Current perspectives on Medical Affairs

in Japan

February 8, 2018

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Five+ years ago, Medical Affairs played primarily a support role

R&D Commercial

Medical Affairs

“Commercial roles matter, Medical Affairs is there to support”

McKinsey & Company 2

Today, the demands on Medical Affairs are rapidly growing globally
New decision-makers

Changing Broader
regulatory definition
environment of value

Emerging
demands

Evolving
Increasingly
commercial
complex science
model

Wide-spread
More data and
adoption of
transparency
technology

SOURCE: Medical Affairs Leader Forum McKinsey & Company 3

Similar changes and demands are arising in Japan
Broader definition of value
New decision-makers
▪ Increasing use of clinical
▪ Ongoing HTA pilot and future
integration into price revision
guidelines by the government
scheme

Increasingly complex science

More data and transparency
▪ New technology such as
▪ Full launch of MID-NET from
CAR-T and gene therapy in
FY 2018
pipeline

Wide-spread adoption of Evolving commercial model

technology
▪ MR visit restrictions
▪ Increasing adoption of digital
channel by HCPs ▪ Rise of multi-channel

Increasingly stringent
regulatory environment
▪ Recent pricing reform

SOURCE: Medical Affairs Leader Forum McKinsey & Company 4

The scope of medical activities continues to increase
Historical focus Growing focus New focus

Relationship management and Post-launch clinical trials

communication of product (e.g., Phase IIIb/IV trials, IIS and
information observational studies)

Medical education Medical strategy

Medical information services Health Economics and

i Outcomes Research (HEOR)

Medical communications, Real world evidence

including publications

McKinsey & Company 5

We see medical taking more prominent role as the “Third Pillar” of the
business in Japan

“The third pillar”

R&D Medical Affairs Commercial

In-market
Highly In-market
data
strategic monitoring
generation

SOURCE: Medical Affairs Leader Forum McKinsey & Company 6

Four priorities for Medical Affairs leadership in Japan

A B C D
Deeper Getting ahead in More integrated Develop and acquire
understanding of digital leadership to working model with talent to cultivate and
the customers to facilitate coordination commercial & other to build a strong,
better target the and integration across internal partners to multi-faceted Medical
different needs of different medical data enhance patient Affairs organization
physicians and be and knowledge access to and best that encompasses the
able to provide use of optimal new set of
tangible value medical treatment competencies

McKinsey & Company 7

Four priorities for Medical Affairs leadership in Japan

A B C D
Deeper Getting ahead in More integrated Develop and acquire
understanding of digital leadership to working model with talent to cultivate and
the customers to facilitate coordination commercial & other to build a strong,
better target the and integration across internal partners to multi-faceted Medical
different needs of different medical data enhance patient Affairs organization
physicians and be and knowledge access to and best that encompasses the
able to provide use of optimal new set of
tangible value medical treatment competencies

McKinsey & Company 8

Quality of MSL interaction have clear correlation with the satisfaction and
scientific influence of the company
Correlation between quality and quantity of the MSL activities and overall impact of a pharma company
Percentage of respondents per case; n =460
Level of satisfaction with the “Scientific influence” of the Likelihood of
company company recommendation to peers

Process management skills of MSL 0.66 0.47 0.49

Level of scientific and medical

Quality 0.64 0.44 0.49
knowledge of MSL

Interpersonal communication skills

0.60 0.45 0.46
of MSL

Number of MSL visits 0.33 0.25 0.28

Quantity Number of MSL related activities 0.27 0.17 0.35

Average duration of MSL visits 0.10 0.10 0.15

SOURCE: Japan MAPES 2016 McKinsey & Company 9

Yet, most companies are measuring quantity metrics of MSL activities
than quality or impact metrics
Performance management & metrics, 2015
Percentage of respondents gathering the metrics1

▪ What are the quality and

Quantify of impact metrics that are
78
activity representative of Medical
performance in Japan?
▪ How can we find more
practical and objective
Quality of ways to measure these
40
activity metrics? More real time?
▪ How can we build a better
feedback mechanism for
Impact of continuous performance
20 improvement?
interaction

1 N=13
McKinsey & Company 10
Four priorities for Medical Affairs leadership in Japan

A B C D
Deeper Getting ahead in More integrated Develop and acquire
understanding of digital leadership to working model with talent to cultivate and
the customers to facilitate coordination commercial & other to build a strong,
better target the and integration across internal partners to multi-faceted Medical
different needs of different medical data enhance patient Affairs organization
physicians and be and knowledge access to and best that encompasses the
able to provide use of optimal new set of
tangible value medical treatment competencies

McKinsey & Company 11

Pharma players in Japan generally lag behind digital leaders across
most elements of digital enablement
Rating on 5 point scale by 40 digital leaders across industry in Japan Digital leaders Japan PMP

Strategy Organization Results from

What share of your Digital round-table in Japan

How aligned are your 4.1 3.2
digital talent has
digital and corporate Participants:
experience from
strategies? 2.6 3.0
outside?

