MSL INSIGHTS. The MSL KPI Disconnect A Global Survey of MSL KPIs and Metrics. Oct The Medical Science Liaison Society

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1 MSL INSIGHTS The MSL KPI Disconnect A Global Survey of MSL KPIs and Metrics Oct The Medical Science Liaison Society

2 Executive Summary How to properly measure Medical Science Liaisons (MSLs) and what they should be measured on is open to consistent debate. As a result, the Medical Science Liaison Society conducted a first of its kind global survey to gain insights into what KPI s and metrics are currently used to measure MSLs across the pharmaceutical, biotechnology, medical devices and other healthcare industries. The survey included 781 Medical Science Liaisons (MSLs) and MSL management from 46 countries. What made this survey unique was that in addition to discovering what KPI s are being used, we also identified how MSLs want to be measured and the challenges of measuring the value of the MSL role. A summary of the findings was revealed during the recent Annual MSL Society Conference in Boston, September 29-October 1st, 215. What follows is the complete results of the global MSL KPI survey. Quantitative & Qualitative KPIs MSLs are measured on a mix of both qualitative and quantitative KPIs. The mix can change considerably from one company to another and MSLs prefer one type over the other. Currently, the most frequently used quantitative metrics for evaluating MSLs are the number of KOLs visited in a month/quarter (74%), followed by the number of scientific/education presentations delivered by MSLs to external stakeholders (57%), and the number of face-to-face meetings per month/quarter/year (56%). Each of the following KPIs are common to about 4 out of 1 MSLs: number of proactive interactions with physicians and KOLs (44%), number of KOL relationships maintained (4%), number of unsolicited medical requests resolved/month (39%). For the most part, as it relates to quantitative KPIs, MSLs are evaluated by the metrics that they want to be measured on. The correlation between what quantitative metrics they should be measured by and which they are measured by was.78, explaining 61% of the variance between the two measures. A majority or near majority of MSLs want to be measured by the number of scientific/educational presentations delivered to external Oct 215 Page 1

3 stakeholders (6%), the number of KOL relationships maintained (58%), and the number of face-to-face meetings per time period (49%). However, less than a quarter of MSLs indicated that they should be measured by the following metrics: Number of drugs/formularies supported Number of effective interactions with hospital administration in gaining formulary access Amount of spending on kol interactions Number of promotional presentations delivered to external stakeholders The only quantitative KPI in widespread use that isn t a favored measure by MSLs is the number of AdBoards per time period. Conversely, one KPI that MSLs revealed that should be used to evaluate performance but it is not commonly used is the number of new KOL relationships. Alternatively, MSLs much more prefer to be measured by qualitative KPI s. The most commonly utilized qualitative KPIs are observation and feedback from managers/directors (75%), special project participation (5%), and feedback or surveys from internal stakeholders (44%). In stark contrast to the quantitative KPIs, every qualitative measure was desired by the majority of MSLs! Oct 215 Page 2

4 KPI-Related Activities MSLs were asked how many times they interact with KOLs and other physicians in a typical quarter. The median responses were 4 times face-to-face, 3 times via , 1 times via telephone, and 5 times via other methods. On average, MSLs spend 58% of their communications time face to face, 24% via , 13% via telephone, and 3% using other methods. (Responses do not total 1% due to rounding.) MSLs said they spent 65% of their time engaging with KOLs being proactive and 35% being reactive. The majority of MSLs formally communicate at least every other week within the team regarding field activities: 4% weekly and 18% bi-weekly. When it came to communicating formally with commercial or brand teams, the most common response was monthly (31% of MSLs) rather than weekly or bi-weekly (3%). MSL team meetings are held most frequently as WebEx or teleconference meetings, either weekly or bi-weekly (56% of MSLs). In-person face-to-face meetings were held at a much lower frequency, either quarterly or semiannually (55%), with virtual face-to-face meetings held less often than annually for 45% of MSLs. 63% of MSLs reported that their organization conducted performance reviews for MSLs on their team semiannually, with 18% saying they re held annually. Monthly reviews were held for just 4% of MSLs. Those with annual performance reviews are much more likely to be measured by annual KPIs: 53% of those reviewed annually are measured annually, compared to just 18% of MSLs overall. The majority of MSLs have their KPIs tracked at least quarterly (62%): 28% quarterly, 32% monthly, and 2% bimonthly. Managers were more likely to report monthly tracking: 48% of managers vs. 27% of MSLs. Oct 215 Page 3

5 MSL Responsibilities While the MSLs surveyed represented over 32 different therapeutic areas, almost two-thirds of MSLs (65%) were in one of three therapeutic areas: oncology (29%), cardiovascular/thrombosis (19%), and central nervous system/neurology (17%). The most typical MSL supports one drug (25% of respondents), and 61% support 3 or fewer drugs. Managers, of course, are much more likely to support more drugs: 3% support 5+ drugs, compared to 19% of individual MSLs. A majority of MSLs support drugs in Phase III (52%) or registration and launch (58%). A majority (5%) of MSLs spend most of their time supporting drugs immediately prior (33%) or immediately after launch (17%). However, a solid minority (16%) support drugs 6+ years after launch. MSLs who spend most of their time on drugs in the registration and launch phase are least likely to be measured annually: just 21%, compared to 33% overall. Firmographics The majority of MSLs surveyed work for large pharmaceutical firms (51%), followed by medium pharmaceutical (2%), small pharmaceutical (11%), and biotechnology (1%). Only 3% work for medical device companies. A plurality of MSLs surveyed were from North America (48%), followed by the European Union (25%), Asia (8%), Latin America (8%), and Oceania (6%). The three most represented countries were United States (39%), Canada (9%), and Australia (6%). MSLs from 46 different countries were included in the survey. Oct 215 Page 4

6 Demographics Respondents were nearly evenly divided by gender: 51% of respondents were female; 49% were male. The median career tenure was 3-4 years (4% have less tenure; 41% have more). Managers have greater tenure and were twice as likely to have been an MSL for 15+ years: 1% of managers vs. 5% of non-managers. Career tenure varied by region: 31% of Asian MSLs had been in the industry less than a year, compared to 12% of North American respondents and 16% overall; 46% of Latin American respondents had been in the industry 1-2 years, compared to 19% of North American respondents and 24% overall. A third of MSLs surveyed have a PhD (34%) and just under a quarter have a PharmD (23%) followed by a Master s degree (19%), MD / MBBS (11%), and those with a Bachelor s degree (8%). Oct 215 Page 5

