Garth Sundem  00:00

Welcome to this episode of the Medical Affairs Professional Society podcast series, Elevate, gathering the voices of Medical Affairs thought leaders and stakeholders to explore current trends, defined best practices, and empower the Medical Affairs function. I’m your host, Garth Sundem, communications director at MAPS. And today we’re speaking about scientific communications platforms with John Eichert, Senior Principal at IQVIA, with a mission to discover previously unseen insights, drive smarter decisions and unleash new opportunities. So John, to start, can you tell us a little bit about yourself and how you came to your current position?

John Eichert  00:41

Yeah, I started a company back in 2003, called Rivermark. And we specialize in the identification and engagement planning for thought leaders in the medical field. And we were acquired by IQVIA in August of 2019. And now I lead the thought leaders Center of Excellence for IQVIA.

Garth Sundem  01:02

Oh, that’s interesting is that the thought leader Center of Excellence it sounds like, you know, I didn’t realize this IQVIA kind of segment its activities by the Centers of Excellence.

John Eichert  01:15

Yeah, there’s different centers around IQVIA that each have a dedicated specialist specialty in a specific discipline, and ours happens to be identification, profiling, segmentation and engagement of medical thought leaders.

Garth Sundem  01:32

Well, okay, so can you catch me up on on the background? What is the what is the interface between scientific communication platforms and this thought leader, Center of Excellence? How do those two interface?

John Eichert  01:50

was first, this thing, it’s important to understand what a scientific platform is and why it’s important to the successful launch of any given medical product. And scientific platforms? Very simply, our core beliefs are assumptions that really provide a foundation for all brand medical and promotional messages. It’s the foundation on which all medical communications is developed. And it’s a core element of of the strategy and is essential for effective engagement of thought leaders by Medical Affairs as well as commercial teams.

Garth Sundem  02:30

Okay, and it seems like with our exploding data universe here, that this would be an area of great change. What major changes have you seen in in the scientific platforms in the context of stakeholder engagement?

John Eichert  02:51

I think the first is science these days with the new newer biopharmaceutical products is much more complex. And it requires a whole, wholly different level of expertise on what on behalf of the Medical Affairs team. And it really translate transfers or transitions, the Medical Affairs teams into really helping healthcare practitioners understand the core science that that is driving the value of a particular product. And I think the second is, data, there’s a lot more data. And I think there’s a lot more specialization in where these products are used. So Medical Affairs has to become much more adept at managing data so that they can help healthcare practitioners understand which patients benefit the most from specific new therapies.

Garth Sundem  03:49

And are there so in addition to more data overall, what sort of new data sources are you looking at?

John Eichert  03:57

Well, there’s a whole host of them. And really, when we’re thinking about scientific platforms and thought leaders, there’s a wide range of data sources, that one begins to utilize to identify who the experts are in a given field, in which experts are most aligned are most appropriate for engagement by a particular Medical Affairs team. So you start out with peer reviewed publications, clinical trials and conference presentations, and you have, you know, research grants becomes, you know, important to say, who’s who is it that’s receiving funds for research in a given therapeutic area? Then we have, you know, there’s a lot of primary research opportunities to really understand who talks to whom and who seeks advice from whom when treating patients with a given disease. And then there’s a wide range of claims data, you know, you got prescribing data, you’ve got diagnosis data, you got medical claims and hospital claims. And there’s a wide range of sources is an information that all can go into understanding, you know, not only who the experts are, but how is the disease managed currently? And where are the unmet needs?

Garth Sundem  05:11

Well, you know, it seems to me, you know, and I know cuvier has been working in this area a lot. But it seems to be that the scientific communication platforms and Medical Affairs involvement in stakeholder engagement starting earlier and earlier, you know, could you talk a little bit about the feedback that Medical Affairs professionals get from, you know, say physicians, payers, external scientific experts, early in the development?

John Eichert  05:42

Right. That’s a trend that we’re seeing is that Medical Affairs is getting involved earlier and earlier. And I think one of the common gaps are mistakes that companies make because they don’t engage soon enough. And that and they, they assume that the marketplace understands the science understands what the unmet medical need is. So my Medical Affairs gets involved earlier, they’re able to really frame the opportunity where the unmet medical need is, what our current treatment practices where current beliefs and assumptions that physicians have about the diagnosis, management and treatment of disease of a given disease, with the burden of the diseases, you know, there’s both a medical burden on the healthcare system, but there’s economic burdens on the patients. There’s burdens on society, and really fully understanding what those unmet needs are and what the burdens of the disease are. Medical Ferris is able to have a strategic role in framing not only the opportunity, but really building the foundation for the product profile.

