Participants will learn the functions and activities of key internal partners and will identify potential areas for compliant collaboration with these partners.
This Medical Affairs webinar assembles leading biopharma industry experts to discuss preparing your organization for digital transformation.
Medical Affairs thought leaders discuss the Pre-21st Century Cures Act uses of Real World Evidence (RWE) in regulatory decision-making.
The Series Podcast Objectives are:
Podcast objectives include understanding how the medical affairs strategic planning process can drive decision making throughout the year
As VP and Head of the Asia-Pacific Medical Affairs function at Amgen, Victoria Elegant saw COVID-19 a full two months before colleagues in other parts of the world. In fact, in January 2020 as news of COVID-19 outbreaks in China reached beyond the country’s borders, Elegant was finishing a ski trip to Switzerland. “The second I got off the phone with our crisis team, I went out and bought masks and hand sanitizer,” she says. Elegant was traveling with what she describes as a “big, international group of doctors,” and remembers that at least half the group was amazed by her reaction. “I passed out masks, saying ‘You will need these,’” Elegant says. Here the Medical Affairs Professional Society (MAPS) speaks with Elegant and colleague Ka Weng Mah, Director of Medical Capabilities, Amgen Asia Pacific about the takeaways for the practice of Medical Affairs afforded by their front-row seats to the pandemic, and also about results of a recent Amgen survey of healthcare provider preferences.
MAPS: You talked a little about Europe’s reaction to news of the pandemic – what did you see when you returned home to Hong Kong?
Victoria Elegant, VP and Head of the Asia-Pacific Medical Affairs function at Amgen
Elegant: Healthcare professionals in Hong Kong knew what was coming. In Asia, we went through SARS and there is a culture of wearing masks if you are sick to protect other people. Even flying back to Hong Kong in January, everyone on the plane and in the airport was wearing masks. In the middle of it, it was intense – trying to figure out what we needed to do for our staff, for patients, how to continue clinical trials.
Mah: As early as in late Jan/early Feb, many people in Asia were even more progressive than the governments, with calls to close borders immediately. The majority, almost 98.8% in many Asian countries, also took the initiative to wear masks.
MAPS: So, effectively, you had a two-month head start on the pandemic compared with the rest of the world. Did this put you in a position to see early transformations in the practice of Medical Affairs?
Elegant: Even before the pandemic, we had seen that we needed to do things differently and had appointed a Medical Affairs digital lead in July 2019. So when hospitals suddenly wouldn’t let us do face-to-face healthcare provider interactions, in a way, we were lucky and perhaps a bit ahead of the game: We had already laid the foundation for digital.
Mah: Previously, we had aspirations to drive digital transformation but it was just experimental. Then with COVID, it meant squeezing years of work in one month. What we said is that every MSL can be e-MSL, every event can be an e-Event, and it was COVID-19 that hastened the transformation of our business – the future we were working towards, came today.
MAPS: On the organization side, digital transformation was driven by the realities of the pandemic, but did you see the same adoption from healthcare providers?
Elegant: China changed almost overnight. But Japan and Korea are conservative countries and change can be more challenging. Asia is still a face-to-face culture. For example, the more people you have in a meeting with an important person, the more you show respect. These were attitudes we had to work on. We saw that we needed to facilitate this change management and get stakeholders to accept a new way of doing things. Therefore, back in April we performed a systematic review of industry reports, followed by internal (MSL) and external (KOL) surveys, in order to identify and drive the necessary new ways of working in this peri-COVID era.
MAPS: And what do you see now in these countries?
Ka Weng Mah, Director of Medical Capabilities, Amgen Asia Pacific
Mah: We spent so much time educating and bringing people up to speed, then all of a sudden we had way more transformation than we could handle. Korea had practically no virtual interactions but were forced to adapt and flipped overnight and now they are embracing digital completely. Japan, as well, embraced digital but now many healthcare providers in Japan are already wanting to go back to face-to-face interactions. Perhaps there is a cultural element to this, but there’s no way we can go back. The new world will be a blended one. I think that for a more digitally open country like China, it will go 50percent digital or more, while countries like Japan and Korea may end up being somewhat less.
MAPS: There must have been some element of excitement watching these initiatives that had been moving along slowly suddenly gain momentum?
Elegant: We had to do this transformation overnight, working 24/7 to get capabilities and systems in place. Big corporations have their challenges with innovation but MSLs have to do their jobs and meetings had to go ahead. We spent a lot of time trying to support teams and engage with them and figure out how they could managethis We also had to support the teams to find a balance between the work that needs to get done and also keeping themselves mentally and physically healthy in the new way of working.
MAPS: Does all this work and all this dramatic transformation simply bring you back to the level capabilities you had before the pandemic or is there some benefit to these activities beyond simply learning how to do your old jobs in a new world?