7 Methodology The MSL Society surveyed 781 MSL professionals from 46 countries. The online survey was open from August 8 to September 19, 215 using Survey Gizmo survey software. Both fully completed and partial surveys were counted in the results. The survey was only open to current MSLs (or equivalent title) and MSL management. Respondents were only allowed to participate one time and duplicate surveys from a single address were not accepted. The survey results were not weighted. Respondents to the survey were recruited from a range of sources including: Announcements in our LinkedIn groups Medical Science Liaison & Medical Affairs Networkers as well as Medical Science Liaison World The MSL Society newsletter Personal direct LinkedIn contacts As this was not a probability-based sample, calculating the theoretical margin of sampling error is not applicable. However, as with probability surveys, it is important to keep in mind that results are estimates and typically vary within a narrow range around the actual value that would be calculated by interviewing everyone in a population. Again, as with probability surveys, on occasion the results from a particular question will be completely outside a typical interval of error. There are many types of survey error that can limit the ability to generalize to a population. Throughout the research process, The MSL Society followed a Total Survey Quality approach designed to minimize error at each stage. The MSL Society is confident that the information gathered from this survey can be used to make important business decisions related to this topic. We only report differences between subgroups when they are statistically significant at the 95% confidence level. While this is the industry standard for reporting results, it does mean that reported differences are simply due to chance 1 out of 2 times. Oct 215 Page 6

8 TABLE OF CONTENTS Executive Summary Quantitative & Qualitative KPIs KPI-Related Activities MSL Responsibilities Firmographics Demographics Methodology Table of Contents Table of Exhibits Detailed Results Metrics Quantitative Qualitative Activities Quantity Time Spent Communicating Frequency of Activities Challenges Responsibilities Firmographics Demographics Appendix - Questions Oct 215 Page 7

9 TABLE OF EXHIBITS (Optional) How would you explain to senior management the value that you produce for your organization? How satisfied are you with how MSL performance is measured in your organization? (Optional) Why? Which quantitative metrics are used in evaluating the MSLs within your organization? (Select all that apply.) Which quantitative metrics SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) What qualitative measures are used for evaluating the MSLs within your organization? (Select all that apply.) Which qualitative measures SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) On average, how many times do you interact with KOLs and other physicians via each of the following channels in a typical quarter? On average, what percentage of time do you spend on interacting with KOLs and other physicians via each of the following channels in a typical quarter? On average, what percentage of your time is spent in proactive versus reactive engagement with the KOLs you engage with? How often do MSLs in your team communicate formally within the team/department (e.g., team meetings, department meetings) regarding field activities? How often do MSLs in your team communicate formally with commercial or brand teams (e.g., inter-departmental meetings) regarding field activities? How often are your MSL team meetings held in each of the following formats? Oct 215 Page 8

10 TABLE OF EXHIBITS How often does your organization conduct performance reviews for MSLs on your team (i.e., evaluation of each individual MSL)? What time period is most typically used for tracking KPIs (Key Performance Indicators)? (Optional) What are the challenges you see of measuring the value of the MSL role? What Therapeutic Area best describes your responsibility? (Select all that apply.) How many drugs and/or devices do you or your MSL team support? In what stage is the drug that you or your MSL team spend most of the time supporting? How would you classify your company? Global Region What is your gender? How many years of MSL and/or MSL management experience do you have? What is your highest academic background? Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? What is your current role? Oct 215 Page 9

11 DETAILED RESULTS Medical Science Liaisons (MSLs) explain their value to the organization by emphasizing their role as scientific and medical resources and their relationships with Key Opinion Leaders (KOLs). As one respondent said: An MSL translates data to key stakeholders who have the ability and scope of influence to translate this data out to their broader community of practice, in the form of publications, medical education, research, surveillance activities and clinical guideline development. MSL activities, when performed well and in advance of launch, have the potential to build solid support, as well as accelerate integration and funding of a brand in the public payer system. (Optional) How would you explain to senior management the value that you produce for your organization? The larger the word, the more respondents who used it in their response. Sample Size: 252 (32% of Respondents) Oct 215 Page 1

12 Word Count Quote Scientific 81 "This is actually a very tough area for my team: we are managed care MSLs and our function is both similar and different to that of a therapeutic area MSL. Currently we bring value by acting as a scientific resource to payers, public payers, MCOs, ACOs, and IDNs. We work to establish relationships with OLs within these organizations. Additionally, we cover all therapeutic areas and pipeline products. We bring fair-balanced information to the payers. We bring CI to our company that affects millions of patients vs. that of a single practitioner. We are liaisons between our company and the organization and work to align interests that result in HE/OR research that is of value to both the organization and the company. We are a bridge between HEOR and market access within the company." Medical 7 "MSLs establish peer level relationships with OLs and develop advocacy for the company's products as well as scientific platform, often in situations where commercial teams have limited or no access. These relationships can be called upon when OL/HCP support is needed in institutional, association, governmental and/or payer negotiations/discussions. MSLs also develop and train company speakers on relevant product information and science to ensure fair and balanced presentations, provide actionable field insights back to medical and marketing colleagues, and engage interested OLs in research opportunities. MSL involvement in research support can speed appropriate site/pi identification, study recruitment and completion and enhances site-sponsor communication." KOL 58 "The ability to network with a variety of HCPs, from top tier KOLs to everyday practitioners, and discuss science and disease state information on a peer level. This is a much different approach than the sales promotion approach and builds a rapport that leads to long lasting relationships. The MSL brings vital information regarding disease state, medication use, and gaps in data back to the organization, which can help guide strategy and research decisions." Company 53 "Now that access to sales staff, and severe restrictions on what they can discuss have made the sales role less about providing scientific information and more about delivering marketing messages, the HCPs value a visit from me, actively seek appointments with me, and will give me 3 minutes to an hour of their time. They value (and request) in depth discussions on evolving data, and appreciate the level of scientific knowledge I have. The win for our company is that while I maintain balance in my discussions, my visits are largely focused around our data. In addition we provide two way feedback that is essential to market intelligence and scientific and clinical development programs as well as providing a stream of investigator ideas." Product 49 "1. In terms of providing valuable insights and opinions from interactions with Key Medical Experts on current and pipeline molecules. 2. From product pre launch initiatives to understand like disease management, patient journey, current challenges or unmet needs which help in a better preparation and strategize the brand positioning. 3. Identifying potential Medical expert and Patient recruiting in clinical trials. 4. Training the sales team to enhance their product knowledge, overcome objections to facilitate their productivity." Oct 215 Page 11

