Peg Crowley-Nowick 0:24
Welcome to the first season of Medical Affairs Unscripted. I’m your host, Peg Crowley-Nowick, President and Founder of Zipher Medical Affairs, a full-service consulting firm. During this podcast, we’ll explore a range of topics related to the strategic role of Medical Affairs from the perspective of industry experts. Through these conversations with our guests, we will share firsthand experience to provide the listener with insights and knowledge about the evolving role of Medical Affairs. Please stay tuned at the end of the podcast to learn more about Zipher.
I’m really excited today to have a good friend and colleague on the show to have a really interesting discussion about insights. I’m happy to welcome Muriel Siadak, who is a Senior Medical Director at Seattle Genetics. Great to have you, Muriel.
Muriel Siadak 1:28
Great, thanks, Peg. I’m excited to be here today and have an opportunity to talk about, you know, our work in Medical Affairs and how important it is to drug development.
Peg Crowley-Nowick 1:38
I think that it’s a great topic. And I am really happy to have a chance to talk with you for a couple of reasons. One is, uh, we worked together a long time ago and have a lot of experiences from our time working in Medical Affairs and in the field. And the other side of it is you’ve done a lot of work to help train some of our MSLs here at Zipher as they were coming up and moving into field position. So, I know you have a very interesting story about your transition into Medical Affairs and everybody that I talked to has a different route that they’ve taken. So, I’d really like to hear about your journey into Medical Affairs.
Muriel Siadak 2:18
You bet. I certainly had a prolonged journey, I guess I would say. Peg, you and I have known each other scarily enough for almost 20 years, it seems like yesterday, we worked together. But I certainly started more on the clinical side. So, I’m a PA by training and worked with bone marrow transplant patients for a number of years. I was involved in clinical research, cutting edge research, and found it incredibly gratifying, and I loved going in every day. But as time went on, I realized I wanted to broaden my exposure in oncology. And that was something that I got the opportunity to do 21 years ago now scarily. But it was fascinating, because I had an opportunity, I had heard about MSLs, but coming from the clinical space and from a PA background, it wasn’t something that you would routinely think about. So, I had the opportunity with a smaller local Biotech to come into that realm, had never been really exposed to industry before, and so, it was a big jump for me. It was a big jump. But had the opportunity to start with this company with a few other individuals who were well experienced. They really helped, you know, bring me into what does an MSL do, what’s our rule for that particular Biotech. And then, surprisingly enough, you know, three months into my first job in industry, the company was sold. And it took a few months for that to all come out, but that’s when one of the products I had been working on was sold to another company. And that’s where I met you, Peg, and we moved a drug into this other company that already had an MSL Team that was already working with another approved product. And so, it was a very interesting step to go from brand new and now into another team. And I think many of us have had that opportunity where you come into a team, and it’s already built, and so it is a lot of openness and interaction, and that certainly what the company that we worked for there, which was Germany based but had a US arm, and I think we had a really excellent stint there for about five years. And then of course, that company was sold. And then moved on to actually the company I’m with now, although I had a break from that also. That is the one company that I’m with now at Seagen, that has not been sold anytime I’ve worked for them. But then had the opportunity to move to some global activities. So, I actually moved from the Seattle area down to California for about two and a half years, worked for two companies there, both of which were sold. So again, two more acquisitions that I was through. And but it was an excellent opportunity to be exposed to oncology drugs that were in a very different space, I think that really helped me grow into different indications. And most recently, in the last five, six years, had moved into Medical Affairs, Medical Director roles. I was in clinical development for a short period of time, but really gravitated toward the Medical Director roles in Medical Affairs. That to me, was the type of interactions and teams that I really have learned to enjoy and love being in.
Peg Crowley-Nowick 6:24
Well, it’s an interesting story to hear you go from being a PA, straight through to now, Senior Medical Director, and the biggest thing I take away from your story is, I should be following you because you seem to be able to pick the winners, because all the companies that you work for had had very successful products in development and have done quite well, even though they were purchased. The other side of it is maybe we’ll need to do another discussion about what does it take to integrate? Because you’ve certainly must have a lot of experience there. But I’d like to just take one minute and ask you, when throughout your career was that aha moment that you realized that Medical Affairs could have a significant impact?
Muriel Siadak 7:09
I think I recognized that when you and I were working on the team. Prior to that we had been in the company I had been in, the Biotech, it was pretty much one product that although approved, did not have a huge…we were trying to find what the impact would be of that drug. And coming into a team that had another drug that actually had some different Medical Affairs needs — for me, all of a sudden, I saw that come together. I was able to go, “Oh, this is what we need to be thinking about. This is how we grow this. This is how we bring that information together.” And that really did help as I moved forward, I was like, “Yes, this is important!” We have a role that is so important to development of drugs for companies.
