Hey, guys. Welcome to the podcast. My guest today is Andrew Fariello, and he is the vice president of global medical affairs and head of medical excellence oncology for AstraZeneca. And we talk about how data and information is consumed and how MSLs can be more impactful. Great conversation. We actually have never talked about this before on the podcast, so I know you guys are gonna enjoy it.
Don't forget to follow on LinkedIn and check us out for MSL talk live, which is the 1st Tuesday of every month at 1:38 PM EST right here on LinkedIn. Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Andrew, welcome to the podcast. Thanks for joining me. How are you doing today? Great, Tom. Thanks. Wonderful to be here. Appreciate it. Yeah, man. I am excited.
So, guys, Andrew was introduced to me, friend of a friend kind of thing, and came up with this really awesome idea for a podcast. So I'm I'm really excited to, to bring this to you guys today. But before we get into the topic, Andrew, why don't you do an introduction and share, you know, who you are, where you're from, and all that good stuff? Sounds great. So Andrew Ferriello. I work for AstraZeneca, and I lead a group of medical excellence on the global oncology side.
I've been with the company a long time, over 20 years, and started as an MSL and worked up through the organization, MSL leadership and the like. And so field medical, and the like is is an area that's near and dear to me. I'm a pharmacist by training, and did a a number of years in pediatric clinical pharmacy before I joined AstraZeneca. Awesome. Well, we're excited. I think this is an amazing topic. Before we get into it, we do have a sponsor for this episode.
It is sponsored by the Aspire MSL program, which is basically an online course that was created by Sarah Snyder and myself to help aspiring MSLs land their first MSL role. So for more information, go to mslmastery.com and join our coaching program. We'd love to have you and, yeah, consider it. So let's jump into this. We're gonna talk about how information is consumed. And, guys, this is some uncharted territory for this podcast. We haven't really talked about this.
So Andrew brings some really he's gonna bring some really good insights. So I think what we should start with is, like, where are we now and how is data shared and how is it consumed? Yeah. I think the the the way I've been thinking about this really was, spurred obviously by the pandemic and all the changes we went through, and we've obviously evolved into to a different place, but we all know how fundamentally it's changed, information sharing that the pandemic brought on.
And I think today, the way health care practitioners and decision makers will consume new scientific information or new information that's gonna be relevant to patient care is really fundamentally different than the way they did a few years ago. And if we don't think about how our organizations change to respond to that, we're gonna really be playing catch up.
And so when I think about it, yes, there are still very traditional ways where medical information, scientific information is shared, and and technology advances make that easier. You know, you still peer reviewed literature, peer reviewed presentations, and the like are still the benchmark that really build the confidence that the information that we're seeing is actually done in a rigorous environment.
But how that information then gets disseminated to the rest of the world and how the average practitioner or healthcare decision maker gets it, I think is really so different. The number of people that actually attend to Congress may or may not change. I think we certainly saw them, you know, saw it go down, you know, it was virtual over the pandemic and now the numbers are back up, but you don't have to be in the forum in in the auditorium to get the information and get the information shared.
It is it is shared instantaneously. We learn, you know, from from our phones, from Twitter and everything else, the healthcare practitioners or at least the the digital thought leaders, opinions on data as soon as it's presented, as soon as embargos are breaking. And so I think that really changes in how you leverage a medical affairs team on on what they need to go do, what they need to go learn, and insights to bring into the organization.
I think the other piece of it is with so much information, so many channels, we all know you can get caught in doom scrolling. You can get caught in information coming at you in so many different ways that that stuff gets missed. Right. And even really important stuff can get missed in the noise.
And I think when you're dealing with scientific information or or or, medical information that's relevant to your particular therapeutic area, you don't know that that the top thought leaders all the way down to the practicing, you know, in the trenches, healthcare practitioner are getting the information they need and where they're getting it from. In all likelihood, they're probably not reading full manuscripts the way they used to.
