Hey, guys. Welcome to the podcast. My guest today is Rucha Parikh. He is associate director of medical affairs strategy and training at CTI BioPharma. And we talk about market access, what it is, and how it relates to the MSL role. So this is a great conversation. I hope you guys enjoy it. Don't forget to follow me on LinkedIn. Check us out on YouTube while our videos are up there.
And don't forget to join us for MSL talk live, which is the 1st Tuesday of every month at 1:30 PM Eastern time, and that's on LinkedIn Live. Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSL's and all things field medical. Hey, Rujit. Welcome to the podcast. How are you doing, buddy? Hey, Tom. I'm good. How are you? I'm awesome. I'm awesome. I'm excited. Really looking forward to this topic, and, can't wait to get into it.
And, guys, just so you know, this is one of these things that just kinda developed. Richard reached out to me, and and we started talking. And I'm like, hey. You know what? Why don't you come on and and came up with this idea of of doing an episode on market access. We haven't done this before. Totally novel idea. So I'm really excited to learn more about what market access is, how it relates to MSLs and medical affairs.
But before we do that, why don't, Richard, why don't you introduce yourself? Sure. Yeah. Absolutely. Tom, thank you, obviously, for having me on. And, of course, thank you, for putting on the MSL Talk podcast. I've actually spoken with a few colleagues of mine in the industry, and the consensus is is mutual that this and these sessions are very beneficial to all of us, whether we're seasoned MSLs or aspiring MSLs. So thank you for that. Appreciate it. So my name is Richard Barrick.
I, am associate director of medical affairs strategy and training at CTI Biopharma. I'm kind of in a hybrid role right now where I also function as an MSL, so I have field responsibilities. But I also am responsible for, training the team and working on, field medical strategy. So happy to be on the call today and talk a little bit about, what I've done, related to market access. Awesome. Yeah. And before we get started, we actually do have a a sponsor for today's podcast.
So our sponsor today is, is Larval. And if you guys might be familiar with that name, Bruno Larval, who's the founder, of the company, was on my podcast. He's awesome. And if you haven't checked out those episodes, please do so.
The company was established in 2004 and combines the best of artificial and human intelligence to deliver expertly curated and personalized data solutions to medical affairs, competitive intelligence, commercial, and r and d teams within the pharmaceutical and biotech industry. So for more info, please visit them at larval.com. Check these guys out. Great company. You should definitely know who they are. So let's get into the market access idea.
So to start, I think the first question is, like, where does market access sit in the suitable industry and as it kinda relates to medical affairs? That's kind of the first question that pops into my mind. Sure. Yeah. Absolutely. So I think let's take a step back. Let's talk about what market access is.
Okay. So market access is a department within a pharmaceutical or biotech company that ensures that patients can get the drug that they've been prescribed within a timely manner while addressing, and I think these are kind of the 2 key components here, reimbursement and affordability.
So the ultimate objective of the market access department is to ensure product availability through trade and distribution partners like Cardinal Health, the McKesson, or AmerisourceBergen, and patient access and reimbursement by commercial plans. And by commercial plans, I mean Aetna and UnitedHealthcare, etcetera, and also government payers. So going back to your question, market access is where does it sit within a pharma or biotech.
It usually is an independent function, and it has several subsets. So there's, departments that sit underneath market access, like trade and distribution, which I mentioned, pricing and contracting. And one of the most important ones, is patient support services. I always and don't go by me because I really don't know. But I always thought market access was that sat under the commercial organization. Is that typical? Again, it depends on the company.
I've seen cases where they can sit under commercial. For us here at CTI, it's independent, but we work very closely. So they work very closely with commercial. They work very closely with medical affairs. So I guess it depends on the company. Got you. Got you. Yeah. It's funny. You know, you don't think about it. But if company develops a drug, gets approved, and then, you you know, we just magically think that it just appears on shelves. Right? But it doesn't.
There's a whole department that's responsible for that. Is is that why this piece is so important? Yeah. Absolutely. I I I think you you hit the nail, right there on the head. So it's important to have, an effective market access team, but also an effective market access strategy because without that, you can have, as you say, you know, the best product in the world. But without having coverage or reimbursement, patients are gonna have a really difficult time accessing it.