Peg Crowley-Nowick 8:05
Let’s now turn to our topic. So, our topic today is insights. What are they? How do you communicate? And when do they really get used? I think this is a topic that everybody’s talking about. I have a lot of different clients that I work with that are all trying to figure out the best way to make this work. And whether that’s at a global level, at a regional level at a small Biotech, the challenges seem to be the same, they just get magnified as the organizations get bigger. So, I really would like to have a chance to talk to you about how you as a Medical Director use insights and how you think about insights. And to start, I want to ask it, because every company has slightly different culture around what a Medical Director does. So, could you give me a little bit of description about your role as a Medical Director?
Muriel Siadak 8:53
Yeah, my current role as a Medical Director is really to lead the product within a region. So, I actually currently am the US and North American Lead for a product and for all of the insights that come into the company. I need to make sure that we’re getting those insights in, understanding what kinds of things we need to ask and making sure we share that with our teams. So that whoever is interacting with our external stakeholders, that we do bring back in information that is going to help us strategically, you know, tactically, as we move our product forward within Medical Affairs. So, I think what we… Oh, go ahead.
Peg Crowley-Nowick 9:48
Yes. So, Muriel, do you have the responsibility of working on the Medical Affairs strategy? And do you lead a core team of all the Medical Affairs functions so that you are sure that everybody’s aligned? Is that how it works within your organization? Are you engaged in different teams?
Muriel Siadak 10:08
I am engaged in different teams; I do lead the product team for our drug that I’m working on. So, I have what we call our Medical Affairs sub-teams that are cross-functional, and I lead that. I have close relationships with our Field Teams that are important, but also a strategy around publication planning, presentation planning of new data, interactions, and close insights to the IST programs that are moving forward with our particular product. And having the opportunity to make sure we help guide some of that, both internally and working closely with our stakeholders externally. So, although I don’t have direct reports, I actually interact in a really cross-functional way, both within Med Affairs, but then I also have the role with our clinical development team, and with our commercial organization, to be that glue between our three products, or three areas.
Peg Crowley-Nowick 11:27
I like that concept, the glue, because oftentimes the Medical Director doesn’t have direct reports. So, being the glue is really the leadership that you have to bring. So, that’s perfect because that will help the audience to understand what you’re looking for and how you might be using those insights or communicating insights. So, let’s talk about what your opinion is on the differences between information and insights.
Muriel Siadak 11:54
Absolutely, that is a question that comes up quite a bit as you think about — what is an insight? To me, I think the insights are information that we ask for; so, definitely strategically, working with the teams, we need to know X, Y, and Z, or let’s find out what the thought process is within our healthcare providers or within advocacy groups. We need to understand that as we think forward with our strategic direction. But in addition, relying on making sure our especially our Field Teams know exactly where we’re heading, and ask them to really think about, what are things that would feed into this? I think having the Field Teams, really interacting with the Medical Director role that I have is so important that I literally can call them up at any moment and ask a question. But then it’s having the opportunity to bring all this information together. And what’s it really saying? You know, what are we hearing? It’s not just what you hear, but how does it impact what we are thinking about where we’re heading? Good examples would be, each quarter I will work, and it’s not just each quarter, but when new information is needed to specifically meet with the Field Teams, meet with these sub-teams cross-functionally within our Medical Affairs group, and have the opportunity to talk about, “Oh, I’ve had some questions about this…” or “Our team has had questions; where are we heading? And what kinds of things do we really need to dig into?” rather than just saying, “Bring whatever you hear in.” You know, I want to craft a little bit of, “Okay, great, I want to hear what’s going on — But let’s really be more specific, really focus on some of these, because those are going to be important points for us.” I don’t want to just, I don’t think anybody just wants to hear the day-to-day, “Oh, yeah, they sort of like our product.” That’s really not an insight for us.
Peg Crowley-Nowick 14:26
Muriel Siadak 14:27
But it’s, “How are they using it? How do they think they’ll use it in a new way?” — if there is a new indication coming. “How are they handling side effects? Is that something we need to be aware of? Is there a particular side effect that we want to dig into a little bit more?” And then importantly, “How are they thinking about us in relationship to potential competitors, or within our competitive space?” You know, I’ve been working within the HEOR 2 space for the last almost six years now, and that landscape has just exploded with new potential drugs in that space, the landscape, how they treat… And so, there’s been a lot of questions we need to ask about our competitors in an appropriate way, obviously.