They're probably scanning blurbs or excerpts that have come from different, sources and apps and sites and and through the course of their day or in the evening. So it's it's the signal to noise ratio is is very difficult. And so trying to get information to be communicated in an impactful way is is is just completely different than than I think it was before. And those are just a couple of the areas to start with. Well, and it I I think just listening to what you're saying makes it complicated.
I'm confused, and we didn't even start talking yet. So and you and you you mentioned the term instantaneous information. I think the fact that we that the instant the information is shared instantaneously, and we have this constant ability to see, share, and access information, it makes it even more complicated. So the question that I have for you knowing this and hearing this, is how how do you know, you're in medical excellence. You're a medical affairs leader.
You've you've done everything, been everywhere. You're at a at a an organization that's cutting edge. How do you navigate this process? How what do you do to be able to to properly strategize this piece, the data piece, and how to get it out there properly? Yeah. Thanks. I think, you know, a couple of different ways. 1, we need to have our own infrastructure surveillance, what whatever you wanna call it, to make sure that we're on top of everything that's happening. Right?
And and so there are lots of tools out there that that we didn't have a few years ago. Right? So we have there are platforms for social media listening. There are other platforms that assess, you know, health care practitioners and what they're saying, what they're presenting and doing. And some of those are are, you know, vendor things that that you could buy from some of the major known known providers. Others, I'm sure different companies have come up with their homegrown versions.
But you certainly need a pretty established network to keep track of all that's going on in your space. I think that's whether that's competitive intelligence or just understanding the latest and greatest in what's happening in that space, you need to be able to do that. The other end of it is I think you need to then think about how are your most important external stakeholders consuming their information and what do they need from you and where are they hearing it from others?
And you have to think differently than about how you're gonna use the teams that you have and the resources you have against that because we all have limited resources in what we need to do. But back to your question, first thing is really is is is having some sort of surveillance network in place to be able to understand all the information that's out there. The other thing about this is just real world data, especially in the US, much more available now than it had been before.
Most companies I would I would venture are probably purchasing it in various forms whether to interrogate it for real world evidence, study purposes, or or or to supplement clinical trials, but also to understand unmet need. And I think there's a data source and availability now of different where you can layer different data sources together to have a better understanding of where unmet needs are in in in the external world that before you had to go out and ask.
You had to go out and talk to people and ask the questions and figure it out. Now you can know a lot of this information before you ever send anybody out the door. And I think putting in place the the knowledge, putting in place the the processes and the like and the tools to be able to interrogate those data to understand that can then make you strategies for how you wanna deploy your teams, whether human teams or others, very different than what you might have done in the past.
Yeah. Yeah. That's a great way to put it, and and it it helps to understand. So as we talk about, the what and the how, it now I'm left with, okay. How like, where does the MSL fit into this equation in the sense that what comes to them? What's the the strategy for them? How does this get to them, what do they do with it, and what's their role? So let's talk about the MSL piece of the equation and how that gets gets carried out.
Sure. So, you know, in its essence, I I look at the MSL role still in 2 large buckets. Right? One is to bring information out from the company to ensure the health care practitioners really understands how to best use our therapies, for the right patients so they could hopefully realize the outcomes that we've seen in clinical trials.
And at the same time, bringing in the insights to understand where are those patients, how are they being diagnosed, where are they being treated, what what what's leading to one treatment course versus another, our best available guideline therapies really being adopted? If not, why not? Right? All that insights and stuff. And the role is I think largely still those two pieces. There's other components as well, clinical trial support, partnerships and the like for the organizations.
But in essence, I don't think that changes, but I think how you go about doing it can certainly change. 1, the information they bring out has to be done through this lens of all the noise that's out there and all the other ways people are consuming it. And you have to be able to figure out then, like, what do people really value? What are they gonna value from an MSL, from a from a, you know, a personal relationship that that that they would want versus information they could get elsewhere.
And the other piece is, where do you need them to go out and ask? Like, do they do you need to go have them have the same conversations as you did before? Maybe not if you have these other data sources already. It might affect who they go see. Right? Back in, you know, traditional ways as you go to the you have a limited MSL team. They're they're small in size.