Garth Sundem  06:54

It’s interesting, it’s like building a scientific brand around a product. Well, so can you see then? Or how to medical address professionals message this impact and message this value? Can you quantify the benefit of early involvement, or you know, even involvement at all?

John Eichert  07:17

Well, I think the benefit, primary benefit is making sure that the assumptions The company has about the relative value of the product or developing is aligned with the assumptions and beliefs of the medical community. And I think too many companies often assume that the medical professionals are going to understand the science understand and see the value of their product. And those assumptions need to be confirmed as soon as you possibly can, so that you’re making sure that the medical messaging and the rationale for utilization of a new product is aligned with the beliefs and assumptions of not only the experts, but the practicing physicians, those who are seeing patients and making treatment decisions, who may not be the traditional, you know, thought leader or medical expert, or caol, as often as the term that’s used, yeah, but but they’re individuals who are seeing the patients and making those treatment decisions, it’s really important to understand not only how that kayo ELLs are the thought leaders think about a disease, what their assumptions or beliefs are, but also what the practicing physician assumes to be true, and believes to be true about managing a patient with any given disease. There’s often a gap between those two audiences.

Garth Sundem  08:42

Well, let me just follow up on that. That’s really interesting. I’ve always looked at the rationale for use being the safety and efficacy that would come from r&d. But you’re saying that in parallel with that Medical Affairs can be working to ensure that the safety and efficacy that would come from clinical trials is paired with stakeholder understanding of how why when with whom to use the drug, even beyond the the safety and efficacy of clinical trials?

John Eichert  09:24

Yeah, the the, certainly the safety and efficacy of the clinical trials and the design of those trials has to be done in a way that actually addresses the outcomes of those trial addresses the unmet need, and not only it compares the new drug to standard of care, but also highlights the relative incremental new value that’s being added to treatment by a new therapy therapeutic option. And it used to be Medical Affairs sort of listened and answered questions. In reacted to healthcare professionals and Cowell’s questions and that kind of evolved to be able to anticipate and inform on those healthcare professional questions. But now we’re medical fears is today is they have to shape and transform the dialogue and, and make sure that the company understands that fundamental beliefs and assumptions that exist in the medical community, but also aligns the medical community through scientific evidence to the assumptions and beliefs that the company has about cheating that disease.

Garth Sundem  10:41

Okay, so is it that the primary objective for a Medical Affairs team is to create this alignment?

John Eichert  10:51

Yes, first to understand it, yeah. And understandably, help the company formulate its platform statements, its belief statements. But also to be sure that that those platform statements are aligned with how the medical community thinks about the disease. So I think companies often assume that the medical community believes the science that they have, and believes the evidence that they have. But in many cases, unless that’s really confirmed, not only at the expert level, but also at the community level, because oftentimes, there’s a difference between the beliefs, assumptions about mounting a disease amongst bonafide national experts, and those in the community is seeing these patients, they think about these things differently, they often talk about them differently. And Medical Affairs has a critical role to play and to be able to bridge that gap between the national experts lexicon and ways of thinking about a disease and those in the community are thinking about and treating that disease. So they play a pivotal, crucial role not only within the company, but also within the medical community to help align those beliefs and assumptions.

Garth Sundem  12:08

Right, and it’s it’s kind of linear in a way to think about drug development from the perspective of the drug. And it sounds like you’re saying that Medical Affairs team have the opportunity to bring in a more patient focused perspective. Is that yes. Okay. Yes.

John Eichert  12:29

And I think you’re bringing up a really key important element for Medical Affairs is becoming much more instrumental in interacting with patient advocates and disease advocates who may or may not be healthcare professionals. Yeah. So that when they’re talking to the medical community, and the National thought leaders, that they can bring a patient perspective and a family perspective, to that conversation with them with a national experts,

Garth Sundem  12:58

and even to development not just to use

John Eichert  13:05

most definitely in development, you know, part of the whole development process is trying to figure out where the product works, where it doesn’t work, who it works in. Yeah, you know, what, what has to be? What do we have to know in order to make make good decisions about appropriate use. And that’s a discovery process that goes along the way through the clinical trial, phase one, phase two, phase three process, and Medical Affairs as an instrumental role to play in that conversation that takes place between the clinical trials, company’s r&d teams, to be able to be sure that the product is being developed in a way that optimizes it’s it’s it’s not only its efficacy, but its safety and appropriate use in in the right patients.

