Peg Crowley-Nowick 00:27
Welcome to the second 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 will 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. It’s a great pleasure today to introduce Tamas Suto, who is the Senior Vice President of Global Medical Affairs for Merck KGaA, Darmstadt, Germany. Excited to have him on. We’ve been working together for a number of years and have accomplished so much together. Tamas, it’s great to see you.
Tamas Suto 01:33
Thank you very much. Hello. It’s been a great pleasure to work with you over the past many years.
Peg Crowley-Nowick 01:41
On today’s podcast, we’re going to discuss the four areas of value that medical affairs can bring to a pharmaceutical or biotech organization: evidence generation and translation, insight gathering and analysis, personalized stakeholder engagement and most important medical leadership. And before I start and really dig into the concept of medical affairs and our discussion today, I always like to ask everyone about their journey into medical affairs, because we didn’t all start here, but somehow we’ve ended up in medical affairs. Tell me a little bit about your journey.
Tamas Suto 02:14
First, let me just tell you — thank you for the question. Let me just tell you that I’m just absolutely delighted that I ended up in medical affairs, and I don’t think I really would want to leave medical affairs for various reasons that we can go into later. And, you know, I’ve always wanted to become a person who, who, who can, who can say, that, that I’ve done, I’ve done the things I’ve done, I’ve done a lot of things that that, that allow me to become better at what I what I am, who I am, and how I put myself across. I decided very early on in my career, when I when I entered the industry that I’ve I wanted to obtain experience and expertise throughout the entire commercialization process. And when I talk about commercialization process, I mean, from lead candidate identification up until the end of the lifecycle of a compound on a market. And then I wanted to get into the operational aspects of clinical research. And I started to be determined, I started as a CRA. Later on, I worked as a project manager, and a senior CRA and then project manager and then I moved into clinical sciences, I wanted to learn how to write a good rate protocol that would allow physicians to get as many patients as fast as possible into clinical studies so that we can get the license much faster. And I did that for phase one, phase two and late phase clinical development programs. Then I wrote large clinical development programs for certain compounds. And then I thought, hmm, there is something going on in real clinical practice. And that’s something is treatment decision making. And I wanted to be able to influence treatment decision making, because I’ve noticed that even the best study results with significant benefit for patients in oncology have not translated into a change in behavior from the HCPs or the treatment physicians to impact patients lives and I was fascinated by this and was very curious to understand how this treatment decision making works. And as As a trained physician, it allowed me to relive that, that closeness to, to patients. So I’ve decided to move into medical affairs to learn a little bit to learn more about this treatment decision making, and I’ve never regretted it — ever since then I realized that what I was really looking for was to impact strategy, organizational strategy, and that led me later to organizational development, capability building, and operational efficiencies.
Peg Crowley-Nowick 05:44
It’s a great story. And today, you are impacting many lives in your role, as head of GMA oncology. Tell me a story about that aha moment when you knew you had it, what what happened or did anything, any example of something that’s happened that you say, Wow, this is how I know we’re making a big difference?
Tamas Suto 06:06
Oh, I’ve got so many examples of that. But let me just tell you one example from an early stage of my career. And that was when I worked on a compound for which we, as a team decided that, that that the strategy for this compound was that was already on the market was to, to reach out all of the physicians in the supportive oncology field, and, and make it clear to these physicians, what the actual value of this compound is, in treating patients who needed this compound. And after maybe three to four months, going into the tactics and practically working, working with the teams globally, regionally and locally to make sure that the strategy is executed appropriately, we have gathered insights from our HCPs that not everyone agreed with the importance of supportive care oncology, and the value these compounds may add to the treatment strategies of the HCPs. So I looked into the data that we’ve obtained and soon became clear that we should have segmented our customers, our physicians in a more systematic way. And I went up, I talked to my partner, the commercial head of the compound, and we revisited our strategy. And what came out of this was that we turned the the compound around, and we actually managed to deliver value to those physicians who genuinely believed that these compounds could actually bring value to their patients. So we could manage to reach a subset of patients who were looked after by physicians who basically believed in the concept of supportive care oncology. And it was an aha moment for me because I realized, wow, medical affairs by bringing in relevant insights to the organization has the power to change the strategy of a compound, and move away from a one size fits all, to a very targeted approach, which actually leads to commercial success as well.