There's relatively expensive resource, so you're gonna target the most important health care practitioners in the hopes that you get the best insights in and and in the hopes that that information, you know, and influence kinda trickles down through the medical community. The influencing, you know, piece doesn't have to happen the way it does anymore. With the information sharing, it it's it's it's democratizes it as to who gets information when. Right?
And the top of the pyramid may not be the most influential decision makers for many of our diseases, depending on how they're treated and where they're treated, where the referrals are. And so I think teams have always been looking at, well, how should who should our MSLs be targeting? How should their their lists change? How should that be prioritized?
I think now with the way information shared and with the data that that might be available to a company, you may look very differently about how you're gonna deploy an MSL team. It might be for some, you know and and likely it'll be different whether you're dealing with the primary care product, specialty care product, rare disease.
I think there are probably different nuances in each, but you can be much more targeted to where the unmet needs are and really be able to be, I don't know, surgical precision, if you will, on those engagements, to have the right conversations with people who are at the crux of where the biggest issues are rather than just blanketly going to only the top people in the hopes that you'll you'll kinda cover the whole disease area. So I think there's definitely opportunities to change that.
There's also opportunities depending on how a company is gonna implement omnichannel technologies and processes in them as to how they'll leverage their MSLs into that work. Right? You can you know, if you have the right data and analytics in place, you can understand where a customer is on a spectrum, on an adoption spectrum, if you wanna use that term.
And the next best action, next best suggestion of what information to bring, stuff that would have been maybe in the in the heads of a good MSL in the past, like they would have figured that stuff out because they knew their HCP. They knew what they thought and they believed, so they figured next time I go in, I'm gonna have this conversation.
Now we can have the technologies help all the MSLs, not only the best ones, be able to, you know, get better and build those skills because it gives them the tools to be able to do that. So I think the roles can change, you know, significantly. Still need the core, you're still trying to do the same things, you still want the scientific expertise, but you're gonna also need to build some new new new tools for them to be able to leverage, new information and new data to be able to do that role.
You know, it's funny. There's it it just sounds so complicated. It's like there's so much to it, but and there's so much that could be beneficial. Like you said, it really kinda changes the role because the more information you have access to, the more it influences what you do with the MSL and who they talk to. So the question is that I'm left with is how do you keep up with all this? Yeah. It's not it's not a simple thing to do to execute. Right? It is a more complex world.
I think like anything else, you're gonna have to really focus on the priorities and where you're at as a company, as a team in this journey. Right? Because I kinda describe this generic kind of state is if all these pieces were in place, how it could operate. Whereas most of us are somewhere along the journey on building to that. We don't have all the pieces along the way, and you gotta bring your teams along with you. So I think it's being able to look at where are they today.
And I think various teams, different stages of maturity and the like. Some people are still just building up, all those have been in a therapeutic area for many years. And what are you likely to bring in onboard into your system next? It could be more sophisticated customer identification tools. It might be more sophisticated, content generation and sequencing of discussions. It might be a better understanding of of unmet need and the like through RWD.
Like, so I think different companies will be in different stages on what they're gonna do, and they'd be incorporating those pieces as they're ready. You can't hit everybody with all of this at once. 1, you couldn't build it all at once. But 2, they likely wouldn't be able to to, you know, do it all at the same time.
Yeah. And then what about you know, I I'm kinda left with thinking about the patient and how the patient factors into it and how the MSL role really is the end goal is to influence the, you know, the care of the patient and, you know, the families of the patients and maybe even patient identification. So when you look at all of those factors on the patient side, how does that play into the preparation and planning of this concept of both data consumption and data dissemination?
I think there's a a couple of different lenses to this. One is the way a medical team might be providing information for patients or a patient level. They see you see more and more companies and teams creating channels and putting more content on channels or whether it's their own or third party sources with a better understanding of where patients are going in for information and providing patient level information so they could be more informed.