Garth Sundem  13:55

So john, how do we identify these local thought leaders who don’t necessarily have a footprint like these national thought leaders, they’re not publishing as much they’re not the pie is necessarily in charge of big trials. How do we find these people?

John Eichert  14:12

Well, that’s a great question. It’s something we’ve been working on for almost 20 years now. And you know, what we’ve found is that they are hard to identify and the traditional techniques that are used to identify caol are thought leaders often come up short when trying to identify these local communities of practice. So So what we’ve learned over the years is that it takes a number of different data sources to be to get to this question of who is it at a local level, who’s providing advice and who is a trusted discussion partner with practicing physicians, because the other side of it is companies are using claims data. So they’re using referrals who refers to whom, and some are using who’s sharing patient With whom Some are even looking at early prescribing. But none of those techniques actually identifies these individuals, because they’re often in settings where their claims data or prescribing data, the diagnosis data, or patient data is is invisible, they sit in a hospital or they sit in a institutional setting where those claims are not captured at the individual HCP level. So what we’ve learned is that you have to combine techniques. So the first thing we start with is doing primary research. And we ask a very specific set of peer learning relationship questions. And these have been validated, working with several social scientists. And the one thing that we’ve learned is that we have to say, who talks to whom? So amongst your trusted colleagues, who do you routinely talk to about the treatment of a given disease? And then when you have a difficult to manage patient, who do you turn to For expert advice, these are pure nomination techniques. The limitation of peer nomination is the sample size is small. So if I serve a 5000 doctors, I get 500. Back, that means 4500 doctors I didn’t hear from. But what we’ve been doing using advanced analytic techniques is combining the share patient data, the referral data, affiliation, data, location data, especially data, age demographics, we’ve developed the machine learning model that actually allows us to use the peer nomination data from the primary research projected to the entire audience. So now we can map out the entire community of familiar communities of practice, what we’re calling learning communities or learning networks, who learns from whom, so that when new treatments are introduced, companies and Medical Affairs teams, as well as commercial teams begin to leverage this kind of information to know how to optimize not only the engagement of thought leaders, but how do I activate their communities of practice.

Garth Sundem  17:08

So you’re actually doing your own surveying to get the data for, say, these 500. And then you’re using all of these existing sources that have been leveraged elsewhere to build out those 500 to the 5000.

John Eichert  17:23

Yes, and that’s where we use the KV a Big Data Factory, you know, there’s I kV as one of the largest healthcare data sets available in the entire world. And we’re able to now leverage all those data assets. But we’re also able to use some advanced analytics techniques. And even using things like natural language processing, to be able to look at, you know, health health physicians, how the medical community is talking about given diseases. So the combination of big, big data, traditional primary research techniques that have been validated over the last 20 years, and advanced analytic solutions that allow us to map out these these communities to really help companies figure out who do I need to engage? And how do I effectively and efficiently distribute information that’s going to help doctors make the best treatment decisions they can possibly make.

Garth Sundem  18:20

And that’s interesting, though, that in this landscape of big data, the what is a keystone is the thing that holds up an arch, right, the the primary search of yours creating within communities using validated social science techniques remains a keystone.

John Eichert  18:38

It is a keystone. And we’ve, we’ve tried to do it without it. And what we find is, you know, these are relations, these are learning relationships that exist between peers. Yeah, you know, we did some work with a Wharton School and USC is Keck School of Medicine. And we learn that these these are unique individuals. These are individuals who are traditionally identified in these other data sources. So without having that information, we really don’t know who they are. We can guess who they are. But we don’t really know. By doing the primary research, we can be can see who is it that’s being nominated? What are their affiliations, where their practice characteristics? Where are they located? How old are they? What’s the patient mix? What’s their prescribing behavior? Are they early adopters, you know, are they followers? Are they sharing patients with others and using all this data, we’re able to look at the patterns between those that were nominated and primary research. And those same physicians in the lab the same characteristics and the same behaviors in the secondary data.