Peg Crowley-Nowick 15:19
Absolutely. So, I think that you’ve made it clear to me that insights to you are somewhat the information that you’re looking for, they’re focused around your strategy, and maybe every now and then there’s something that was a little bit outside, but it’s something so unique that someone brings that to you, potentially. But the other side of it is just all that information that’s collected in the field, all those engagements that happen and maybe what they talked about. But that’s information — Do you use that piece of it, the information piece?
Muriel Siadak 15:52
We actually do, I have set up, and this is specific to the company I’m with right now, where we have a therapeutic expert engagement meeting once a month, which includes our Field Teams. It includes the commercial MDM Teams, the Marketing Development Managers, I think, is what they’re called, and then also the Medical Directors. So, we have two specific indications for the drug I’m working on now. So, I have one section of it, I have another individual that has the other, and we will all meet together and talk about what are we hearing? In these interactions that our teams are having, what’s the important piece? And I think having that cross-functional opportunity, we also have compliance there, so they’re very compliant with this interaction. But it really helps us bounce ideas off of each other. And questions that we have in Med Affairs maybe and are usually different than what the commercial side might be asking. But they can really combine well, and/or help show a little bit bigger picture. So, I like to hear once a month from our field teams directly. And I definitely interact with the regional managers. But the insights from our MSLs are also really important. They’re smart individuals, they know their stakeholders really well, and have some good relations, probably excellent relationships, to be able to dig deeper into, “What are we really thinking here?”
Peg Crowley-Nowick 17:39
I’m going to jump ahead a little bit because one of the challenges that I see is that people are so focused on the tools for collecting insights. So, everyone wants the Field Medical Team, the Medical Directors, anybody who might talk to somebody to put those into a tool so that we can quantitate that, we can analyze it through AI, we can do all kinds of things with it. And yet, what I find is that that’s important, there’s pieces of that that are important, and that has a purpose, but maybe a different purpose than what we were talking about from the insights. Because what I find is that people when they think they’re being counted and measured, there’ll be a lot of information in there, you won’t get really directly to the insights. But if you set people down and talk to them for an hour, people will start to tell you, and they’ll give you the context of where that information was shared and why it was shared. And then you find Oh, that’s what I heard in California. I also heard that in Massachusetts, I heard that in Florida. Maybe the commercial people will say, well, we heard it, but we heard it this way. Is that the same? And you have the people in the room who can share the context. So, I still believe that the human touch is a really important part of this and not discounting the tools. But what are your thoughts on this?
Muriel Siadak 18:52
No, I agree with you 100%. I actually am much more big-picture. I do understand that sometimes tools, certain metrics need to be captured. But truly to, I believe, move things forward in a medical way. We need to have those, whether it’s face-to-face through Zoom, what have you — insight discussions. Because I have sometimes a bigger picture of where we’re going internally. And if I don’t have an opportunity to share that as we’re talking about different stakeholders, what they’re hearing; then my Field Team (I call it my Field Team) but our Field Team doesn’t know where my head is on this or where we’re thinking from our strategic directions internally. And the other thing I think with insight is we have to have good interactions between Field and the Internal, whether we call them Headquarters, what have you, our Medical Affairs Teams, because there’s so much that we can learn when we bring true insights together, and discussions around the Publication Team, you know, interacting with our MSL Team. That’s important for, for both parties to know, what are people thinking? What are we thinking? And does that make sense? Let’s start thinking about this.
Peg Crowley-Nowick 20:30
I’m sorry to interrupt, but insights are almost the glue in a way, because it forces you to make sure that they know the strategy. They know the way your big picture is, where you’re taking this brand from a medical perspective, and then it brings them back because they have to bring that information in that aligns with that, and it helps you, so they know what they’re contributing to. So, in some ways, that is the glue.
Muriel Siadak 20:55
It is the glue. And I think it’s something that you can’t just put on a Medical Affairs Brand Plan once a year and send it out to the Field Teams. Not that I’m suggesting that’s what people do. But sometimes you think, oh, we’ve already got our strategy. Things change so quickly, within oncology, within our Medical Affairs Teams. You want to be able to make sure that everyone is aware of what is changing, what we need to think about day in and day out, you know, it might be once a month we meet. But if there’s something unique that comes in, I expect to hear that from the Regional Director or from the MSL directly. That, “Oh, hey, this is a new thing we haven’t heard about.”