So market access ensures that the product that's prescribed for the patient is covered by their insurance, and they also address the affordability concern, that can come up and help a patient get access to a drug if they do have some of these affordability concerns. Alright. So I'm gonna go back to something you just said. So you said market access team, which means that there are there's a market access department. There's market access folks that are out in the field. Are they like MSLs?
And what do market access reps or market access professionals on this market access team do? Yeah. Absolutely. So you do have, for certain pharmaceutical companies, we'll have field reimbursement managers. Mhmm. Here at CTI, our our sales reps or our key account managers actually act as, our reimbursement our field reimbursement managers. So they're responsible for communicating that we have a patient assistance program. We have, back end patient support services.
Drug is available x, y, and z. It's positioned here on a formulary. So they're the ones that communicate that, and provide any support that's needed to the provider or to the institution, to make sure that the patient gets the appropriate medication at the right time. Got you. Okay. So then let's talk about the MSLs. Yeah. What do MSLs need to know about market access? And are MSL teams educated and trained on market access and what market access is all about?
Yeah. No. It it it's a fantastic question. So MSLs and medical affairs play a vital role, and work collaboratively with market access teams. So prior to the launch of a drug, the market access team will work on scheduling clinical presentations with payers, specialty pharmacies, etcetera. And these clinical presentations are typically delivered by the MFL. So these presentations will set the stage for payers to understand your disease state and your product.
Now most MSLs are not educated or trained on market access. I actually didn't know much about it, till I attend a business school, and actually found myself in a consulting role prior to becoming an MSL where I worked on, going to market strategies for, drugs with a companion diagnostic. So I kinda had to learn about what the differences and the nuances there are. But, basically, MFLs are not really educated or trained on the various, responsibilities of a market access team.
Yeah. Again, it's just something that happens, you know, magically in the background. Right. It's like, yeah. Nothing to see here. This is just going on, and everybody else goes about their business. Yeah. But but it's but it's very important. I mean, this this team is vital to ensuring that, a drug is launched, and also that patients have access to it. Absolutely. 1000%.
Because there's situations where access is a real issue for certain companies, and that obviously is going to have a huge impact on performance and sales and and and the the the profitability and success of the company, the launch, and and what's gonna happen with that organization.
Even even when you look at how important this is, if there's if there are access issues, it'd be creates a bottleneck for the organization in every other way, including when it comes to the venture capital side and funding and making sure investors are happy. If you have an issue in at at in in the beginning, like, at the forefront where you're not able to get the right access for a drug, you're in trouble. Yeah. No. I I completely agree.
Yeah. So what about and that kinda makes me think that this has to look different in different size companies. I imagine that smaller companies have different challenges and differences with larger companies. What's your experience been? Yeah. Absolutely. So there's definitely challenges, but also opportunities. If you kinda think about market access teams and they and how they differ from large pharma to medium sized pharma to small pharma biotech, size, obviously.
The size of the team is probably the first thing that comes to mind. Right? Mhmm. They might have teams for and by they, I mean, larger pharma might have teams specific for a therapeutic area or even, branching across several therapeutic areas, whereas smaller companies will have it potentially one therapeutic area, one product. So that's kind of the first thing. The other thing is the strategy.
The strategy probably differs, you know, depending on the size of the pharmaceutical company and also the the number of approved products you you have. So, the go to market strategy or the market access strategy for someone like where I'm at, CTI, may differ from, you know, a larger pharmaceutical company with a with a a broader portfolio. Got you. That makes sense. And then what about let's get back to the MSLs. So what do the MSLs need to know or do? Or how do they relate to market access?
What, like, do they have responsibilities as it relates to market access? Yeah. Absolutely. So we talked a little bit about the clinical presentations. Right? So the MSLs are the experts during these clinical presentations. We're responsible for knowing our disease state, and our product. It's also important for us to do a little bit of homework prior to engaging in these clinical presentations. So you wanna understand the payer that you're speaking to.
