The Impact of the COVID-19 Pandemic on the Digital Transformation of Medical Affairs

Within the pharmaceutical organization, the medical affairs role encompasses a broad range of tasks and responsibilities. It may serve as an internal link between research and development (R & D) and commercial functions, or as an external link between the organisation and its customers, depending on the nature of function (1). Medical Affairs is now viewed as a strategic pillar alongside research and development and commercial teams, despite the fact that historically, Medical Affairs was seen as a support group to various functions within a pharmaceutical organization. The current COVID-19 pandemic has tipped the scales in favour of a greater level of scientific collaboration between healthcare professionals (HCPs) and pharmaceutical companies. The medical affairs function is being requested to step up their support to doctors, patients, health authorities, and other groups within their organisations as the coronavirus pandemic continues. Medical affairs professionals have been entrusted with additional critical responsibilities such as virtual interactions, quicker dissemination of information, enhanced digital capabilities, and personalisation. As a result of these new digital prospects, the emphasis has moved to the critical role that technology plays in satisfying increasing consumer expectations. With the science underpinning many medicinal products growing more complicated, HCPs increasingly seek pharmaceutical companies for high-level scientific information and engagement. Therefore, pharmaceutical organisations must ensure that a modular, adaptable architecture enabled by technology is in place to facilitate smooth handoffs from one channel to another, as well as connect disparate data sources to provide a single perspective on the consumer.

1.????Medical Affairs function in pre-pandemic era

One of the primary functions of the medical affairs has been to bridge knowledge gaps among HCPs by facilitating scientific interaction across various formats (2–4). By using a strategic evidence, medical affairs professionals may assist understanding data and insights, establishing a clear evidence-based narrative for communication with HCPs, payers, patients, and internal stakeholders (5,6). The other areas of focus to Medical Affairs function, has been studying and collecting patient-reported outcomes in clinical and, particularly, real-world studies (7,8), leading tailored disease awareness and patient education campaigns (9,10), and providing real-time treatment analytical support (11).

Before the pandemic the medical affairs organisations had already started realising the importance of adapting newer technologies and digitally empowering their MSLs. However, face-to-face meeting was still perceived as the most impactful and focus was on product-led science. Unaware of the COVID pandemic, the pharmaceutical organisations were already transitioning to digital capabilities to make the communication more impactful and started to adapt data generated insights into their communication strategies. At the sudden onset of COVID pandemic this became a compulsion rather than a thought strategic choice. Overall, pharmaceutical organisations, especially Medical affairs functions have responded well to the demand of the virtual interactions.

2. Medical Affairs Challenges and Expectations During the COVID-19 Pandemic

There are multiple constraints and challenges associated with the COVID-19 pandemic, such as uncertainty about patient timing and service demand, discontinuity in connection with patients, shift towards telemedicine and telecommunication, as well as disruption of the entire continuum of care (12). Demand shifts, regulatory amendments, and research and development cutbacks were all short-term effects of COVID-19. On a global and local level, there has been a slowdown in growth, delays in the approval of non-COVID-19 related drugs, and a shift toward self-sufficiency in manufacturing and supply chain (13). The COVID pandemic has shifted the focus from disease to patients, and from product-led to patient-led development (14).

The epidemic presented new problems and expectations to medical affairs. For example, repurposing pharmaceuticals or compassionate requests were prevalent during the epidemic, in addition to quickly replying to the unsolicited off-label queries (15). Due to time savings and restricted access to HCPs, MSLs and field-based medical colleagues are taking on additional office-based activities.?

3. Driving levers of ‘New Medical Affairs’

The COVID pandemic has undeniably accelerated digital transformation and raised the stakes of medical affairs. Medical affairs has emerged a strategic leader due to its overall positioning, scientific competence, and responsibilities that connect internal and external stakeholders. With the growing volume of scientific data and the difficulties of understanding and presenting research to direct interactions with stakeholders and, ultimately, improve patient outcomes, medical affairs is expected to become the pharmaceutical company's third strategic pillar (16). This would need close collaboration with the commercial, market access, and public relations departments. Some of the areas of focus for the ‘New Medical Affairs’ would be following:

3.1 Interactions with patients and patient advocacy groups

Another area where Medical affairs has been impacted due to COVID pandemic is the way of interactions with patients and patient advocacy groups. Due to the COVID related restrictions, time for patient education and counselling has adversely been affected. Medical affairs teams may contribute to the development of an eco-system in which patients assist one another and the community. This include disease awareness, early detection and referral, adherence to therapy, and overall health (17