Peg Crowley-Nowick 21:41
And when you’re hearing an insight, what’s going on in your head? Are you looking at your strategy in your head? You’re thinking about where it fits in? Are you thinking about the future? What goes on in your mind, as you hear something?
Muriel Siadak 21:54
I think a little bit of all of that, you know, obviously we’ve spent time thinking about strategically where we want to get, but again, to me that’s sort of the big picture. And what I need to understand is, in this big picture, okay, what’s changing? What am I hearing? Are there nuances that are going to change where I think we need to go in the future? What new data is coming out? You know, I think that’s another piece, whether it’s our data, and that’s important, obviously, but also, what about our competitor data? And how is that going to impact where we’re going? And that’s important to have those insights from each member of the Medical Affairs Team.
Peg Crowley-Nowick 22:41
And are you having to go back to that question again because you’re thinking about the strategy, you’ve just mentioned how you might have to change the strategy. But what about the tactics?
Muriel Siadak 22:52
Peg Crowley-Nowick 22:53
It may impact what you’re doing. So, this is the potential — there are several potential actions that come from great insights. So, the strategic piece we just talked about; What about the tactical piece?
Muriel Siadak 23:03
Tactics? Absolutely. Those in fact, can change much more quickly and can be a response that, “Oh, we know, X, Y, and Z is changing. Okay, we need insights from these stakeholders…” I need to hear from those stakeholders because there’s something new and different. Or other data is coming out. And then working with our Field Teams, working with the other Medical Affairs Individuals. So, we might change our IME tactics. Definitely, what are the needs in the field? We may need to change some of the slide decks that are used in the field. What is necessary because we’ve incorporated and understood these insights? And that certainly is something we look at all the time. You know, how do we need to react or proactively address something. And that’s the other piece is to help individuals realize we’re not going to just react; we’ve got to be proactive in our thought process.
Peg Crowley-Nowick 24:19
Right. One of the things that you mentioned, that is something I don’t hear a lot is it sounds like you are validating those insights that come in by saying, Okay, now we need to go back and talk to other people maybe get more details. Let’s find out if this is a trend? Was this just a one-off piece of information? How does it work? I think that’s a step that’s sometimes forgotten is that validation, because we hear things, they sound important, but you’re never sure if it really means something or it’s just that particular individual. So, the validation piece is just as important. How about from… So, we’ve talked a lot about from where you sit, how about your senior management and going up the chain is that something that others are interested in? Do they use the information? Is it? Does it get used in clinical development? Does it get used in your Market Access Team? How? How does it work across your organization or in any organization that you’ve been in? And you might also maybe give us some hint as to differences in the larger companies versus the small companies?
Muriel Siadak 25:21
Absolutely. Absolutely. It is so important that we validate the insights. But as we share them, especially internally, because you hear from senior leadership, what’s happening, what’s going on, tell me the insights. But sometimes, it’s just a quick ask. So, we have found some ways over the last few companies I’ve worked with, to make sure that we actually can take these insights, as we talked about our planning our strategy, on a quarterly basis, directly to the CMO through our senior leadership, and have a quarterly meeting. And that has been some of the best way for our leadership to understand what is going on in the field, based on where we are strategically right now. And a good example is they may have heard from one part of the organization, or they’ve thought in general, that a particular piece of data may not be that important. I think a good example for me is we had an IST, that obviously was being handled by the investigator, it was a very small subset of our population, but it has probably the highest unmet need, even though it’s a small population. We as a company are not going to ever go after that, but bringing those insights in and up the chain, not only to my senior VP, but then the Chief Medical Officer really makes a difference. And then at the same time, I work closely, again, that glue with, you know, with, with our Marketing Teams, as well as Market Analysis and thinking about how does this impact what we need to understand from perhaps an HEOR perspective, or prevalence or something that we need to bring forward. And I think that, again, it gets back to what we talked about, we can send metrics up the chain very easily. You know, there’s a monthly report that goes up, and we put in the current insights. But I don’t think that they really get looked at that much. They’re in a document, it doesn’t mean as much to leadership until you can talk about the nuances of what you’re hearing, just as you said to validate it. Oh, we’ve heard this, but we think it’s a regional issue. But we have found that it actually is or isn’t. And so those are some important, for me, again, back to this — you need to have discussion about your insights, putting them on paper, or in a tool is obviously needed for some things. Smaller companies not so much, I think you get an opportunity to do a lot more hands on discussions with your leadership in a smaller company. But in a larger company, you can find ways to do that. It’s sometimes you got to push it against the grain a little bit. But I do believe you can build some of that in.
