so, again, the value here is not the technology. It's that the teams can see patterns as they emerge in near real time, not months later. And so, when you finally start to close that gap between the signal to the decision to the action, that's when you are really addressing that core problem we're trying to solve.

11:40No, that's a really good point, especially, you know, when there's no alignment, there's going to be a lot more challenges later down the line. So better to have that alignment in the beginning than face those challenges later. So to kind of pivot the conversation from operating to engagement, Jay-Z, scientific engagement has always been the core of what medical affairs do. But the expectations on both sides, the HCP and the MSLs, of that conversation are shifting. What does genuine, effective,

12:10scientific engagement look like today and how is that different from what it looked like five years ago? Yeah, I'll describe an interaction that happened a few months ago and one of our field medical individuals described to me. So she was in the field and she was meeting with an HCP, a KOL, and as she was going through the information she was trying to share, the KOL had one of the AI tools actually open on their desktop and was entering what she was saying into the tool and prompting AI and saying, hey, actually,

12:41this tool doesn't agree with you. And so, you know, as she described this interaction, it became really clear. And, you know, to answer your question, that would never have happened five years ago because these tools didn't even exist five years ago. You know, there was a real wake-up call to us at B1 as we're really trying to build this world's leading oncology company that we need to be able to understand where the customers are coming from. On the medical affairs side, it made us realize, look, our customers are even, in a lot of cases, are even more informed of the

13:12latest, greatest science, more so than a few years ago where they had to wait for an MSL to come tell them what just happened at the latest conference. They have that information right at their fingertips with these AI tools. Now scientific engagement is even more important, but also a little, it's different in that our field medical individuals need to be able to go deeper into the science and also have to really tailor their interactions in a very specific way based on the information

13:43they're getting from clinicians. It's really that combination of our customers being more informed, the science getting to them more quickly through other means. And so in our field engagement, our scientific engagement really calls for individuals that are thinking more quickly on their feet, have more tools at their fingertips, and have more information that they can share in a very specific, tailored fashion based on those dynamics that our customers are having. And Jalpa, for decades,

14:13engaging top-tier KOLs was the backbone of how medical affairs educated clinical practice. Is that model still the right one when scientific information is democratized and every HCP has access to the same evidence at the same time? So the KOL model is not wrong. It's just that in today's world, it's no longer sufficient. So as Jay-Z just shared the example, scientific information is now democratized. Every HCP has access to the same data

14:44at their fingertips, right, at the same time often. So influence is now much more distributed and the real question becomes who is actually driving the change in clinical practice? Across a lot of research that ZS has done with KOLs and broader physician networks, we consistently see that KOLs still shape the direction, but they don't always drive adoption. And in many disease areas, you will see that practice change today is often accelerated

15:16through highly connected community physicians that are actively exchanging their experiences, even when your KOL engagement levels were similar. You will see regional referral networks taking precedence. You also see peer-to-peer exchange outside of formal KOL channels. And in several of these cases, the treatment shifts are happening faster in regions where these networks are active, even, as I said, even when KOL engagement levels are similar. So today, if you're just engaging

15:46your top 5,200 KOLs, you're really missing the real drivers of change. And so the shift is that medical affairs really needs to move towards what we would call a network-aware, precise engagement. That's what Jay-Z said. You need to really tailor your engagement to who you're speaking with. And it's going to become important to map how your influence is flowing across these micro-communities, identifying those non-obvious, you know, nodes of influence for scientific exchange,

16:17and then delivering those targeted exchange that is tailored to the context. It should not be a one-size-fits-all narrative any longer. Those are really good points. So you both talked about how medical affairs needs to operate differently and engage differently. But none of that happens without the right people, the right culture, and the right leadership behind it. Jay-Z, with building capability inside a medical affairs harder than buying technology, what does it take to develop a medical affairs team that can operate at the level this environment