Who's on the other side of that, that that table or that conversation? Are they big or are they small? And by that, I mean, how many patient lives do they cover? Where are your competitors positioned on their formulary? Understanding what the process is like post approval, to get your drug on their formulary. So it's a good idea to have a sense of some of these things when you're prepping for a clinical presentation so that you can answer questions that come up more effectively. Got you.
Yeah. Because so you have MSLs on the medical affairs side. You have your commercial counterparts on the sales side, so sales reps. And then you have these market access folks that are on the reimbursement side. Right? So you have these kind of three areas that are somewhat interchangeable, so to speak, are all kind of working. They're all working together. I mean, if you think about, you know, kind of gears all working together, that's that's basically how it is.
And then what I have to imagine that there are, like, gaps that exist Sure. In that equation of some sort. Yeah. So I I think if you kinda think of gaps, I wouldn't say that there are gaps between, market access or medical affairs. I think these two departments work very closely together. Medical affairs has a hand in developing the amcp.ca, which amcp stands for the Academy of Managed Care Pharmacy.
And that document, very extensive, very detailed, contains the clinical and economic evidence, which is the information that payers request to ultimately make their formulary coverage decisions, their reimbursement decisions. So medical affairs plays a huge role in developing that document. In addition, all the information that's shared during clinical presentations, that's all created and owned by medical affairs. So, again, we play a huge role in in all of that as well.
If anything, I'd say the gaps exist between MSLs, and not really knowing or understanding the role of market access. And I'd actually encourage every MSL that kinda has an interest in learning more about it to, look up things online. There are various resources available online, but also connect with internal stakeholders. I think these folks are probably your best bet, to learn a little bit about market access and the role that medical affairs, but also MSL play. Right.
And then there's so now as I'm hearing you and I'm trying to put this all together and on there being on the recruiting side, you always look at this in in in the the idea of titles that exist. Yeah. So there's you have your MSLs. And again, we talked about the market access folks and sales folks. But then there's, like, managed care MSLs or medical outcomes liaisons or health outcomes liaison. So how does how does that fit into this? Yeah. I mean, so so they all play a role here.
The the titles obviously are different, and our responsibilities may differ. So managed care liaisons may work more closely with payers or even larger institutions, as opposed to working, you know, in the community as as much or with individual key opinion leaders. Health, economic outcomes liaisons obviously kinda work more on the back end where they're looking for, data, and and kinda work on that to to further develop your story or your messaging. So again, different titles.
There's a little bit of interchangeability depending on the company. Here kind of at CTI, we have our hands kind of all over, and in multiple pots. Because we're a smaller company, we wear we wear many hats. So we're doing a little bit of all this. Yeah. The thing that's exciting though, it just hearing you talk and having this conversation, like, it's a great time to to be in pharma, to be in medical affairs, and to to be field based and and know all this stuff.
Because years ago, when I first started in my business, this stuff didn't exist. Right? You had your sales reps. You had your MSLs. You had, you know, your reimburse folks on the reimbursement side. But it just seems like there's so much more opportunity now to either get promoted or morph into, and transition into other roles that are field based that exist within pharma and biotech. Do you agree with that? Yeah. Absolutely.
I mean, our our boss here at CTI, on the medical side says this all the time. I totally agree with her that, the MSL is probably the best role in pharma, but I'm obviously biased. But, yeah, it it is a great time. There's there's a need for folks in these roles. There's a need for folks that have experience in these roles, but also folks that are eager and willing to learn. So I I completely agree with you. I think this is kind of a golden age of, you know, field medical affairs.
Yeah. And you mentioned when we talked, you mentioned to me you mentioned the term, unicorn of skills. So tell everyone what what you mean by that and what that is. Yeah. Absolutely. So this is kind of based on what I've heard, so folks may not agree. But I've spoken to several folks in the industry. I've heard it from from a couple of folks. But if you're looking to break into or even grow in an MSL role, there are a couple of things to have. So the first is launch experience.
It's important to launch a drug or a diagnostic. Having experience working with commercial compliantly working with commercial is also very, important. And then finally, having what we're talking about today is payer or market access experience. Those kind of round out the unicorn, of skills. Outside of that, I think, yeah, you know, MSL build relationship both internally and externally.