13 Word Count Quote Insight 48 "Our ambition is to create a structured and systematic approach to the acquisition and management of medical and health care insights and knowledge. Strategic relationships with recognized external experts will form the basis of knowledge acquisition, and best-in-class information exchange systems with social networking functionality will enable the application of this knowledge for everyday decision-making. The knowledge gained from the Medical Advice Network Program will be a meaningful source of competitive advantage and will be used to craft and disseminate a medical consciousness that will be the foundation for leading the future of healthcare." Relationship 47 "- faster enrollment into clinical trials, thereby bringing new drugs faster to the market - enhancing the company's credibility in the medical community: building and managing relationships with therapeutic area experts/key opinion leaders so that they have a positive image of the company and the drug by using science and facts - raising awareness for the company's drug before market approval and ONLY MSLs can do but not sales reps." Information 43 "Convey complex scientific information to scientific community, thereby increasing knowledge and understanding surrounding disease state and company compounds Face of Medical Affairs for scientific community Conduit for collaborations between scientific community and internal stakeholders Key partner for hearing, listening, gathering, and reporting unsolicited feedback on topics of strategic importance to the company, thereby driving medical strategy planning, modification, and implementation -'bringing the outside in'" Support 34 "Support Sales by providing field-level medical information support and training. Support Marketing by providing personalized speaker training, recommendations for Ad Boards, and reporting competitive and disease-state intelligence. Support Clinical Development by providing study-site recommendations and encouraging timely study enrollment, which leads to shortened NDA filing times and ultimately maximizes time on market, once approved. Support Publications by providing recommendations for authors." Oct 215 Page 12

14 Only about a fifth of respondents (23%) are very or completely satisfied with how MSL performance is measured in their organizations. How satisfied are you with how MSL performance is measured in your organization? Sample Size: 577 (74% of Respondents) How satisfied are you with how MSL performance is measured in your organization? Not at all satisfied Slightly satisfied Moderately satisfied Very satisfied Completely satisfied 13% 19% 45% 2% 3% Note: Only a single option could be selected Oct 215 Page 13

15 Those with monthly KPIs are more satisfied: of those measured monthly, 53% selected "moderately satisfied" vs. 41% of everyone else. (Rates of those very or completely satisfied didn't vary by tracking period.) What time period is most typically used for tracking KPIs (Key Performance Indicators)? Total Monthly Bimonthly Quarterly Semiannually Annually (%) (%) (%) (%) (%) (%) Total Not at all satisfied Slightly satisfied Moderately satisfied Very satisfied Completely satisfied indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 14

16 (Optional) Why? The larger the word, the more respondents who used it in their response. Sample Size: 255 (33% of Respondents) Oct 215 Page 15

17 Satisfaction Reason Not at all satisfied "Lack of understanding of the role I.e. Inherent idea that the MSL role should be used to supplement ineffective sales teams. Lack of understanding of what is truly important to physicians, company tactics not based on physician needs and insights gained from MSLs. Lack of visibility in office and expectation that all contact internally should originate from MSLs and not be seemed out by office staff or be communicated internally on behalf of the MSL team by their MSL manager who could benefit the team with showcasing the MSL teams achievements while they are on the road up to 8% of the time." Slightly satisfied "As Managed Care, we have the same KPIs as therapeutic area MSLs, however our job function and the way that we do our jobs are significantly different and cannot be measured in the same way, e.g., # of proactive meetings with KOLs is not an appropriate measure. " Moderately satisfied "The pharmaceutical industry has yet to move away from equating performance and value in terms of sales figures posted, and so traditionally activity has been a surrogate measure of performance for MSLs in the absence of measuring sales activity. This completely disregards the quality of the interaction in the field and does not account for any added value highly skilled and qualified scientists add internally to the brand team. In an ideal world MSL performance should be measured and aligned to delivery of the medical plan. There should be a balance of input driven quantitative measures together with long term qualitative measures at specific and agreed milestones on delivery of the medical plan. Further, added Value cannot always be measured directly and I think that as a function we have been backed into a corner to justify our role existence and has been overly scrutinized. No one questions how the marketing department are performance measured; their performance is assessed on delivery of the brand plan. I don't see why medical should be treated any differently." Very satisfied "I think they capture all I do in the metrics. Also, it is well defined that can be measured objectively. The only thing I go back and forth about it is the number of KOLs that we should see. Also, I believe that with the advancement of technology, phone calls and face time with my KOLs should be counted against my metrics. " Completely satisfied "We don't use the term KPI. We keep track of interactions for compliance reasons mostly and to keep track of the universe of our relationships. When we do share interaction numbers, it is around a specific initiative and supported by verbally delivered field insight." "It is difficult to evaluate what we do. My director utilizes what she hears from customers, both external and internal to determine if I am meeting the needs of the district. Pure numbers never show our true value. " "High level performance with demonstrated impact in the field with KOLs." Oct 215 Page 16

18 Metrics Quantitative The majority of MSLs have the following KPIs: The number of KOLs visited in a month/quarter (74%) The number of scientific/education presentations delivered by MSLs to external stakeholder (57%) The number of face-to-face meetings per month/quarter/year (56%). Each of the following KPIs are common to about 4 out of 1 MSLs: Number of proactive interactions with physicians and KOLs (44%) Number of KOL relationships maintained (4%) Number of unsolicited medical requests resolved/month (39%). Which quantitative metrics are used in evaluating the MSLs within your organization? (Select all that apply.) Sample Size: 542 (69% of Respondents) The least used KPIs were the number of drugs/formularies supported (13%), the number of promotional presentations delivered to external stakeholders (12%), and the number of effective interactions with hospital administration in gaining formulary access (9%). Oct 215 Page 17

