Optimizing the Size and Improving the Impact of CNS Field-Based Medical Teams in Major Global Markets

This report will enable CNS drug manufacturers to fill knowledge gaps around key field-based medical team operational areas, including: staffing levels, resource allocations, productivity measures, efficiency (time spent on key external and internal activities), frequency of thought leader interactions by tier, effective communication channels, and tactics and tools for leveraging CNS field insights across the organization.

Study Snapshot

Best Practices, LLC engaged 17 medical affairs and field-based medical team leaders working in CNS/neurology/pain management therapeutic area at 15 leading biopharma companies through a benchmarking survey. Six deep-dive interviews were conducted with medical affairs leaders, whose insights were provided to enrich the data and add real-world context to the metrics and trends established.

To provide clear understanding of field medical trends across major markets, benchmark data is segmented by: Total Benchmark Class (N=17); Global Market Segment, excluding U.S. (N=9); North America Market Segment (N=8); and Europe (EU5) Market Segment (N=6).

Key topics covered in this report include:

• Optimization of CNS field-based medical team staffing levels
• Regional differences when building CNS field-based medical teams
• Number of thought leaders that are supported by MSLs
• How CNS field teams are staffed depending on stage of product lifecycle
• Budget allocations and revenue supported per MSL
• Duration and frequency of MSL and HOL interactions
• The degree of proactive vs. reactive interactions
• Time spent on internal and external activities

• Staffing Trends & Field Team Makeup:

• Average staffing for all field-based medical teams in this study (across 17 total country level survey responses) shows: 34 MSLs, 5 managers, 2 effectiveness leader, 5 HOLs and 1 manager
• Global teams deploy 17MSLs, 2 managers, 7 effectiveness leaders, 1 HOL and 0 managers
• U.S. teams deploy 57 MSLs, 8 managers, 3 effectiveness leaders, 9 HOLs and 2 managers
• EU5 teams deploy 11 MSLs, 2 managers, 1 effectiveness leader, 1 HOL or 0 managers


• Gaps in Weekly Time Spent vs. Goal Time on Key External Activities: Administrative and travel activities tend to take significantly more time than expected, while actual in-person time with KOLs falls well short of goals

• On average, MSLs spend just 7.5 hours directly interacting with KOLs vs. a 9.5 hours weekly goal (11% under goal)
• Instead, MSLs spend a weekly average of 7.4 hours on logistics and travel vs. a 5.9 hour goal (17% over goal)
• External meeting prep, post-interaction activities and medical head office support time spent are all relatively in line with goals

I.	Executive Summary	pg. 3
	Study Objective, Background
	Methodology, Segmentation, Topics Covered
	Key Findings and Recommendations
II.	Optimal CNS Field Team Staffing & Resources	pg. 12
	Portfolio Size
	CNS Field-Based Medical Team Staffing Levels
	Thought Leaders Supported by MSL
	Key Accounts and Payers Supported by MSLs and HOLs
	MSL Staffing in Product Lifecycle
	MSL Professional Background
	Budget Allocated, Revenue Supported
III.	Thought Leader Engagement	pg. 35
	Total Annual Interactions by Thought Leader Type
	Duration of MSL and HOL Interactions
	Frequency of MSL and HOL Interactions
	Proactive vs. Reactive MSL Interactions
	Frequency of 2253 Filings
	Effective Communication Channels
IV.	Field Activities and Productivity Levels	pg. 53
	Time Spent on External and Internal Activities
	Leveraging Field-Based Insights Across the Organization
V.	Appendix	pg. 60
	Level of Job Titles

• Total number of in-line and pipeline products supported by an MSL – Total benchmark class
• Total number of in-line and pipeline products supported by an MSL – Global, North America and EU5 market segments
  Total number of staff allocated to different field-based medical roles – Total benchmark class
• Total number of staff allocated to different field-based medical roles – Global, North America and EU5 market segments
  MSL vs. HOL staffing ratio
• Use of HOLs, HOL managers and MSL effectiveness leaders at benchmark companies
• Average number of thought leaders supported by each MSL; Mix of thought leaders supported by each MSL – Total benchmark class
• Average number of thought leaders supported by each MSL – Global, North America and EU5 market segments
• Voices from the field: Benefits of “Key Communication Maps”
• Proportion of KOLs and HCPs supported per MSL
• Voices from the field: Top-level driver of MSL value to the organization
• Thought leader tiers supported by each MSL
• Average number of large key accounts (hospitals, care networks or academic institutions) and payers supported by each MSL – Total benchmark class
• Average number of large key accounts (hospitals, care networks or academic institutions) and payers supported by MSLs and HOLs – Global, North America and EU5 market segments
• Percentage of the peak MSL team size assigned to support a product at each phase of the typical product lifecycle
• Voices from the field: Role of U.S. MSLs in training fellow field liaisons and preparing global affiliates to help support new treatments
• Effectiveness of onboarding MSLs at each phase of the product lifecycle
• Professional background of MSLs
• Effectiveness of listed types of prior MSL work experience in engaging thought leaders in high quality scientific discussions and building long-term relationships – Total benchmark class
• Voices from the field: Mix of MSL professional background enables flexible approaches to allied health professionals and other emergent treatment stakeholders
• Effectiveness of listed types of prior MSL work experience in engaging thought leaders in high quality scientific discussions and building long-term relationships – Global, North America and EU5 market segments
• Average MSL experience, budget allocation and in-line revenue supported by each MSL

• Total yearly MSL interactions with thought leaders
• Total KOL and HCP interactions per year
• Total annual interactions with global, national and regional thought leaders
• Voices from the field: Insights on net promoter score
• Duration and frequency of MSL /HOL interactions with thought leaders and payers – Total benchmark class
• Duration of MSL /HOL interactions with thought leaders and payers – Global, North America and EU5 market segments
• Average frequency of MSL interaction with global, national and regional thought leaders; and average frequency of HOL interactions with payers
• Percentage of proactive and reactive MSL interactions with thought leaders
• Frequency of listed proactive activities conducted by MSLs
• Frequency of listed reactive activities conducted by MSLs
• Proactive vs. reactive MSL interactions – Global market segment
• Proactive vs. reactive MSL interactions - North America market segment
• Proactive vs. reactive MSL interactions - EU5 market segment
• Frequency of 2253 filings in North America market segment
• Effective channels for communicating with thought leaders – Total benchmark class
• Effective channels for communicating with thought leaders – Global, North America and EU5 market segments
• Voices from the field: KOL engagement

• Actual time vs. goal time spent by MSLs on external-facing activities – Total benchmark class
• Actual time vs. goal time spent by MSLs on external-facing activities – Global and EU5 market segments
• Actual time vs. goal time spent by MSLs on internal-facing activities – Total benchmark class
• Actual time vs. goal time spent by MSLs on internal-facing activities – Global market segment
• Most effective processes for leveraging field-based insights across the organization
• Most effective tools for leveraging field-based insights across the organization