Peg Crowley-Nowick 28:40
It’s so important to build that in. But I liked the two points that you made one in a small company, maybe you don’t need to put it all into the tools, maybe you do just need to get together and talk. And things also probably move faster. Because you’re depending on the lifecycle of the product you’re working on, that probably determines how quickly you need to have these insights. I want to change the subject just slightly about going back into the field. And thinking about what it’s like to engage with a thought leader or stakeholders at different levels — and you’re hearing an insight. One of the things that I always enjoy about listening to you teaching people how to work in the field, is that you always talk about how to ask the next questions. So, talk to me a little bit about getting to the depth of what an insight is and how you would tell somebody to approach that.
Muriel Siadak 29:32
Absolutely. You know, it’s very easy to go in and just say, oh, I’ve got this list of things I need to ask. And that’s really not. These questions are to be the starting point for conversation and to be able to help the field get to that piece of, “Okay, they’ve answered.” Let’s say they’ve answered this question that we have posed — But dig a little bit deeper. Don’t be intimidated by the individual. Ask them some of those questions. The next question, which is, “Oh, well, why do you think that?” You know, “This was your answer, but what leads you to that?” You know, “What do you think might happen in the future?” You know, “How are you going to think about your patient, next year or next month? If there’s new data coming out?” And I think that’s the piece in helping the field, not think that we have this — that we have shared questions, we want insights on these questions; but they don’t stop right there. You want to actually have that conversation. And most of the physicians in the field I’ve worked with, at these other levels I’ve worked with, really do want to have those conversations, they want to have you dig a little bit deeper, and hear what they truly have to say, not just answer one question or answer a couple of questions, and okay, let’s move on to something else. And that means that sometimes your conversations with them, you may not get all your questions answered, because you’re actually digging into something they’re very passionate about, or they want to tell you about.
Peg Crowley-Nowick 31:18
Right? More in depth conversation. So that you walk away with something that’s much more valuable than just an answer to a question.
Muriel Siadak 31:27
Peg Crowley-Nowick 31:28
That may still have some bias in it; that may just be that quick answer off the top of their head, but they really are thinking about it with much more depth than you’re picking up on if you just stop at the first question.
Muriel Siadak 31:39
Peg Crowley-Nowick 31:40
Muriel, it’s fantastic to talk to you about this. Not only do we both think the same way about insights and potentially about Medical Affairs and having had worked together for so long. But this conversation, I think is so valuable to people who are working in the industry right now, to so many companies that are getting ready to launch a new product and are trying to figure out how do we get the most from the Field Team? How do we get them engaged internally? At one point, I think the Field Medical Teams were very closely engaged with Medical Directors; and over time, maybe there’s been bigger walls that are put up for reasons that I can’t even explain. But that’s kept people from understanding the strategy, from really taking advantage of what they could do in the field and bringing that back to you. So, I’m excited to hear, to have this kind of conversation, to think about insights and the value they have to you as a Medical Director, to your organization from a strategic perspective. And also, to know that you’re thinking about the difference between an insight and information. And we need everyone to think about that if we really want to elevate the perspective of what Medical Affairs can do from an impact.
Muriel Siadak 32:54
Yeah, absolutely. And I think that’s really also what our internal leadership really wants and needs to help them think about where we’re headed also, is that they really need those insights, not just an information flow.
Peg Crowley-Nowick 33:12
This is fantastic. I think I think that covers it, Muriel, is there anything that you think we should have talked about that we didn’t?
Muriel Siadak 33:18
No, I think we’ve got it for today. I actually think of a lot of other conversations we can have digging into some other areas. But I want to thank you for having me here today. And I really look forward to working with you in the future.
Peg Crowley-Nowick 33:36
I am looking forward to speaking to you again because I think we can have many conversations. Have a great day.
Muriel Siadak 33:41
You, too. Thanks, Peg.
Peg Crowley-Nowick 33:51
Zipher Medical Affairs is a full-service consulting firm dedicated to providing strategic services to Medical Affairs organizations. Programs designed by Zipher can help you recognize the most critical insights from your in-house and Field Teams and then capitalize on that data to develop strategic Medical Affairs plans, strengthen your engagement with thought leaders and build cutting edge data generation programs. Success in these areas allows the Medical Team to provide leadership and demonstrate maximum value to your brand and organization. Zipher Medical Affairs is here to help you. You can reach Zipher at info at Zipher med.com that zi P H ER med me d.com or phone us directly at 508-748-3007.