19 Which quantitative metrics are used in evaluating the MSLs within your organization? (Select all that apply.) Number of KOLs visited in a month/quarter Number of scientific/educational presentations delivered by MSLs to external stakeholders Number of face-to-face meetings per month/quarter/year Number of proactive interactions with physicians and KOLs Number of KOL relationships maintained Number of unsolicited medical requests resolved/month Numbers of investigator-initiated trials (IITs) organized and managed Number of training events provided to sales/brand teams Number of scientific/educational presentations delivered by KOLs organized by MSL Number of Medical Conferences attended per quarter/year Number of AdBoards per quarter/year Number of scientific/educational presentations delivered by MSLs to internal stakeholders Number of internal meetings participated in Number of new KOL relationships Number of speaker programs developed for KOLs Average time spent per visit with KOL Amount of spending on KOL interactions Number of training events provided to new MSLs Number of medical publications per quarter/year authored by KOLs Number of effective interactions with payers Number of drugs/formularies supported Number of promotional presentations delivered to external stakeholders Number of effective interactions with hospital administration in gaining formulary access Others 74% 57% 56% 44% 4% 39% 38% 37% 35% 35% 32% 3% 28% 25% 24% 24% 19% 18% 17% 16% 13% 12% 9% 14% Note: Respondents could select multiple options Oct 215 Page 18

20 For the most part, MSLs have the quantitative KPIs they want. The correlation between what quantitative metrics they should be measured by and which they are measured by was.78, explaining 61% of the variance between the two measures. A majority or near majority of MSLs want to be measured by the number of scientific/educational presentations delivered to external stakeholders (6%), the number of KOL relationships maintained (58%), and the number of face-to-face meetings per time period (49%). Which quantitative metrics SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) Sample Size: 512 (66% of Respondents) Oct 215 Page 19

21 Which quantitative metrics SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) Number of scientific/educational presentations delivered by MSLs to external stakeholders Number of KOL relationships maintained Number of face-to-face meetings per month/quarter/year Number of new KOL relationships Number of Medical Conferences attended per quarter/year Number of unsolicited medical requests resolved/month Number of training events provided to sales/brand teams Number of scientific/educational presentations delivered by KOLs organized by MSL Number of scientific/educational presentations delivered by MSLs to internal stakeholders Number of KOLs visited in a month/quarter Number of proactive interactions with physicians and KOLs Numbers of investigator-initiated trials (IITs) organized and managed Number of AdBoards per quarter/year Number of internal meetings participated in Number of speaker programs developed for KOLs Average time spent per visit with KOL Number of training events provided to new MSLs Number of medical publications per quarter/year authored by KOLs Number of effective interactions with payers Number of drugs/formularies supported Number of effective interactions with hospital administration in gaining formulary access Amount of spending on KOL interactions Others Number of promotional presentations delivered to external stakeholders Note: Respondents could select multiple options Should Be Used 6% 58% 49% 47% 46% 45% 44% 44% 44% 43% 4% 4% 36% 33% 33% 3% 28% 25% 25% 21% 2% 18% 14% 12% Are Used 57% 4% 56% 25% 35% 39% 37% 35% 3% 74% 44% 38% 32% 28% 24% 24% 18% 17% 16% 13% 9% 19% 14% 12% Oct 215 Page 2

22 The only widespread KPI that is less desired than the median is the number of AdBoards per time period. The only uncommon KPI that is desired is new KOL relationships. Widespread (3+%) Number of AdBoards per quarter/year Number of KOLs visited in a month/quarter Number of scientific/educational presentations delivered by MSLs to external stakeholders Number of face-to-face meetings per month/quarter/year Number of proactive interactions with physicians and KOLs Number of KOL relationships maintained Number of unsolicited medical requests resolved/month Numbers of investigator-initiated trials (IITs) organized and managed Number of training events provided to sales/brand teams Number of scientific/educational presentations delivered by KOLs organized by MSL Number of Medical Conferences attended per quarter/year Number of scientific/educational presentations delivered by MSLs to internal stakeholders Uncommon (<3%) Number of internal meetings participated in Number of speaker programs developed for KOLs Average time spent per visit with KOL Amount of spending on KOL interactions Number of training events provided to new MSLs Number of medical publications per quarter/year authored by KOLs Number of effective interactions with payers Others Number of drugs/formularies supported Number of promotional presentations delivered to external stakeholders Number of effective interactions with hospital administration in gaining formulary access Number of new KOL relationships Unwanted (<39%) Wanted (39+%) Oct 215 Page 21

23 Some MSLs were aghast at the quantitative measures, arguing for more qualitative assessment of the value provided to the organization. Representative "Others (please specify)" responses to: Which quantitative metrics SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) "I would need more space to be able to describe measures I would feel would add value - all the above just seem to reflect the quantitative measures senior management are used to applying to HSS and if that is all they are looking for they may as well re-name t." "Do not think any of these metrics are a good measure of MSL value, and can reduce value if MSL is focused on achieving metrics versus providing value. In my opinion the best way to measure value is to establish objective and build personal metrics for the." "Every choice in this question starts with numbers of. This is no way to measure a MSL. Geographical regions are very different and numbers used to compare one MSL territory to another can be very misleading. Need to get a qualitative measure not quantitative." "We should move away from the number crunching exercise and focus on the quality of interactions. If it is a must, then we can measure the coverage of KOLs. No point in calculating the coverage and frequency. Just the coverage will do. But if you look from." "Number of unsolicited medical requests resolved/month + time frame executed. A measure of supporting the commercial part of the organization in a compliant fashion. Being part of the scientific/medical solution that is brought to bear on an initiative." "You should measure your performance against objectives that might include the following: Numbers don't matter. Value to organization matters. Based on objectives, how have you added to the value of the organization via strategic plans, product development." "The value of what we do has nothing to do with numbers, money spent or time spent. You could have all the KOL visits in the world and spend your limit and spend tons of time and not show value. These numbers are not appropriate to evaluate an MSL." Oct 215 Page 22