So maintaining a high clinical acumen, as a medical affairs colleague, but balancing it appropriately and tailoring, your messaging to your audience. Because you know this. You've spoken to several people on the podcast that we don't just talk to one type of person. We talk to folks across the spectrum here, both internally and externally. So you have to understand how to tailor your message, and articulate it clearly so that it's compelling to whoever you're speaking to.
So that kinda ties into. Got you. Yeah. I love it. And so MSOs that are out there that wanna learn more about this, like, where do they go to learn more about market access and some of the stuff we're talking about? Yeah. Absolutely. So great question. And I think it's important because there's a wealth of information available online. Right? And it can actually be overwhelming. So I would first start by asking yourself a question. Like, what do I wanna learn specifically about market access?
And I think that kind of guides you to where you can look for information. I've used LinkedIn. I think that's a fantastic resource. They've got some pretty basic information on there. We mentioned AMCP, the Academy of Managed Care Pharmacy. They've got a a pretty full website, very detailed information on there. MMIT, which stands for Managed Markets Insight and Technology, is also a great website, and they have a monthly newsletter that goes out that provides you with monthly updates.
But the biggest and probably best bet, and we talk a little bit about this too, is talk to your internal colleagues. Reach out to that person in market access. It doesn't matter where they fit in market access. Ask them a question. There's probably mutual interest there, and you're working towards a a mutual goal. So it actually probably makes more sense to talk to that person first so you can learn about, you know, what you're working on directly.
So that's kind of the guidance that I would give folks that are interested. Yeah. Those are awesome resources, guys. Definitely rewind that. Write those down. Check them out if you're looking to find more information. And so, Ruchi, as as we're talking right now, we're we're we're finishing out 2022. We're getting ready for 2023. Where do you see things going for MSLs, and what advice do you have for the MSL that wants to be a top performer in 2023?
Yeah. You know, I this is guidance for for any MSL. It's not just to be a top performer, but be eager, be be willing to take on new things, be willing to learn, kind of step out of your comfort zone. You know, take on a new task even if it's tough. Like, you have colleagues that are around you. And I know we're field based, so it might seem like you're disconnected.
But chances are you're probably part of a team, so you can reach out to folks, to to get help or to understand something that you may not understand. But I think take the risks, take the steps, to learn something new. That's I think it's it's kind of the best guidance that I can get. That's great advice. And what about challenges? Like, what do you expect to happen? And, obviously, we're in this never end ending phase of of you know, there's always something that comes up that you don't expect.
Right? We're post COVID. People are still in this hybrid, you know, environment where we're trying to get FaceTime, and sometimes that's virtual, sometimes that's that's in person. But what challenges do you expect MSLs to face in 2023? Yeah. I mean, access, as you just mentioned, is probably a a really big challenge. I think the other thing is you have to understand that our HCPs and our KOLs are, have have less time. Like, it just it it it seems like they have less and less time.
Yep. You know, there's 3 to 5 people from each company pulling them in different directions. Right? The sales rep needs some time. The MSO needs some time. Maybe your pub team is reaching out to them to do you know, for a publication that they're an author on.
So being mindful of that, I found that being very respectful, of their time and understanding that, oh, if my colleague has reached out to you this month, like, I might not need to unless obviously there's something that we need to talk about. So being respectful, and I think that is also gonna be a challenge is that they're so pressed for time. You know, sometimes a 30 minute meeting is not gonna be 30 minute minutes. It'll be 5 minutes.
So just, you know, being flexible, which we obviously know is one of the the key skills that an Amazon needs to have. Yeah. No. For sure. Especially now. Yeah. You know, I think that we well, the one thing that we've learned is that the KOLs are gonna dictate the cadence and the pace at which things go and the mode by which they want to communicate. So I think if you're not flexible, you're not doing yourself any kind of justice. Absolutely. And I completely agree.
So what about you know, we always like to talk about and, you know, there's a lot of folks that listen to this podcast that are looking to break into the pharmaceutical industry, and are trying to get their 1st MSL role. So put yourself back in their shoes. What advice would you give those folks as they're trying to break into industry? Yeah. Just be persistent. Don't don't give up.