Peg Crowley-Nowick 09:10
So I love that story. Because it brings in two of the things that I like to talk about the most: strategy to begin with, you have a strategy, you set that out when you launch a drug, but you need to refine it. And sometimes we think it goes onto a slide deck, it goes into the file, and we never look at it again. But that that’s a perfect story, because the insights coming in should take you right back to looking at that strategy. Are you doing the right things? Are we going in the right direction? And if not, it’s okay. It doesn’t…you don’t have to wait until September. Make those changes early and get them going in the field as quickly as possible. So fabulous AHA story.
Tamas Suto 09:47
You know, and I think that it’s very important when you are just what you’ve just said because in my opinion, how we actually obtain Insights is one of the most important value creator for medical affairs in my opinion, medical medical affairs… the future of medical affairs will be hinged on how the organization obtains, analyzes, interprets and articulates insights and the quality of the insights and also on the generation of evidence and the dissemination of evidence in the form of personalized customer engagements, stakeholder engagements, or HCP engagements as well. So I believe that the future of medical affairs will be very much hinged upon these two core core competencies or capabilities of just organizational capabilities, in addition to other two capabilities, that entails the leadership, how the medical organization is able to own the patient’s voice within the organization, and how the medical organization is able to create advocacy, scientific advocacy around our compounds.
Peg Crowley-Nowick 11:21
And that was a great segue into our conversation today, because you touched on some really important points that fit right into our discussion about the value of medical affairs, how do we bring value to the organization, to physicians, to patients, to payers, and then what kind of capabilities are necessary in order to really be successful in bringing that type of value? So I know you have some pretty strong feelings about the areas that we bring value in from a medical affairs perspective, why don’t we talk about what what you think brings value to the organization?
Tamas Suto 11:56
Thank you for the question. If I could summarize how, in my opinion, medical brings value to the organization, I would say that there are four important areas. The first area is insight generation. What I mean by this is, what kind of tools we have, competencies we have, to acquire, analyze, interpret, and articulate insights. Area number one. Area number two is evidence generation that in particular, using various data sources, and addressing current and future evidence needs of our stakeholders. Area number three, is stakeholder engagement. And in particular, I feel that personalized stakeholder engagement is the way forward. In fact, I personally believe that personalized stakeholder engagement is going to be a differentiator for various organizations in the future. I believe that during this process of personalizing our stakeholder engagement, we would be able to develop scientific advocacy around our compounds and chaperone our stakeholders along their scientific knowledge journey to reach that advocacy stage. And the fourth area is leadership. How the medical organization could represent the patient’s voice in the organization, and how we can upgrade internal decision making based on the insights and our leadership to demonstrate patient value, and and to demonstrate the outcomes — patient outcomes — in our activities.
Peg Crowley-Nowick 14:25
And probably the patient needs.
Tamas Suto 14:27
And possibly… and patient needs as well, you’re right.
Peg Crowley-Nowick 14:29
The boots on the ground certainly has good visibility into that side of it. I think that those four foundational points that you’ve just brought up around medical affairs are critical. I know a lot of people are talking about them right now. But not everybody can do them well, and maybe they only do parts of them well, and if you had all four flowing and really functioning for an organization, it’s probably amazing how you could impact the lives of, as you said, 10s of millions of people.
Tamas Suto 14:58
And more importantly in my opinion — if I may just add to that — insights, why do I put emphasis on insights and techniques. Insights will allow the organization the company to embetter or to improve or strengthen the brand strategies and all functional strategies for that matter. And I believe that better strategies where we want to play and how we want to win, and excellence in translating those strategies into high impact medical tactics, will eventually allow the organization to maximize the number of eligible patients who need our compounds, and accelerate time to market for the pipeline products. And that’s the way I articulated the value proposition of the medical organization. Let me just repeat it again: accelerating time to market for the pipeline products and maximizing the number of eligible patients who need our compound.