24 Qualitative The qualitative measures reported by a majority of MSLs are the observation and feedback from managers/directors (75%) and special project participation (5%). Surveys and feedback are also important, if not pervasive: surveys from internal stakeholders (44%), unsolicited KOL feedback (36%), and KOL surveys (36%). What qualitative measures are used for evaluating the MSLs within your organization? (Select all that apply.) Sample Size: 496 (64% of Respondents) Oct 215 Page 23

25 What qualitative measures are used for evaluating the MSLs within your organization? (Select all that apply.) Observation and feedback from managers/directors Special Project participation Feedback or surveys from internal stakeholders Quality and depth of KOL relationships Unsolicited KOL Feedback KOL surveys Others 75% 5% 44% 39% 36% 36% 5% None of the above 8% Note: Respondents could select multiple options Examples of "Others (please specify)" responses: What qualitative measures are used for evaluating the MSLs within your organization? (Select all that apply.) "Platform for entering all activities, able to generate reports." "Feedback/surveys from external stakeholders (e.g. survey after advisory board)" "How you meet your objectives in terms of behaviors like teamwork, collaboration, openness, etc." "Input for medical strategy and planning, collaboration with regional team, taking initiatives as project leaders." "Moving a KOL from local speaker to international speaker." "KOL engagement plans, Evaluation of MSL engagement and impact on KOL scientific position." "Ability to speak externally, measured by customer feedback on evaluation." Oct 215 Page 24

26 Unlike quantitative KPIs, every qualitative measure was desired by the majority of MSLs. Both the observation and feedback from managers/directors and the quality and depth of KOL relationships were important to 73% of MSLs. Other types of feedback, surveys, and special project participation were desired by at least 55% of MSLs. Which qualitative measures SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) Sample Size: 495 (63% of Respondents) Oct 215 Page 25

27 Which qualitative measures SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) Observation and feedback from managers/directors Quality and depth of KOL relationships Feedback or surveys from internal stakeholders Unsolicited KOL Feedback Special Project participation KOL surveys Others 73% 73% 62% 61% 6% 55% 8% None of the above 1% Note: Respondents could select multiple options Sample others: Which qualitative measures SHOULD BE used to clearly demonstrate the value that MSLs provide to the organization? (Select all that apply.) "Share of voice from KOLs. Also brand or message recognition measured by independent market research companies." "Giving input of medical strategy and plan, leadership capability, communication skills with other internal stakeholders." "Independent, blinded KOL surveys; feedback from KOLs on educational event quality; ideally some measure of effectiveness of educational programs that demonstrates application of learning." "Initiatives taken, ideas generated, new and original projects established, knowledge. In the field, meet the customers needs." "Collaboration for clinical trials, mapping and profiling KOLs, mapping and profiling of clinical trials centers, market access collaboration, sales force collaboration." "Field information of a medical manager, evaluating the engagement of KOL and scientific exchange." "Development of programs, innovative processes, quality of material developed, quality of post-activity reports. Oct 215 Page 26

28 ACTIVITIES Quantity MSLs were questioned as to how many times they interact with KOLs and other physicians in a typical quarter. The median responses were 4 times face-to-face, 3 times via , 1 times via telephone, and 5 times via other methods. On average, how many times do you interact with KOLs and other physicians via each of the following channels in a typical quarter? Face-to-face Telephone Other Minimum Median Average Maximum Time Spent Communicating On average, MSLs spend 58% of their communications time face to face, 24% via , 13% via telephone, and 3% using other methods. (Responses do not total 1% due to rounding.) On average, what percentage of time do you spend on interacting with KOLs and other physicians via each of the following channels in a typical quarter? Face-to-face Telephone Other Minimum % % % % Median 6% 1% 2% % Average 58% 13% 24% 3% Maximum 1% 6% 95% 7% Oct 215 Page 27

29 On average, MSLs said they spent 65% of their time engaging with KOLs being proactive and 35% being reactive. On average, what percentage of your time is spent in proactive versus reactive engagement with the KOLs you engage with? Sample Size: 336 (43% of Respondents) The majority of MSLs formally communicate at least every other week within the team regarding field activities: 4% weekly and 18% bi-weekly. How often do MSLs in your team communicate formally within the team/department (e.g., team meetings, department meetings) regarding field activities? Sample Size: 452 (58% of Respondents) Oct 215 Page 28

30 How often do MSLs in your team communicate formally within the team/department (e.g., team meetings, department meetings) regarding field activities? Weekly Monthly Bi-Weekly Quarterly As needed Semiannually Don't know Annually Less often 4% 27% 18% 7% 6% 1% 1% <1% <1% Note: Only a single option could be selected Oct 215 Page 29

31 When it came to communicating formally with commercial or brand teams, the most popular response was monthly (31% of MSLs) rather than weekly or bi-weekly (3%). How often do MSLs in your team communicate formally with commercial or brand teams (e.g., inter-departmental meetings) regarding field activities? Sample Size: 452 (58% of Respondents) How often do MSLs in your team communicate formally with commercial or brand teams (e.g., inter-departmental meetings) regarding field activities? Monthly Weekly Quarterly As needed Bi-Weekly Semiannually Don't know Less often Annually 31% 2% 15% 13% 1% 4% 3% 2% 1% Note: Only a single option could be selected Oct 215 Page 3

32 FREQUENCY OF ACTIVITIES MSL team meetings are held most frequently as WebEx or teleconference meetings, either weekly or bi-weekly (56% of MSLs). In-person face-to-face meetings were held at a much lower frequency, either quarterly or semiannually (55%), with virtual face-to-face meetings held less often than annually for 45% of MSLs. How often are your MSL team meetings held in each of the following formats? Sample Size: 451 (58% of Respondents) How often are your MSL team meetings held in each of the following formats? Weekly Bi- Weekly Monthly Quarterly Semiannually Annually Less often Don't know (%) (%) (%) (%) (%) (%) (%) (%) LIVE in person face to face meetings Virtual face to face meetings using online video (e.g. Facetime, Skype) WebEx or teleconference meetings Note: Only a single option could be selected Oct 215 Page 31