Because obviously, they're having greater and greater say in their own health care decision making, right, which is a good thing at the end of the day. I think different companies are taking different views as to which roles do that work, right, because there's risks involved in that and there's compliance within internal companies' policies on what they wanna do.
But I think in general, I see a greater desire for companies to have a more direct connection with patients and a better understanding of what the patients want out of their journey in that disease area, not just hearing it through the eyes of the HCP about what the patients want. Right?
So you see whether it's in medical or it's in other groups with patient advocacy groups or direct with patients to be able to engage them in specific ways to really understand their needs and their perceptions and understanding.
And I think the better those insights come into an organization, and in this case, a medical affairs organization for MSL teams, the better richer understanding you have of what the, external world's goals are, the better you can position and think about the strategies around our science and our medicines to be able to understand how they can best meet those needs. And I think they can factor into those those discussions as well. The other end of it you talked about is patient identification.
For, you know, if if we have small teams in a specialty area and we're calling on the specialists and if they're the ones that are making the the decisions and identifying those patients, then great. But if it's a disease area where the specialists are really in the referral stage of it and the the patients are really being identified or need to be screened and diagnosed in another setting, then teams have to be able to engage where those patients actually are.
And they might not be obvious to even healthcare systems. I think in the US I think it's a problem everybody's trying to solve. And so this is a partnership opportunity, I think, between, biopharma and healthcare systems and healthcare because the healthcare systems, healthcare practitioners want to identify patients at an earlier stage of a disease as well to have a better chance of having better outcomes with them.
And depending on how fragmented or how sophisticated that health system is, they may be better or not at doing that themselves. There's, there's some learnings that probably we could bring to the table with them, with all the right privacy and other kind of, guardrails in place, but be able to work with him to help to help identify and scrutinize their own populations or give them, suggestions and ideas on how they can scrutinize their own datasets to identify appropriate patients.
So hopefully, they could be identified, diagnosed at the right stage, and they could, you know, benefit from earlier earlier types of interventions. There's so much to look at. It it and and that's why I keep saying it's so complicated. Even like there's so many different directions we could take this conversation.
But for the sake of thinking about the audience and the fact that, you know, a lot of MSLs and MSL leaders listen listen to this and even aspiring MSLs, What so when you take all of this into consideration and when we talk about all of the information that's available and the different channels, that are available now, social media, AI, and and just how how expansive this is, how does that change the approach in in what the MSLs are required to
do, what engagement looks like, and even what the future looks like? Yeah. Fortunately, I think, you know, we're all adapting to the new technologies together. So it's not like there's a bunch of us who are I mean, I may be a bit of a Luddite here myself, but, you know, we're we're all adapting to the new technology. So I think I think I see MSL teams across the board being very innovative with leveraging the tools that are available to them.
A core piece of the job has always been, you know, a strategy for your territory, understanding who the most important customers are, establishing a relationship, bringing them value so that you can have an ongoing engagement with them and you could hopefully through those engagements over time, be able to foster good outcomes on behalf of patients in the business. Right? That piece doesn't change.
I think, you know, having more data available to you quicker about who's doing what in your area, where are the patients, where are the where are the unmet needs? What does that look like? It allows teams to be much more strategic and thoughtful about where they go instead of saying, I'm gonna go see the same 30 people this month or 40 people, and then I'm gonna see what's new and find out what's happening in your practice. What happened since last time. Right?
You still may need to do a bit of that, but I think you can come into it with more information at your disposal as to who's out there and who's doing what. And there are likely many more people who have influence among their peers, among their healthcare peers because of the technologies than than existed before before it was likely the academics. So you have to know who these other people and players are in your communities.
Who's who's speaking, who's on those digital channels, who's out there because they're gonna be heard by others and therefore you're gonna wanna, you know, be able to hopefully be able to interact with them and engage them as well. So I think there's a piece on understanding your territory, understanding who the players are, and being able to then develop your plans to engage them. And then I think you have more tools to be able to actually track, like, is something happening?