Peg Crowley-Nowick 16:23
Perfect way to articulate that, let’s take a few minutes then and dig in a little deeper into each of these four areas and talk about the capabilities that an organization would need to build in order to make these work. And I’d like to start with insights because I think that this is probably one of the hotter topics for everyone is: everyone wants insights. Everybody wants to know what’s happening in the field. And almost everybody has the same challenge. They have a lot of noise, not a lot of insights, which is what I would expect, but how do you cut through that? How do you use it? What capabilities are necessary in order to really build a successful insight analysis program?
Tamas Suto 17:04
It’s a great question. When I talk about capabilities, I mean, various things and I like to just define the way I look at capabilities. Capabilities for me, mean at the organizational level — so, organizational capabilities — they include competencies at the individual level, which means skills, behavior, attitudes; number two, resource; number three, governance, decision making; number four, process; and number five, tools and systems. In my opinion, all five elements of this “organizational capabilities” should work well to create create competitive advantage for the organization. So it’s a very complex issue, and I believe that many organizations struggle therefore, because some or all or even just one part of this organizational capability may not be at that level that would enable the generation of differentiating insights or impactful insights. So, when we talk about improving organizational level capabilities for insight generation, as you might imagine, it includes a lot of things. It includes our our employees, competencies to be able to articulate a hypotheses based on a data point that has been submitted by the field force; field-based medical data points that one can actually obtain from published literature and various other data sources; competencies to be able to gather more data; competences to be able to articulate a scientific question; competencies to be able to articulate the finding; communication — competencies around effective communication; and analytical skills to be able to understand what the data mean. And also competencies to be able to articulate insight gaps, so that we can go out to the field-based medical staff and ask for further information on that particular insight gap because insight generations are never ending, it’s a continuous, it’s a virtuous cycle. And we always learn something that we would want to know more about and answer those why’s that really would allow us to obtain granular, almost intimate understanding of that insight gap. So that’s, that’s on the competency side. But we would need to resource the organization appropriately, to handle the people…
Peg Crowley-Nowick 20:32
To handle the people to have those competencies.
Tamas Suto 20:34
Sure, sure, we would need to have processes in place, where would these insights be discussed at the local level, regional level, global level? Who would be involved? Who actually makes the decision governance? Do we have digital tools to collect insights from so that we can actually run analysis and identify trends? Or even, you know, artificial intelligence and algorithms to pick up insights from various different sources, socially, etc, etc. So all of these competencies must actually be in place to declare that we are really good at that organizational capability.
Peg Crowley-Nowick 21:16
So that’s the starting point. Competencies.
Tamas Suto 21:19
That’s the starting point. Yeah, in my opinion, yes. Yes. I personally believe that it’s all about our people.
Peg Crowley-Nowick 21:26
It’s so often now I’m hearing, “it’s about the technology,” if we buy the technology, we’ll have insights that we can move. And yet, over and over again, I talk to people and I see — no, it’s it’s really about the people understanding the context, understanding what’s happening, when they’re talking to somebody understanding what an insight is, and how to communicate it. And then the next steps that you’ve just mentioned, the analysis, which does need the technology; you need the technology as a place to hold it and to analyze it. And then again, humans looking at it, and then how the communications go, and many of the competencies that you mentioned around insights, seem to me that they’d be similar for evidence generation.
Tamas Suto 22:07
Correct. Correct. Correct.
Peg Crowley-Nowick 22:09
And so those two tie together tightly and are vital to an organization. Are there other competencies that you didn’t mention, it seems like their their ability to come up with a hypothesis — to think, to analyze, to communicate, to be able to put all the dots together and align and understand how they work so that can be communicated — that all seems to tie together into evidence generation also. Is are you thinking about it that way? Or have I have I missed some points?
Tamas Suto 22:39
It’s a great question, and and you’re spot on. I think insights are actually pieces of evidence. And I put insights in the context of knowledge development, which starts with a piece of data, which will then be contextualized, into information. The information will then be vetted with various different stakeholders, and then becomes evidence. And then the evidence will then be discussed, and large-scale consensus will be achieved. And that’s when it becomes knowledge. So in this knowledge creation, which is very relevant in medicine — very relevant in medicine, and in various other professional fields as well — insights, in my opinion, fits into this evidence category. So all we’re doing is practically creating evidence, we just call it insights.
