Medical Science Liaisons in the Age of Personalized Medicine – Part 1
The idea is logical and straightforward: we are all created differently, and therefore, the best medicine and the most appropriate dose is likely to be unique for each of us.
Welcome to the idea, if not quite the age, of personalized medicine, where the goal is to treat every patient with the proper medication, in the appropriate dose, at the precise right time. This customized approach to medicine comes on the heels of the exact opposite, the era of the blockbuster drug - one drug designed to treat as many patients as possible, creating economies of scale for the manufacturer and a way to leverage the very long and expensive drug development process.
Though the roots of personalized medicine go back to the late 20th century, it is the 21st century that brought personalized medicine into focus. Innovations like reasonably cheap and fast DNA sequencing has allowed researchers to understand the minute variations between individuals better and relate DNA sequences with precise traits, e.g. how individuals differ in their reaction to medications.
An example is the effect of variations in the CYP2D6 gene – the gene that encodes the enzyme Cytochrome P450 2D6 - on drug metabolism. The CYP2D6 gene is involved in the metabolism of many commonly prescribed drugs, incl. tamoxifen, a drug used to treat breast cancer. More than 100 different variants (alleles) of this gene exist, many of which affect an individual's ability to ingest a drug and digest it safely. Based on the rate at which an individual metabolizes a drug, the dosage must be adjusted accordingly.
Personalized Medicine Means Data
Though we are still far away from achieving the ideal iteration of personalized medicine, one thing is clear: personalization involves the creation of vast amounts of data: specifically genetic data, clinical trial data, and the enormous trove of so-called "real-world data", like all the information that healthcare professionals collect from their patients. This data needs to be collected, stored, analyzed to be made accessible to the entire healthcare provider (HCP) community, not just in a hospital, or a group of hospitals. It must be available on a national level, and even more so, on a global scale.
To find the optimal treatment for you implies anonymized access to all patient data out there, in an attempt for HCPs to explore similar cases as a source of reference when handling your particular circumstances
Impact on Medical Science Liaisons
Personalized medicine also means a significant adjustment for medical science liaisons (MSLs). The amount of medical data out there is already staggering, and a study has shown that to keep up with the speed of new data creation, physicians would have to read 29 hours a day.
MSLs face the same challenge of increasing data, confronted by healthcare providers who are pressed for time and searching for more in-depth and targeted information that meets their specific needs. Being able to provide said information is what makes MSLs invaluable to HCPs now, and if not even more in the future. MSLs will have to be prepared to work with HCPs on very specific cases and provide custom-tailored information that helps physicians manage the challenges of personalizing treatments.
MSL as Conduit for Real World Data Flowing back to the Company
With more focus on real-world data, the role of the MSL in channeling valuable insights between HCPs and companies is also becoming increasingly important. Insights gained by highly trained MSLs in the field can inform internal decision making and planning. For this process to be efficient, an MSL must discern what information to report and how to effectively communicate it to ensure it reaches the appropriate internal groups.
Distilling the ever-increasing amount of data into actionable insight custom-tailored to the specific situation of each healthcare provider and potentially each patient requires automated, cloud-based systems and virtual interactions. MSLs need to be able to access information quickly, requiring an automated system assist with at least some of the requests for information.
However, the HCPs need for more profound scientific exchanges with their MSLs suggests that real MSLs are not going to be replaced by virtual MSLs any time soon.