Like, so we had a great meeting.
Like, I'm heading back to the car in the parking lot feeling like, oh, we had a breakthrough because, you know, we had a good scientific discussion and and she was asking me these great questions about about our studies and I was able to answer them and I'm like, but did that actually lead to a change in how that therapy was adopted in their practice and like, instead of having to just go back and ask, you can actually look at other datasets and see what's happening in that area.
And it so I think it allows allows the team to have more if they if they leverage what's available to them, they can have more impact because they could there's more information out there. We didn't talk about like, we're talking about MSLs, which is which is great and it's obviously the focus here. But obviously, these are multidisciplinary and cross functional teams.
And I think, you know, the the information and the like that's available is is available to lots of different functions in the in the organization. And I think the MSLs have to really work in a cross functional and probably an account based approach with other stakeholders. Because if you do that well, then you could really have impacts, not just on the few patients who might be seen by this doctor here, but within a whole health system.
And so I think the the tools that are available and and the information that's available allow all these cross functional teams to be more impactful. Diagnostics commercial managed care. Absolutely. Yeah. Right. The diagnostics, the act the access side to things, understanding protocols, understanding guideline adoption, understanding, you know, how a health system is is incorporating and adopting guideline guided therapies.
You know, the the teams that really can work most effectively with those cross functional colleagues understand a little bit of the business end of things as well as what they're trying to achieve from scientific objectives are other ones that are gonna have the best outcomes. And and I would hope also some of the greatest satisfaction in the role because you're able to help more patients at the end of the day. Right.
Yeah. So the information piece, access to it, isn't just how do we take this information and now use it for the external piece of the equation, engagement and, you know, influencing the care of the patient.
But it's also how do we utilize that internally so that we could become better as an organization, more strategic, more aligned, more less fragmented maybe, because there's all these channels and and there's all of these these tools, and there's all this stuff that we could do now that maybe we couldn't do 5 years ago. So knowing that, here's a big question. Is the MSO role even more critical and more important now or less because of all the technology? Yeah. It's it's more.
I you know, you could say, oh, you can have all this stuff at the end of the day and I don't need MSLs, but my gosh. No. It doesn't. This is still this is still human. We're still human beings and a human to human interaction and relationships, I think, are critical to really be able to have that that deep understanding and that that deep impact. And the tools facilitate that. They may be able to accelerate it in some ways, but they they're not a replacement for it.
And I still, in my heart of hearts, believe that the type of interaction that an MSL has by being able to go deep in the science, being able to answer, questions that may be outside of label and the like really understand answer the questions that the healthcare practitioner truly has the need for, not just driving a promotional message is a value proposition that is more and more important to the organization.
Because the noise because of that noise of all the stuff out there, I think some of the more traditional promotional things become more noise than anything else. And and it's like, where is the value? And and if if an HCP is gonna spend any time engaging a company in any way, in any channel, it's gonna be the area that brings them the most value. What are they looking for? What are you looking for so they can make better decisions, faster decisions, make their lives easier?
And I think an MSL is still absolutely integral in that process and will and will continue to do so in the future. Well, I'm glad you I'm glad that's your answer. Otherwise, I'm not mad at your job. This podcast is over. I'll be talking That's right. I don't know, refrigerator maintenance. I'm not sure what the next step is for me, but, so and and and I I knew the answer, but at least in my heart, I knew the answer. But I'm I'm glad to hear you say that. So what happens next?
Like, how do you where do you see this going? And what what areas do we have to improve and what areas do you think we need to double down on? So, you know, I think the age old issue, I'm sure you've talked about it many times before, is how do you demonstrate value of a team like an MSL to the organization? I think that's that's always gonna be an area of focus. I think if you're in a company where you feel like you've done it and you've succeeded, great. You can't stop. Right?
Because stakeholders will change and you'll be starting over. Like, it has to be something that drives you at the end of the day. Anytime no matter where you are on that journey is understanding, like, what is what are we actually doing with this team? Like, what is the outcome? Are we achieving those outcomes?