Building Medical Affairs Capability

16:47now demands? Yeah, I think you sort of already just said it, which is, you know, it's really easy to buy AI tools and technology, but it really comes down to hiring the right people. Our greatest strength here at B1 is building teams that can operate at the right level where people are grounded in purpose, focused on patients, willing to challenge the status quo, and able to work really fast. So it's really about building the right culture where people feel empowered to speak up, to learn quickly, to adapt quickly, to collaborate,

17:18and to turn insights into action. At the end of the day, technology is helpful, but it really comes down to having the right people and the culture willing to use that technology in the right way. Okay, so some final rapid-fire questions for both of you. If you had to bet on one thing that will fundamentally be different about how medical affairs operates two to three years from now, what would it be? I would say two things. Medical affairs really needs to be able to continue to have ways to show its value

17:48to make sure it is appropriately resourced. So I would say that's probably number one. And then number two is, you know, sort of what I was saying a minute ago, which is great people and technology together. And we tell people all the time, you know, on our field teams, you know, AI is not going to take your job. An MSL willing to use AI might take your jobs. You need to embrace it. But then on our side, we really need to train folks on how to use these technologies. So I think it really comes down to those two things, you know, better and more

18:18effective ways of showing the value to resource medical and then, you know, training folks to use technology in the right way to give your teams competitive advantages. Yeah. And if I would build on top of what Jay-Z just said, I think it would be moving away from explaining the past that we are now doing to really predicting and influencing what happens next. So leveraging the AI to now look at where the clinical practice is about to change and what do we do about it now. And it's not to,

18:49you know, just leverage AI for automating work, but to surface those early signals and making them actionable. because once you're able to do that, you're no longer just responding to change. You're actually looking ahead of the curve and shaping how clinical practice evolves. Is there one capability medical affairs cannot afford to not have two to three years from now? I think if I had to pick one, it will be the ability to translate the data into action in real time, which is really what I've been saying kind of throughout

19:19this conversation. So it's not about more dashboards or more reports, but the ability to answer what should we be able to do differently next week? Because the gap today isn't data, it's really the decision making. And the teams that will lead in the future are not the ones with the most analytics. They're going to be the ones with the fastest, clearest decision loops. And that's a shift. So moving from data science to decision science.

19:50Yeah, and I would build on that, Jalpa, which is I totally agree with what you just said. And then on top of that, I would say making those decisions really comes down to taking all of those insights that you're getting from the field and distilling that into, you know, actionable insights that affect strategy. And then you make the decisions based off, you know, that strategy. And technology is helping us with that. So I would say it's, I agree, you know, moving fast and making great decisions, but those decisions should be based

20:20on information you're gathering from your interactions with the scientific community. Absolutely. Last one. If a head of medical affairs listening today does only one thing differently starting next week, what should it be? Yeah, I would say doing everything you can to make sure the most senior leaders in your organization understand the value that medical affairs is bringing to the company. I would say that's got to be at the top of the list. And I would add on that

20:51and say in order to ensure we're bringing the most value to the organization, leaders should ensure that they're creating this single shared view of what is changing in clinical practice and use that to drive decisions. Because again, today we do see that insights exist, but they don't translate into action fast enough. And also most organizations don't struggle with effort. They really struggle with that alignment. So when teams are able

21:22to operate from that same understanding of what's changing, why it's changing, and what we need to do next, then they can really close this gap between insight and action and then truly operate at that speed of science that we talked about. No, I think that's a great way to round out that conversation. So it sounds like medical affairs is at an inflection point and what will define the next era is not access to more intelligence, but the ability to translate that intelligence into action. The shift will require

21:52greater accountability and faster decision-making, demand a culture change across medical affairs, and elevate the leaders who can move their teams beyond activity to demonstrating real change. And the question now is who will make that transition and becomes the business driver of the future? Thank you, Joppa and Jay-Z, for sitting down with me today. Thank you. It was a really exciting time. Thanks for having us. Thank you everyone for listening on this episode of The Top Line. I'm your host, Irina Lowell. That's the bottom line from The Top Line.