Garth Sundem  19:47

Well, it’s so in personal but then so personal, finding these people who eventually reach patients.

John Eichert  20:00

Yes, you know, ultimately, our responsibility is to make sure that those doctors and health care providers that are seeing patients with any given disease, know how to use a product, know who to use it in know what to look out for if something goes wrong, and makes the best possible decision they can make about making about any given treatment for that patient. And companies have a responsibility to make sure that information is provided to the health care practitioners who are seeing these patients. And oftentimes, they fail to recognize there are informal advisors is something in the literature, it’s called curbside consultation, where physicians talk to one another, they seek advice from one another, they learn from one another. And this is a very powerful, powerful relationship, that that can really help make sure that doctors are making the best decisions they can about any given new product.

Garth Sundem  20:57

Okay, so now we have all this, we have all this information in, you know, we have we have Medical Affairs, listening to external stakeholders, and hopefully formalizing some of that into what we would call insights. We also have the information in that’s coming from from clinical trials at the same time. So now let’s go back to scientific communications platforms. And is this where we start talking about information out?

John Eichert  21:29

Yeah, I think there’s, there’s, it’s a two way communication process. It’s not only company to the healthcare community. Yeah. But the healthcare community is voice into the company. And that voice is coming through multiple channels, it’s certainly coming through the r&d team and the clinical research teams. But also, it’s coming through from the Medical Affairs teams, who really is looking at things from called a practical sense, you know, what is a real world application of this new treatment? And what is it that the company needs to know? And what is it that the healthcare community needs to know, to make maximum use or the most effective and safe use of the given therapeutic option for for any given disease? So the Medical Affairs team becomes sort of a translator, so to speak, you know, they kind of translate the the clinical trial language into more practical application language and make sure that those two things are aligned. Ultimately, you want to be sure that the label and the approved indications for a given product are aligned with the the market opportunity in the market need? Where is the unmet need? And where is it that a product’s going to add the most value?

Garth Sundem  22:52

Well, and this sounds like a strategic role. This is not just an execution role on the on the Medical Affairs part, which traditionally was Yes. So can you tell us about the opportunities of Medical Affairs in this strategic role in in the context of being this translator and creating this alignment?

John Eichert  23:21

Yeah, so it’s, I think it starts with understanding that Medical Affairs traditionally has interacted with what I’ll call national key opinion leaders. These are individuals who are in academic settings, they write lots of papers, they do lots of research, they own you know, good, you know, leadership positions, in professional societies, they sit on guideline committees, you know, and maybe even Journal editorial board members. And that certainly is a critically important segment of the thought community. But it isn’t the only segment of the thought theory community that’s important to engage. And I think where we see medical fairs going is certainly starting and building on that foundation with the national experts, making sure the rationale for for use of a given product is aligned with health physicians and health experts think about it. But also medical fair’s is becoming more strategic and now starting to say, how does the practicing physician who’s seeing patients make treatment decisions? And how do I make sure that the knowledge and expertise that we developed with a national key opinion leaders is translated into language and and that’s understandable at the local level, because it’s important to understand their local thought leaders as well as national thought leaders. So what we see is happening is Medical Affairs is transitioning and becoming more instrumental player Our strategic player in making sure that that bridge is is built between the national experts in the language and lexicon they use and the local experts who who are seeing and treating patients. And what we have been finding. As critically important as there are local communities of physicians were thought leaders are providing expert clinical advice. They’re routinely talking to their peers about about new treatments, and they’re in essence, playing a translators role in translating the high science and clinical trials into language and, and, and practical understanding of what what does it mean to you in a local practice and what you’re doing today?

Garth Sundem  25:50

Well, that that’s so interesting that the bigger data gets the little or we can get in a way where we’re able to find and engage these these local leaders who are actually making a major difference in patient outcomes and how new treatments are used. Yes. Okay. Well, john, let’s leave it at that. So thanks for joining us today. To learn more about how your organization can partner with IQVIA to explore the strategic opportunities of scientific communications platforms, visit IQVIA.com. That’s IQVI a.com MAPS members, you can continue the conversation at the MAPS Connect app. And don’t forget to subscribe. We hope you’ve enjoyed this episode of the Medical Affairs professional society, podcast series. Elevate