33 63% of MSLs reported that their organization conducted performance reviews for MSLs on their team semiannually, with 18% saying they re held annually. Monthly reviews were held the least amount, with only 4% of MSLs selecting it. How often does your organization conduct performance reviews for MSLs on your team (i.e., evaluation of each individual MSL)? Sample Size: 451 (58% of Respondents) How often does your organization conduct performance reviews for MSLs on your team (i.e., evaluation of each individual MSL)? Monthly Quarterly Semiannually Annually As needed 4% 1% 63% 18% 4% Note: Only a single option could be selected Oct 215 Page 32

34 Those with annual performance reviews are much more likely to be measured by annual KPIs: 53% of those reviewed annually are measured annually, compared to just 18% of MSLs overall. What time period is most typically used for tracking KPIs (Key Performance Indicators)? Total Monthly Bimonthly Quarterly Semiannually Annually (%) (%) (%) (%) (%) (%) Total Monthly Quarterly Semiannually Annually As needed indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. The majority of MSLs have their KPIs tracked at least quarterly (62%): 28% quarterly, 32% monthly, and 2% bimonthly. What time period is most typically used for tracking KPIs (Key Performance Indicators)? Sample Size: 451 (58% of Respondents) Oct 215 Page 33

35 What time period is most typically used for tracking KPIs (Key Performance Indicators)? Bimonthly Monthly Quarterly Semiannually Annually 2% 32% 28% 25% 13% Note: Only a single option could be selected Managers were more likely to report monthly tracking: 48% of managers vs. 27% of MSLs. Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? Total No, I am not an MSL nor do I manage any MSLs Semiannually Annually (%) (%) (%) (%) Total Monthly Bimonthly Quarterly Semiannually Annually indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 34

36 CHALLENGES (Optional) What are the challenges you see of measuring the value of the MSL role? The larger the word, the more respondents who used it in their response. Sample Size: 179 (23% of Respondents) A common theme was "Quality", mentioned by 21% of respondents. "Metrics (e.g. # of meetings) don't capture the value of the MSL interactions and drive individuals to get more meetings rather than quality meetings. Metrics make the managers job easier." "Value difficult to capture as we do not have a tangible objective measure as sales colleagues do. Most MSL want a measure of the 'Quality' of these work but can offer no easy way to do this. Many MSLs resist being measured at all, even though this is the reality of everyone in the organization. We need help MSLs realize that just because we measure output, does not mean we are trying to turn them into sales reps." Oct 215 Page 35

37 "MSL is not always the sole role involved in an activity and not fully responsible for outcome. E.g.: number of IITs can reflect budgets (or lack thereof) rather than MSL efforts rather than quality of investigator research proposal." "Its really difficult because the KPIs must be qualitative not quantitative. Normally number of ME meetings don't tell that the MSL is good or not. For me the KPI must be related with the quality and amount of information provided to ME..." "Lack of understanding of our day-to-day and week-to-week activities; lack of ability to define or measure quality interactions; inconsistent activities and reporting not only between organizations, but often within the same company or even within the same MSL teams." "Difference between quality (project-related) and quantity (typical KOL-related KPIs: easy to fulfill numbers (KPI), if required, but difficult to deliver quality - relative invisibility of MSL (or in general: field-) work vs. in-house work - difficulty to find the right performance criteria and to link them to a formal career development path." "This survey highlights what I see as the major issue - i.e. Trying to apply HSS type metrics to a non-promotional team. I frequently feel pushed to see people face to face to make my numbers for issues that could be solved via /phone which does not help build relationships. I also feel pushed to book rep appointments to fulfill proactive activities developed to 'keep us busy' when requests are low which have limited value to the HCP other than a nice chat and I don't see the value to the company particularly when it's taken HCP facing time that the HSS would otherwise have been able to book. I have been working with a great in-field team who greatly value me in my reactive role largely due to the value they see and what the HCP's tell them they gain from me. This has been eroded by a constant push for numbers leading HCPs to see little difference between HSS and MSL. With the large MSL teams I see companies building up I see this continuing with MSL's and HSS increasingly competing for diminishing HCP facing time and question the value to the company as well as the NHS. Make any customer facing function focus on quantitative metrics and we'll somehow hit the numbers which some manages take as a reason to increase the size of teams exacerbating this issue further. Take away the quantitative and maybe we could see how many MSLs are really required to provide a quality service that delivers what both the HCPs and company wants/needs." Oct 215 Page 36

38 "There has to be a quantitative measure, and number of interactions is as good of a measure as any. There is no standardized way that I am aware of to measure quality of interactions including are we meeting with the right people (very subjective) or what are the outcomes and value of these interactions (either the measure is soft (they like us) or the value won't be realized immediately (investigator initiated study completion years later)." "Senior Management is still trying to look at KPIs used for Sales Reps Difficult to measure value and quality of interactions in numbers Many interactions may only 'pay off' at a later point in time Different stakeholders are interested in different KPIs Ensure all MSLs worldwide in the organization have the same understanding on what needs to be documented in order to allow for consistent regular quantitative reporting." 2% of respondents referenced "Interaction": "Placing a number value of metrics the team will play to that number; geographic area may affect access, national/regional/ local status of KOL. Some are harder to see, concentration of academic vs. community sites-will determine how often you are allowed to visit and the type of interaction you will have...overall, certain metric achievements may not be uniform across the country." "The definition of an MSL is not proactive most of the time. So it's a challenge when they would like to see numbers of interactions. Also, MSLs spend many hours preparing for a meeting and follow up on it, which is time in the office that is not captured anywhere. I am lucky that all departments see a real value on the MSL role. I know not a lot of companies give such support to their medical colleagues." "Much of what we do is reactive to unsolicited request...can't really control that number. Often the outcomes of our interactions are unknown or only become known months down the road. Internal stakeholders say you bring value and they want you, but they can't articulate what it is exactly that they value so how do you know what to measure. Just seeing a bunch of people face to face doesn't mean much!" Oct 215 Page 37