Elegant: One of the things that’s emerged for us is patients as an even more important stakeholder. The COVID process has led to the realization that the healthcare system is set up for providers and not necessarily for patients. It’s super inconvenient – generally – to be a patient. And now we see there are things we can do to help – things like delivering clinical trials supplies to patients’ homes or providing a 6-month prescription instead of a 1-month prescription or providing an ongoing supply of medications to homes for chronic conditions. One of the big things to come out of this pandemic experience is how to work with patients to amplify their voice, especially in Asia where the patient voice hasn’t been so strong. This inclusion of patients as core stakeholders opens our eyes to other non-traditional stakeholders in the patient-care continuum, for example caregivers, physical therapists, pharmacists, nurses, occupational therapists and others. It is not just physicians in this healthcare ecosystem and digital transformation gives us the opportunity to engage with some of these categories that have traditionally been overlooked.
MAPS: And how do you reach these people?
Mah: The gist is that someone needs to engage those important stakeholders as partners, not just when we need them every three years. The patients are, and will remain, at the core in everything we do. So this is our immediate priority to sort – who, when, how to reach out to them. Then we have to go sector by sector: A more democratized world, the patient voice, more virtual and digital as well so that everyone gets the information they need. I don’t think we’ve figured it out exactly who and how to reach out.
Elegant: One thing we learnt from the survey we conducted (see White paper) is that doctors want scientific interactions, so maybe they’re prioritizing their interactions with Medical Affairs, or maybe it’s just easier to have remote interactions with us. We find that it’s easier to have a remote interaction if you have an established relationship first, but setting up that relationship remotely can be challenging.
MAPS: Do you have any other takeaways from your survey of HCP preferences for continued MSL interactions?
Elegant: Certainly. If I were to point to one area of our report, I would look to our recommendations for the future. First, putting patients and their caregivers in addition to HCPs at the core/center of Medical activities. Second, successful Medical teams will use innovative, modern approaches in scientific engagements. And finally, leading Medical teams need to invest in (and incorporate) rapid and radical digital transformation to ways of working. We are focused on making sure that these transformations will be executed and embedded into our ways of working, in order to improve patient outcomes and standards of care in Asia Pacific.
Medical Affairs thought leaders discuss the function, activities and opportunities for compliant collaboration with key internal partners.
Q&A with Medical Affairs thought leaders describing changes in Digital and Field Medical during the pandemic and beyond
This webinar describes the NeuroLeadership Institute’s SCARF model (Status, Certainty, Autonomy, Relatedness, Fairness) and its application to the practice of Medical Affairs
Nothing could stand between Joseph Eid and his dream of becoming a doctor—not even gunfire.
Attending medical school in Lebanon at the height of the country’s lengthy civil war was a risk, but Joseph wanted to complete his studies in his home country. He vividly recalls a period when the war shut down the school and he traveled to the U.S. to spend the time off with family. It was a prudent plan, until a classmate contacted Joseph to let him know classes were starting again and he had to be back for a test on Monday. It was Thursday.
At the time, Lebanon was under military blockade, so he couldn’t fly back to school directly. Instead, he flew to Athens, then Cypress, then bought a ticket for an overnight speedboat to the Lebanese coast.
The boat left at 2 a.m. Sunday night. Just as Lebanon appeared on the horizon, the captain shut off the boat’s lights and told everyone to hit the deck. Then the bombing started. The passengers could hear splashes as the bombs and rockets exploded around the speedboat. Somehow, the boat survived the assault and so did Joseph.
He arrived in Lebanon at 4 a.m.—just four hours before his exam.
Joseph Eid was born in the late sixties, the youngest of four children. At the time, Lebanon was a peaceful and prosperous country—but that was changing. Shortly after he was born, the Six Day War erupted, and a full-blown civil war followed a few years later.
Growing up in a war zone was challenging, to say the least. Going to school was a risk every day, as militant groups often targeted schools. Over the course of the war, his family lost their home to the bombings as well as countless friends and family members.
Joseph’s father was in the army’s mechanized division and accountable for material procurement. After visiting multiple U.S. army installations to procure equipment for the Lebanese army, it became his mission to bring his family to the US to provide them a safer future.
From a young age, both parents taught Joseph and his siblings dedication, discipline, and commitment to education. Joseph recalls a year when he was eight years old that schools were shut down due to the war. When school was back in session, he had to complete two grades in one year to make up for lost time. A couple of years later, after he was awarded scholarships for his academic performance, the principle told him there was no need to take a final exam. Joseph’s parents sent him back to school to write the test anyway. They told him he shouldn’t be treated any differently from other students.