And that's where I think the real world data really helps because if we can track in a much more granular level, an accurate level, changes in healthcare, like whether patients are getting the right diagnostic tests at the right time, whether they're starting on got right guideline, you know, recommended therapies at the right time, you could you can be able to assess whether or not the MSL team is actually effective in their roles.
It may not be the most direct, qualitative measure, but to me, it's a much more important one than some of the other measures, quantitative or qualitative, we might have used in the past, you know, market research surveys or or activity metrics. Right? And so I think you always wanna have a focus on on the value the team is providing and the impact and the outcomes with patients they're providing. I think because that that that gives you a north star in leading your team in the right direction.
I think another area is being able to look at how do your teams evolve with this mix of face to face and virtual now? How are you as a company gonna leverage this? And I expect MSLs need to do both and will continue to do both. The skill sets to be able to do both well are not necessarily the same skill set and how are you building that? Do you do it where you have a relationship with if it's a new relationship, it's hard to do. Right?
I think I think there's work for all of us to continue to do even though we learned a lot over the past few years of a pandemic. I think there's still a lot of learnings, especially as new people come into these roles as to how you manage that balance, as you did before. And then then then I think there are other pieces that might be they're gonna be specific to a company or to a disease area. Like, I'm I'm in the oncology area right now.
As anyone who oncology knows is how fast that science is evolving, how fast it comes from all different, areas, and being sure you have a team that can keep up on all that science that that and and those advancements so that they bring expertise and credibility, but also the skill sets to be able to effectively be able to help implement new therapies, I think are are are key things.
And I'm sure other disease areas, in other therapeutic areas have have similar challenges, but I think that's just one that I I feel acutely because I live and breathe it every day. Yeah. For sure. You know, what I love about this conversation is that it crosses over so many areas. There's a lot of times I do these these episodes and these podcasts, and it's it's kinda one-sided. It's just for MSLs. It's just for aspiring MSLs.
There is a lot of information that you shared today that's great for leaders and folks on the medical excellence side, people that are on the strategy side. Talk to the just the MSL at this point. What advice do you have just for the MSLs, current MSLs listening, and maybe maybe even aspiring MSLs that may become get into the role sooner than later. What advice do you have for them on what they need to do to be successful moving forward in this day and age?
Yeah. So, table stakes are gonna be your scientific expertise and being able to really be able to master that, and be able to communicate to the level of your audience. I think you don't get the job unless you demonstrated you could do that well, and that will continue to be to be the case. I think where it gets more interesting is you're not gonna have the time to go in and give a 30 slide presentation. You probably didn't before, you certainly don't now and going forward.
So how do you really get to the crux of what your HCP needs to hear? Not what you wanna tell them, but what they need to hear to be able to make better decisions, you know, for their patients or whatever that out that that objective is that you're trying to do. And being able to be agile enough, nimble enough to be able to dial it focus, but also be able to give enough depth so that there's credibility in what you're providing with being able to be flexible in that manner.
I think that's a skill set that needs to be honed every day in this environment just because time is short, time is precious, people are busy, and you can't waste their time. And if you can bring them what they need in an impactful way and get out of it and interaction what you need, then then I think, you know, those MSLs will be most successful.
And so if your company follows a process that has a good sound, method, especially for the new people to kinda learn how to do that, follow that practice that even though it may be a bit awkward at first, I think building the muscle memory in that, really pays off in the long run. Andrew, thank you. Great great stuff, man. I really appreciated your time, and and this was an awesome conversation. And we really haven't had this on this show, so really breaking some new ground.
Appreciate you coming on and, and sharing your wisdom with us. Awesome. Thanks so much, Tom. It's a pleasure. Awesome. Hey. Thanks, guys. Appreciate you listening. We'll see you next time. Thank you so much for listening to the show. And if you enjoyed it, please subscribe so that you don't miss an episode in the future, and feel free to leave a rating or a review or a comment. Thanks again, and we look forward to seeing you soon.