Peg Crowley-Nowick 23:55
Tamas Suto 23:56
Because for us — insights, this term, at least for myself, and that’s what I’m putting across in the organization as well — insights will…insights are those pieces of evidence that will allow the organization to refine and strengthen the strategy that will generate competitive advantage to the organization.
Peg Crowley-Nowick 24:22
Absolutely. So thinking about the four points that you brought up, we’ve talked a little bit about insights, we’ve just now mentioned evidence generation, let’s talk about the personalization of engagement and scientific advocacy building, because that builds off of your evidence generation program, but what does what does that look like from your perspective? What are the competencies, what are the capabilities? How does that how does that work?
Tamas Suto 24:52
I think this part actually is potentially a capability that would create immense competitive advantage for the organization. I think that over the past maybe 20 years, what we see in this Bruker world that various stakeholders would like to obtain information, evidence, data, knowledge from the company through a particular channel they want to use, on a particular topic of interest to them at a particular time when they want to digest when they want to consume that piece of information or evidence. And I feel that the digital revolution brought about the acceleration of this customization of customized consumption of information. In addition, we have been socialized in a world that pushes us to think taglines or very brief…
Peg Crowley-Nowick 26:17
Short…short and sweet.
Tamas Suto 26:18
Yeah, short and sweet sentences. So it has pushed organizations to distill the knowledge, the information, the evidence, and push the organization to develop competencies around effective communication, to get those messages across — scientific messages. So, in my opinion, if we were to do this really well, that could create tremendous value for our stakeholders and for our patients. So what competencies do we require to get that message across? Well, first, I always tell my team that it’s all about understanding the objective, the strategy of that communication, of that interaction, of that that scientific engagement…
Peg Crowley-Nowick 27:13
At the individual level…
Tamas Suto 27:26
At the individual level — exactly. So what exactly do we want to achieve with that particular engagement, activity? That requires strategic thinking, that requires analytical thinking, that requires hypothesis generating — it was all of those building blocks that I’ve just mentioned, for insights and evidence generation as well. Then what else? We would need then to identify the segment of stakeholders that we would like to reach out to as a segment first, then we would need to profile those stakeholders and identify what they really like, what their needs really are. We can use various tools around this, we can, you know…
Peg Crowley-Nowick 28:30
All the social media analysis, all of the writings, all of the presentations, there’s so much information now to do that type of analysis. Right?
Tamas Suto 28:39
You’re absolutely right. And then once we’ve identified and profiled these stakeholders, we would need to select them for that specific engagement objective that we’ve identified. And then we would need to classify where in their scientific knowledge journey they are currently. I would like…I’m thinking about…I’ve asked the team to think about four stages just to simplify the process. These four stages would….the first stage would be: is this stakeholder in the awareness…is the stakeholder aware of all this…the compound the disease stage, the mode of action, etc. The second stage: is the stakeholder now ready to analyze the information that we have provided — the knowledge, the evidence that we’ve provided, and is the stakeholder ready to consider the therapy for the right patient, the patients who really require our compounds, the eligible patients. In the third stage, it’s all about the application — I now I have now the scientific knowledge, the confidence, and now I change my behavior, and I apply this knowledge and provide the medication to my patients, monitor benefit/risk, and analyze the benefits that the patient actually derives from the treatment. And finally, in the fourth stage — which is what I call the Nirvana, which is the scientific advocacy stage — these stakeholders feel so incredibly confident about the compound and emotionally attached and passionate about the compound, that they are now ready to step out to their peers and other stakeholders, and talk about their experiences — good or bad — to ensure that we have embetter treatment, decision making and treatment options to patients. So this kind of classification, requires skills, systems, tools, to ensure that we actually can deliver the customized scientific information and knowledge to these four categories of stakeholders.
Peg Crowley-Nowick 31:46
So the other piece of that that catches my attention, and I see as so critical as you’re putting those plans together, it gives you exactly the reason why evidence generation and insights are so important. You can’t put a personalized plan together unless you have those insights, you can’t move somebody to the next level of understanding and believing in the data if the data isn’t there. So the evidence generation ties in — if it isn’t there…if they say it isn’t there comes right back. So if all of these pieces don’t work together, then you don’t succeed. And that’s part of the problem is they’re not all in sync at the same time, in many cases. Which takes us to the last topic that you’ve brought up, which is probably my favorite, which is scientific leadership. Because to me, that’s the piece where we move from being a medical affairs that is a supportive organization to leaders within the organization. And you can’t do that without having the other three pieces working very well. But I’d like to hear some of your thoughts on leadership.