By the time Joseph started medical school, most of his family was living in the US. But Joseph chose to finish his schooling by splitting his time between Lebanon and France when the war situation got worse.
It’s no surprise that Joseph brought that same fearlessness and gritted determination to his medical career.
Joseph took his tests in the US while still in medical school in Lebanon. After receiving his diploma, he completed his residency and fellowship in New York and New Jersey respectively. During the fellowship, he quickly rose in the ranks and was recruited to the faculty before graduating.
At Rutgers, Joseph was interested in more than just advancing his career—he wanted to solve problems and save lives. When he discovered that many sickle cell patients did well under pediatric care but struggled when they reached adulthood, he decided to do what he could to help. He applied to research grants, but after his applications were repeatedly rejected, he opted to open a clinic to help patients instead. He took training on sickle cell treatment and brought back what he learned to the clinic.
It was an extraordinary step that was life-changing for patients—and for Joseph. He proudly shares that most of his patients were able to go back to school and work because of the treatment and care the clinic provided.
Joseph Eid with his young daughter
But Joseph was a victim of his own success. He kept taking on more responsibilities, to the point where he was on call six months of the year. Now a newlywed with a young daughter, he recognized that it might be time to consider a career change so he could spend more time with his family.
In 2004, he decided to move out of academia and into the world of pharma. It was tough to leave, but he established an arrangement that would allow him to still see patients on a part-time, volunteer basis. He felt it was his duty to continue to care for his patients even after he left academia.
What drew Joseph to pharma was the rigor and scale of the work, which was so much greater than what he could hope to achieve in academia. Still, his experience in front-line medical care had ingrained a profound commitment to putting patients first.
“I knew that to deliver in pharma, I had to have the patient in focus,” he says. “That mindset stays with me today. In every meeting, I bring it back to the patient.”
Joseph cut his teeth in pharma at Roche, before moving on to Merck in 2009 as Executive Clinical Director. At Merck, his focus was late development, when the drugs were in phase 1-3 clinical stage. It was as close as he could get to seeing the science reach patients—exactly where he wanted to be.
In 2011, he took on a new role as senior project manager, where he came up with unconventional strategies and an ambitious vision for an anti-PD-1 antibody which revolutionized cancer treatment. After taking on a new role, Joseph’s leadership resulted in a tremendous increase in the size and importance of the Oncology Medical Affairs department within the organization. From 2014 to 2017, it grew from just three members to over 400.
Before long, word spread of his success and he was recruited by BMS to head up their entire Medical Affairs department.
Joseph Eid with his parents
In the first weeks at BMS, he spent his time listening and asking questions. He quickly realized the teams had their priorities confused. They were focusing too much on to do lists and not enough on their purpose.
To inspire the department, Joseph encouraged the teams to share their triumphs with each other. He asked each team to create posters illustrating their work, then he put them on stage behind him at his first town hall. The atmosphere changed immediately. Once they were given a voice and a chance to share their good work, the department was reenergized.
In recognition of the growing importance of medical, Joseph was asked to join the CEO team at BMS. Now, his ongoing role is to continue to improve the team’s engagement. As he leads the organization through the pandemic, patient care continues to be Joseph’s north star.
He believes that the key to success is reminding all 2,200 team members of the purpose of their work.
“People have to have something meaningful they are working toward,” he says.
Here are his top thoughts on leading truly purpose-driven teams.
For Joseph, the key to effective leadership is to remind team members of the remarkable impacts of their work by sharing patient stories and testimonials. Seeing how their drugs provide hope for people who are out of options has a tremendous effect on everyone, from executives in the c-suite to reps carrying the bag.
It is easy to forget that the decisions pharma people make affect the day-to-day lives of patients. Joseph recalls working with a team to write a protocol and becoming frustrated because it had so many “bells and whistles.”
“If you were a patient would you be able to do all that?” Joseph asked the team.
It was exactly the reminder they needed. The team set to work simplifying the protocol to ensure it was practical and easy to follow.
Over the years, Joseph and his teams adopted countless practices that go against the grain. They followed patient blogs to gain insights into what was on their customers’ minds. They engaged with patient groups and physicians. In trials, they often amended an ongoing phase 1 with more patients and indications to accelerate the clinical development rather than add new trials.
His approach is often unconventional, but throughout his career, he has learned that doing things differently pays off.
With COVID-19 transforming the way people everywhere live and work, there is no better time for new approaches. Daunting as it is, Joseph feels prepared to take on challenges resulting from the pandemic.
“Our mission in life is to make our work matter,” he says. “Everything we do touches patients.”
This article is graciously contributed by Excellerate: Patient-Focused Engagement for Pharma.
Cerise James, MD, moderates this podcast in which Neil Belson, JD, discusses Real World Evidence and its impact to the biopharmaceutical industry.