39 "Often it is the focus on hard outcomes and numbers that is the challenge, when the real value of the MS: is softer (e.g. the relationships, the projects, the valuable information the MSL interactions brings to the internal organization to help us understand the external environment). Often this takes time to understand and to quantify- whereas most senior management want to see quick wins that are easy to measure. It is also sometimes difficult for the MSL to fully understand the value they bring to the organization- they need to 'sell' themselves and the value they bring." "It may be more harmful than beneficial to force interactions with a KOL simply to hit a certain metric. It may be more logical to let the relationship flow organically and interact more (e.g., daily) when finishing up a deadline or less frequently (semiannually) if there is no active investigator-sponsored trial." "Because we are firewalled from commercial, it is not possible to directly measure the impact to the business (i.e., # of scripts written), but at the same time, just counting the number of KOL interactions does not really accurately capture the impact that we may be having on the organization." The difficulty and challenge of the measuring value of the MSL role were brought up by many. Almost a fifth of respondents (16%) brought up "Difficult", and a tenth (1%) brought up "Hard": "Most often MSLs function as facilitators or accelerators ongoing work or planning. It is difficult to assign an impact factor to this function given that there is no baseline from which to measure or the degree of perceived difficulty is impossible to determine a priori." "Of note to above, rotation of conf. calls, etc. evolves with lifecycle of compounds. Frequency may increase when phase III and closer to launch. The value of the MSL cannot be measured merely by quantitative number of contacts, etc. Pulling out the value of nurturing relationships and obtaining insight info to assist product strategy is difficult to measure because it often is a long term value and long term outcomes are tough to measure vs. a rep who makes a sell. I recall someone saying MSL visits result in scientific debate and the commercial team asks for the business. How do you measure the value of 'scientific debate'?" Oct 215 Page 38

40 "The environment is getting more difficulty for quantity measurements. Physician time that can be spent away from treating patients is becoming more and more limited, so to show up at the door based of a metric to have fulfill with the same old conversation is not an adequate way of measuring the value of the MSL role. Our role needs to be expanded, it has been significantly limited over time." "IMO business revolves around sales and marketing. Also, long-term planning is usually defined as 6 months out, so it's difficult to measure an MSLs impact since we are not directly linked to short-term sales and our projects are usually long-term." "Since a great deal of value that the MSL brings to an organization is the relationship they have with KOLs, it is very difficult to measure that relationship. Many times a KOL or an investigator is non-responsive to in-house personal of study teams, however they will quickly respond to their local MSL because of their existing relationship." "Quantitative measurements are commonly used., but can be manipulated by an intelligent MSL. Qualitative measurements are much harder to measure and these measurements can vary greatly by territory." "A lot of the value we provide are intangible and hard to measure in a quantitative manner. For example, what is the value of involving a key KTL to a trial? Or what is the value of improving the protocol of a trial?" "As it is more of a long term results-oriented role, it is harder to measure some of the KPIs on a short term period." "It's been the million dollar question for a long time in the MSL space. Very hard to capture. The quantitative metrics are not reflective at all of anything. Just shows that the MSL can meet with how ever many OLs they are required to meet with and 'check the box' doesn't mean anything. We need to have a solid list of OLs not every single doc in the territory and meet with them 2-4 times a year. That's all." "Value is hard to define and subjective. Hard to document. Compliance concerns as we aren't commercial folks and commercial KPIs don't really [work]." Oct 215 Page 39

41 RESPONSIBILITIES Almost two-thirds of MSLs (65%) were in one of three therapeutic areas: oncology (29%), cardiovascular/thrombosis (19%), and central nervous system/neurology (17%). What Therapeutic Area best describes your responsibility? (Select all that apply.) Sample Size: 448 (57% of Respondents) Oct 215 Page 4

42 What Therapeutic Area best describes your responsibility? (Select all that apply.) Autoimmune Diseases Cardiovascular / Thrombosis CNS / Neurology Dentistry / Oral Medicine Dermatology Diabetes / Metabolic Disorders / Endocrinology Gastroenterology Genetic Diseases Hematology HIV Immunology / Allergy Infectious Diseases Managed Care Medical Devices / Diagnostics Mental Health Oncology Ophthalmology Otolaryngology Pain Pediatrics Podiatry Respiratory / Pulmonary Musculoskeletal / Arthritis Surgery Urology / Nephrology Women s Health Rare Diseases / Orphan Diseases Other Note: Respondents could select multiple options Oct 215 Page 41

43 Some of the other reasons that respondents provided: What Therapeutic Area best describes your responsibility? (Select all that apply.) "Vascular surgery." "Aesthetic surgery." "Health systems." "Molecular Diagnostics." "Regional Manager, not related to TA." "Orthopedics & trauma." "Over all. No TA in particular." The most typical MSL supports one drug (25% of respondents), and 61% support 3 or fewer drugs. How many drugs and/or devices do you or your MSL team support? Sample Size: 447 (57% of Respondents) How many drugs and/or devices do you or your MSL team support? % 2% 16% 13% 6% 21% Note: Only a single option could be selected Oct 215 Page 42

44 Managers, of course, are much more likely to support more drugs: 3% support 5+ drugs, compared to 19% of individual science liaisons. Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? Total No, I am not an MSL nor do I manage any MSLs Yes, I am an MSL Yes, I manage MSLs (%) (%) (%) (%) Total indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 43

45 A majority of MSLs support drugs in Phase III (52%) or registration and launch (58%). In what stage of development are the various drugs that you or your MSL team support? (Select all that apply.) Not applicable Pre-clinical Phase I Phase II Phase III Registration and launch First year on the market 2 years after launch 3 years after launch 4 years after launch 5 years after launch 6+ years after launch Note: Only a single option could be selected Oct 215 Page 44

46 A majority (5%) of MSLs spend most of their time supporting drugs immediately prior (33%) or immediately after launch (17%). However, a solid minority (16%) support drugs 6+ years after launch. In what stage is the drug that you or your MSL team spend most of the time supporting? Sample Size: 448 (57% of Respondents) In what stage is the drug that you or your MSL team spend most of the time supporting? Pre-clinical Phase II Phase III Registration and Launch First year on the Market 2 years after launch 3 years after launch 4 years after launch 5 years after launch 6+ years after launch Not applicable Note: Only a single option could be selected Oct 215 Page 45

47 MSLs who spend most of their time on drugs in the registration and launch phase are least likely to be measured annually: just 21%, compared to 33% overall. What time period is most typically used for tracking KPIs (Key Performance Indicators)? Total Monthly Bimonthly Quarterly Semiannually Annually (%) (%) (%) (%) (%) (%) Total Pre-clinical Phase II Phase III Registration and Launch First year on the Market years after launch years after launch years after launch years after launch years after launch Not applicable indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 46