Tamas Suto 32:24
Correct. Correct. Thank you very much. Thank you very much, I would like to start a new school of thoughts around competitive advantage, and I believe that competitive advantage, perhaps in this new world, in the digital new world, is all about creating motivation, creating vision, and articulating how each and every employee brings value to the organization — every day. And that requires this motivation, and I would like to believe that the new competitive advantage is actually the ability — the capability — to create sustainable motivation and engagement of our employees. I conceptualize leadership in a very simple way. We need to set direction, we need to obtain alignment around that direction, and we need to engage our employees for impacts. So these three important aspects of leadership are the ones that I would like to mention as an answer to your question. And each and every domain requires different skills, different competencies, and even different capabilities as well.
Peg Crowley-Nowick 34:24
I think that the skills and capabilities on the leadership piece — the other part of that is learning the language because as a trained scientist, I have my language that I’ve learned, I’ve been in the pharma industry for a long time. But when I talk to my commercial colleagues, when I talk to my market access colleagues, when you talk to senior leadership, they may speak with a slightly different language. And learning that from a medical perspective is really important in order to lead.
Tamas Suto 34:52
And it’s very challenging. We are all aware of the the way we have been brought up in terms of you know, deductive thinking and we present the background, we identify what’s not working, then we provide the data. And then we actually conclude before we actually provide the data, we actually put it in the context. And then we conclude, that’s the way we have been trained in the scientific world. It takes a village to train medically and scientifically qualified people to think quite the opposite way — articulate the impact, and then order everything, the background, the what we have done under this impact. At Merck KGaA Darmstadt, we have been able to make a significant change over the past year in retraining our employees to change the way they communicate around medical deliverables and the impact the value of medical with our cross functional partners, and it has paid dividends.
Peg Crowley-Nowick 36:10
It’s great the way you described the way we basically write an abstract and thinking, “when you get to the conclusion, how many times have you been told, Don’t put your opinion in there, just give the conclusion.” And really, the impact is your opinion, and what you think you’ve done that does belong at the top. And learning that is not easy. It just goes against everything that’s been trained out of me — they taught us not to do that. So this has been a fantastic conversation, because I love seeing how these four pieces fit together. And how important it is that you don’t just have one, you have all four, and that the four are all in sync with each other — and how you build a culture of this. Yeah, I think in some ways, the smaller companies have an advantage because they can come in and look at this and make it practice immediately. In a large global organization, I can’t remember who we had on the podcast, that this is a barge it just doesn’t move very fast! They were describing medical affairs, but it’s also a global medical affairs organization. It’s very hard to turn that barge — there’s a lot of decision making, a lot of process. What…do you have any advice for people who are thinking about trying to do this?
Tamas Suto 37:23
Never give up.
Peg Crowley-Nowick 37:26
I love it.
Tamas Suto 37:28
I personally believe that every single day when we come to work, and every single engagement with our own people internally or our stakeholders externally, gives us an opportunity to demonstrate a unique way of interacting — of interactions — and also to drive value for that individual employee or individual stakeholder.
Peg Crowley-Nowick 38:12
Very, very good point. And it all comes back down to the people and the team and the leadership of that team. Tamas thank you for joining me today and having this conversation, I really enjoy thinking about the value of medical affairs. Knowing that probably the situation we’re in with the pandemic has accelerated the change in pharmaceutical and biotech companies. And medical affairs is really moving to the forefront faster and stronger than I would have expected in such a short period of time. So learning how to execute on these four points is going to be absolutely critical for the success and to create that competitive advantage. So thank you for joining me and for sharing your thoughts on this topic.
Tamas Suto 38:59
Thank you for your time and thank you for the opportunity.
Peg Crowley-Nowick 39:02
Excellent, thanks a lot Tamas. 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 firstname.lastname@example.org. That’s Ziphermed.com or phone us directly at 508-748-3007.