3.2 Real word evidence (RWE)

In the post-COVID-19 future, there will be a greater focus on generating real world evidence. There will be a need to evaluate the outcome in patients with multiple comorbidities and different health-care systems. In addition to regular safety data collection, post-marketing safety monitoring and post-approval commitment studies will continue to arise. RWE will continue to be high on focus, due to reimbursement and regulatory considerations, and will benefit from growing acceptance (18). Medical Affairs may take the lead in developing digital platforms, including data analytics, and forming and supporting collaborative groups for data collection and sharing (19).?

3.3 External collaborations

The COVID pandemic has also highlighted that pharmaceutical organisation cannot work in silos and would needs to collaborate across organizations, in order to bring holistic solution faster. Some of the area where Medical Affairs may contribute to external collaboration is medical communication, co-developing medical education programs, patient information resources and enhancing the capabilities of healthcare professionals (19).?

3.4 Data dissemination through Congresses

The COVID epidemic had a significant influence on scientific congresses; first, conferences were postponed or cancelled, and later the bulk of congresses became virtual. As a result, pharmaceutical companies are seeking newer methods to exchange scientific information. The issues associated with congresses will persist until the pandemic is over, but organisations that do not equip themselves with tools and technology for virtual participation and digital distribution will suffer in the long term. Medical affairs will need to utilise skills in social media and adult education, as well as traditional medical communication and content digitization, as part of the emerging approaches (20).

3.5 HCP Engagement

Medical affairs will involve a greater range of healthcare stakeholders, including digitally savvy healthcare practitioners, payers, and patient advocacy groups. Engagement must be of a high standard and tailored to each client's specific objectives. Numerous current face-to-face interactions will be supplanted by digital technology (16). Medical affairs will adopt an omnichannel customer approach in response to the COVID pandemic, allowing for the integration of digital touchpoints that prioritise HCPs and patients above pharmaceuticals. The goal is to build an experience that is data-driven and customer-centric across channels and devices. It will be critical to collect and analyse data in a centralised location using good business processes and management (21).

3.6 Role of Artificial Intelligence in Medical Affairs

The adoption of Artificial intelligence (AI) and Machine Learning (ML) technology has accelerated healthcare digitalization in recent years. Medical Affairs is increasingly relying on innovative AI solutions. However, it is only an algorithm and cannot replace human judgement and understanding. Natural language processing (NLP) uses AI and machine learning to replicate and extract information from massive amounts of unstructured text input.

Pharmacovigilance, Medical Information, mobile platforms to enhance health outcomes such as treatment adherence and drug discovery are now using AI. There are several areas where medical affairs can actively use AI, ML and NLP algorithm capabilities. Some of the important ones are: to optimise impact on both internal and external activities are gaining insights from multiple internal databases, by using both structured and unstructured data captured from HCPs and KEEs in the field, to better align engagements within the medical strategy, producing dynamic medical communication material which can be customised as per the preference of HCPs and Medical Information response documents (22). AI may also be used to optimise digital channels for medical information and to get a better understanding of the patient experience. In the past, measuring the effect of field medical interventions has been difficult because of the increasing volume of data being collected from a variety of sources and technologies. We now have the potential to quantify that effect by maximising the use of our current data using analytics and artificial intelligence. The fact that a humanistic AI can be taught to comprehend MSL notes implies that actionable insights, as well as patterns in that data, may now be uncovered.

4. Conclusions and Recommendations

The difficulties and advancements associated with the COVID epidemic have accelerated the pharmaceutical industry's digital transformation, which medical affairs is well positioned to drive and expand. Medical affairs has a bright future, and the function is expected to become the pharmaceutical company's third strategic pillar, alongside research and development and commercial operations. To achieve future fitness, medical affairs must leverage technological advancements and demonstrate digital competency and mindset change, expand partnerships and collaborations across the healthcare ecosystem, develop business leadership acumen, knowledge acquisition and self-development, and the ability to generate real-world evidence using data science, artificial intelligence, and analytics. Additionally, it includes increasing the scope of relationships with technology vendors, pioneers in HCP digital transformation, and even other pharmaceutical companies.

However, sufficient investment in innovation and technology is required to engage meaningfully with decision makers and external stakeholders.

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