48 FIRMOGRAPHICS The majority of MSLs surveyed work for large pharmaceutical firms (51%), followed by medium pharmaceutical (2%), small pharmaceutical (11%), and biotechnology (1%). Only 3% work for medical device companies. How would you classify your company? Sample Size: 442 (57% of Respondents) Sample "Other (please specify)" comments for: How would you classify your company? "Nutrition and other divisions." "Healthcare consulting." "Contract MSL Teams." "Healthcare Nutrition." "Contract Medical Affairs." "Medical Device and 1 Phase III Pharmaceutical." "Large revenue wise, small number of employees wise." Oct 215 Page 47

49 How would you classify your company? Large Pharmaceutical Medium Pharmaceutical Small Pharmaceutical Biotechnology Medical Devices Diagnostic Company Other 51% 2% 11% 1% 3% 3% 2% Note: Only a single option could be selected 78% of Asian MSLs worked for large pharmaceutical firms, vs. 43% of North Americans and 5-59% of everyone else. Global Region Total European Latin North Africa Asia Oceania Union America America (%) (%) (%) (%) (%) (%) (%) Total Large Pharmaceutical Medium Pharmaceutical Small Pharmaceutical Biotechnology Medical Devices CRO Diagnostic Company Other indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 48

50 A plurality of MSLs surveyed were from North America (48%), followed by the European Union (25%), Asia (8%), Latin America (8%), and Oceania (6%). Global Region Sample Size: 439 (56% of Respondents) Global Region Africa Asia European Union Middle East Latin America North America Oceania Rest of Europe 1% 8% 25% <1% 8% 48% 6% 3% Note: Only a single option could be selected Oct 215 Page 49

51 The three most represented countries were United States (39%), Canada (9%), and Australia (6%). MSLs from 46 different countries were included in the survey. Global Region Antigua and Barbuda Argentina Aruba Australia Austria Belgium Brazil Bulgaria Canada China Colombia Croatia Denmark Ecuador Egypt Finland France Germany Greece Hong Kong India Indonesia Italy Japan Jordan Korea, South Lithuania Mexico Morocco Netherlands Panama Peru Philippines Portugal Romania Russia Singapore South Africa Spain Sweden Switzerland Tunisia Turkey United Kingdom United States Vietnam Note: Only a single option could be selected Oct 215 Page 5

52 DEMOGRAPHICS Respondents were almost evenly divided by gender: 51% of respondents were female; 49% were male. What is your gender? Sample Size: 442 (57% of Respondents) What is your gender? Male Female 49% 51% Note: Only a single option could be selected Oct 215 Page 51

53 The median career tenure is just 3-4 years (4% have less tenure; 41% have more). How many years of MSL and/or MSL management experience do you have? Sample Size: 442 (57% of Respondents) How many years of MSL and/or MSL management experience do you have? Less than 1 year 1-2 years 3-4 years 5-6 years 7-8 years 9-1 Years Years More than 15 Years 16% 24% 19% 13% 7% 7% 7% 6% Note: Total does not add up to 1% due to rounding. Managers have greater tenure, as would be expected. Of those who chose 'Yes, I manage MSLs', 1% also selected 'More than 15 Years' vs. 5% of everyone else. Oct 215 Page 52

54 Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? Total No, I am not an MSL nor do I manage any MSLs Yes, I am an MSL Yes, I manage MSLs (%) (%) (%) (%) Total Less than 1 year years years years years Years Years More than 15 Years indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 53

55 Career tenure varied by region: 31% of Asian MSLs had been in the industry less than a year, compared to 12% of North American respondents and 16% overall; 46% of Latin American respondents had been in the industry 1-2 years, compared to 19% of North American respondents and 24% overall. Global Region Total European Latin North Africa Asia Oceania Union America America (%) (%) (%) (%) (%) (%) (%) Total Median 3-4 years <1 year 1-2 years 3-4 years 1-2 years 5-6 years 1-2 years Less than 1 year years years years years Years Years More than 15 Years indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 54

56 A third of MSLs surveyed have a PhD (34%) and just under a quarter have a PharmD (23%). Next in frequency: Master s degree (19%), MD / MBBS (11%), and Bachelor s degree (8%). What is your highest academic background? Sample Size: 448 (57% of Respondents) Sample "Other Degree (please specify)" comments for: What is your highest academic background? "Bachelor Degree in Pharmacy." "B.Sc. with honors." "Physician Assistant." "Degree in Biology." "Diploma Biology." "Registered nurse." "Nurse Practitioner." Oct 215 Page 55

57 What is your highest academic background? PhD PharmD Master s Degree MD / MBBS Bachelor s Degree Other Degree Other Doctorate Degree 34% 23% 19% 11% 8% 3% 2% Note: Only a single option could be selected MSLs and their managers differ in terms of their highest level of education: managers are more likely to have PharmD (3% vs. 2%) and MD/MBBS (22% vs. 8%), and are less likely to have PhDs (24% vs. 38%) and Master's degrees (11% vs. 21%) Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? Total No, I am not an MSL nor do I manage any MSLs Yes, I am an MSL Yes, I manage MSLs (%) (%) (%) (%) Total PharmD PhD MD / MBBS Other Doctorate Degree Master s Degree Bachelor s Degree Other Degree indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. Oct 215 Page 56

58 North American respondents are more likely to have PhDs and PharmDs than those in other regions. Global Region Total European Latin North Africa Asia Oceania Union America America (%) (%) (%) (%) (%) (%) (%) Total PharmD PhD MD / MBBS Other Doctorate Degree Master s Degree Bachelor s Degree Other Degree indicates cells that are significantly greater than all other cells in this row at a 95% confidence level. indicates cells that are significantly less than all other cells in this row at a 95% confidence level. More than three quarters of the respondents answered that they were an MSL, while the rest said that they manage MSLs. Are you currently a Medical Science Liaison (or equivalent title) or do you manage MSLs? Sample Size: 739 (95% of Respondents) Oct 215 Page 57