I didn't break into the role on my first interview, but you can learn something from each interview, right, where you need to improve on. So that's probably the biggest advice I would give is don't shy away if you don't get a role. Go back and review what you did, how you interviewed, where you think, you know, you had some weaknesses, where you can, you know, kind of gain some more insight into the role. There's obviously a ton of us in the community, so reach out to us.
We're happy to chat as well. But but I think that's basically it. Like, don't give up. It's it's not it's not an overnight process. It's gonna take a while. You might not get it on your 1st or second try, but I think you can learn from every single time you interview to ultimately get the role. I think the other thing that is important is, you know, kinda when I talk to aspiring MSLs is don't just blanket, apply to every MSL role that's on the Internet.
Try to tailor it based on your clinical experiences. You know, if you've got, a lot of experience, you know, in anti infective, go for something in that area, antivirus. Go for something, you know, focused on that. Don't just apply to everything across the board. If you got experience in oncology, shoot for oncology roles. So that's kinda what I would say. That's great advice. Absolutely.
I mean, you really wanna sell yourself and your your scientific value proposition because that's what's gonna get people's attention. If you just are are throwing your resume and CV out there without any real specific approach or tailored approach, you're you're doing yourself a disservice. It's just gonna wind up going in a big black hole, probably. Exactly. Yeah. Exactly. Yeah. Final thoughts. I'll let you kinda close this out as this was a great conversation, by the way. I learned a lot.
But final thoughts anything. What what what kind of advice or any kind of final thoughts you wanna share with with folks listening? Yeah. Absolutely. So, I mean, I'd like to just kinda wrap up. Talking about market access, again, it's it's a very important function, within a pharmaceutical company. And I think that as medical affairs, as MSLs, we work very collaboratively with market access. Right?
It's important to understand, the different roles and responsibilities of each team so that we can work together. So if you if you don't have that experience, if you're eager to kinda get that experience or to learn something new, I'd encourage folks to kinda reach out to people. You can reach out to me. You can reach out to people within your company to learn a little bit more. And then just advice for aspiring MSLs, don't give up.
I mean, if this is truly something that you want to do where you see yourself growing, don't give up. Just keep trying. Keep learning from each experience that you have and tie it all in. It's all about how you I think you said it, Tom. Tell yourself. Right? How are you selling your story and what value can you bring to a company that's either growing or or looking for, you know, an MSL in a territory that's maybe new? How do you do that? Yeah. For sure. That's great advice. And, hey, man.
It's, again, it's a great time. We're going into a new year, and I wanna wish everybody all the luck in the world. I I hope you guys crush it. I hope you you set really good goals right now so that you can get after it with intention, and you're going out there with purpose. And a year from now, you can look back and say, wow, man. I crushed all my goals. So that's my hope for you guys. I wish you all the best. Ruchi, thanks for joining me, man. You were amazing. Really good.
Hey, Tom. Thank you for having me. I appreciated seeing you a couple of weeks ago. Appreciated the time, on the podcast here. I really hope that the viewers find this, valuable. Happy to do it any time again. And if I could just close out by saying thank you to, TMAC, the medical affairs company, who gave me my first role as an MSL, but also my current company, CTI BioPharma. It's a fantastic, fantastic organization. And, of course, thank you, Tom. Yeah, man. Hey. Listen. And you know what?
It's I'm glad that you mentioned that. Guys, the you know, when you're in medical affairs, you're not in any profession. It's a body of work. You have to start somewhere and build and grow. So all the advice that Ritu was giving you and the stuff that we're talking about now as far as, you know, reaching out to people, how to apply to jobs, networking, and building out your career, just remember, just each day, you wanna do a little bit to move that needle.
Invest in yourself, invest in your career, invest in your resume, your relationships, LinkedIn, mentorship, networking. It all adds up. And, again, be goal oriented so that you're that you have a target that you're shooting for. And before you know it, you're gonna wind up like Ruchi where you got your first role, your second role, you're advancing in your career, and and the the future is really bright. So we'll Could've said it better, Tom. We'll leave it at that. Yeah, man.
So, guys, all the best. Thanks for listening, and, we'll see you next time. Thank you. 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.