How customer- 3.8 Can your senior 3.6

centric is your managers articulate
digital strategy? 2.5 their digital KPIs? 2.4

Culture Capabilities
What is your How well does your
company’s comfort 3.9 company leverage 3.7
level in taking risks the data you
regarding digital 3.0 collect to generate 2.7
initiatives? insights?

To what extent do
3.5 Are your core 4.0
you use external
back-office
partners to build
3.3 processes digitized? 3.5
digital capabilities?

SOURCE: McKinsey DQ – Digital Benchmarking Survey McKinsey & Company 12

Digital has potential to change ways of working across whole Medical
Affairs value chain NOT EXHAUSTIVE

Medical Field Medical/ Medical Data genera-

strategy Engagement support tion & HEOR

▪ How advanced is my ▪ What are the most ▪ Can we use digital to ▪ How to leverage digital
organization in digital effective ways to make compliance more and analytics to collect
Medical versus other engage Medical KOLs efficient and simple? more granular data and
Pharmacos? in the digital world? better insights about
▪ Can we digitize our patient’s?
▪ What are customer ▪ How to build optimal support (e.g. Medical
preferences and continuum of Medical Information processes) ▪ Can we use digital to
potential future engagement using mix to make them more source new ideas for
disruptors? of digital and physical efficient and user data generation?
interactions? friendly?
▪ How to measure ▪ Are digital tools a
effectiveness of digital ▪ How to bring our ▪ How to run Medical potential threat to our
approaches? content to places where Communication current approach while
HCPs and patients campaigns in digital enabling payors and
▪ How to evolve normally search for world (e.g. which other stake-holders to
engagement model
content (e.g. search channels, what is have granular data
over Lifecycle using
engine optimization) calendar)? about our patients?
digital?
How to respond?
McKinsey & Company 13
There are already numerous sources of data available in Japan
Medical Health Wholesale sales
Treatment data claims data checkup data data

Available
now
NDB open data by
prefecture
(National database)

Pharma can
use by 2020 MID-NET

May open- DPC database NDB

up going (National database)
forward

SOURCE: International pharmaceutical intelligence; McKinsey McKinsey & Company 14

Four priorities for Medical Affairs leadership in Japan

A B C D
Deeper Getting ahead in More integrated Develop and acquire
understanding of digital leadership to working model with talent to cultivate and
the customers to facilitate coordination commercial & other to build a strong,
better target the and integration across internal partners to multi-faceted Medical
different needs of different medical data enhance patient Affairs organization
physicians and be and knowledge access to and best that encompasses the
able to provide use of optimal new set of
tangible value medical treatment competencies

McKinsey & Company 15

Coordination with other functions is critical in creating Medical impact
Typical company interaction with a KOL What we often hear from KOLs
MSL
Conference “I meet at least 4-5 different
Area people from one company. But
website
Manager they don’t seem to talk to each
other.”

“What I hear from one person is

R&D sometimes different from what I
MR hear from another. It is quite
confusing”

Company “Sometimes it takes weeks to get

website an answer to my questions. I
Marketing
don’t know why. By then I am
wrestling with another problem”
e-Detailing
McKinsey & Company 16
Role as a true 3rd pillar will require close collaboration with other functions

“The third pillar”

R&D Medical Affairs Commercial

▪ Where can we find the largest opportunity for impact? What are customers expecting?
▪ Where can Medical take immediate leadership in these collaborations? And how?
▪ What are current barriers in realizing better collaboration with others? Internal policy? Cultural?
McKinsey & Company 17
Four priorities for Medical Affairs leadership in Japan

A B C D
Deeper Getting ahead in More integrated Develop and acquire
understanding of digital leadership to working model with talent to cultivate and
the customers to facilitate coordination commercial & other to build a strong,
better target the and integration across internal partners to multi-faceted Medical
different needs of different medical data enhance patient Affairs organization
physicians and be and knowledge access to and best that encompasses the
able to provide use of optimal new set of
tangible value medical treatment competencies

McKinsey & Company 18

A strength-based approach to Medical Affairs talent
Medical Affairs capabilities
A strength-based approach
Learning agility
▪ Skills and competencies
examined at level of the
group, e.g.,
Scientific – Cultivate individual's
and techno- strengths for the benefit
logical Business of the group
thought leadership – Seek candidates that fill
leadership gaps in the group, not the
Medical Affairs “perfect” candidate
capabilities
▪ Comprehensive talent
Deep strategy supports and builds
Strategic
under- skills and capabilities of group
vision
standing of ▪ “Field and Forum” approach
compliance integrates learning modules
and real work experiences
(as reinforcement)

Emotional intelligence

SOURCE: Managing talent in the Medical Affairs function: Creating value through strengths-based approach McKinsey & Company 19
Medical is the “Third Pillar” of pharmaceutical business

“The third pillar”

R&D Medical Affairs Commercial

Deeper understanding of Getting ahead in digital Integrated working model Develop and acquire
the customers leadership with internal partners talent
McKinsey & Company 20