KOLs are an important extension of the pharmaceutical company’s central nervous system. Only a few years ago KOL management in companies was limited to identifying eight to 11 heavyweights in a therapeutic area that involved them in promo events.

Now, when more regulatory barriers are built around healthcare practitioners by governments, academic and patient communities, physicians have less autonomy and it’s harder to gain access to them. Either local versions of the U.S. Sunshine Act force pharmaceutical manufacturers to report all exchanges of value to healthcare professionals, or laws restricting face-to-face interactions between physicians and company employees are reducing the pool of KOLs available to work with pharmaceutical industry.

Simultaneously, a higher complexity of the science behind the products increased the needs for diverse involvement of KOL expertise. Thus relationships with medical communities became more valuable in establishing market dominance. With the increase of strategic importance of KOLs to pharmaceutical business, Medical Affairs’ role is expanding.

MSLs take on a more important customer-facing role within their organizations bringing the stepwise changes in KOL management approaches. Indeed, meeting with KOLs in person remains critical. In busy classes of medications, the same physicians are contacted by numerous companies, so establishing a face-to-face relationship is one of the few ways to gain KOL solid commitment.

According to the global MSL survey conducted by MSL Society, KOL management is the top activity in which MSLs spend the most time. Together with KOL education and Investigator Initiated Study management (mostly requested by KOLs), these three activities take more than half of MSL working time (see Figure 1).


KOL engagement helps companies to guide new product development, generate data, refine strategy and create relevant, credible and persuasive medical and promotional content. These KOL relationships are always based on trust and needs in long-term cooperation from both parties. From a different perspective, being too reactive to the individual needs of KOLs and not asking questions internally, leads to lack of advocacy for the company’s interests in the relationship.

KOL engagement will go through the same lifecycle as the company products: Increase, plateau and gradual decline of involvement. KOL owners have to ask the right questions to determine if a particular KOL’s current work is aligned with the company’s scientific and business objectives and propose the engagement strategy that fits best. Similarly, Medical Affairs practices in big pharmaceutical companies allow analysis of the experiences across industry. These summarized tips will ensure high-level engagement of KOLs.

1. Clearly define the engagement goal.

Ensure that all engagement activities, from field visits to physician medical education programs, are driven by specific scientific or business objectives that are clear to all sides. A well-orchestrated and objective-driven approach to KOL engagement throughout the product’s lifecycle can be your critical competitive advantage. Distinct types of KOLs are engaged differently in order to reach varying goals. KOL profiling procedure can be useful in building the KOL engagement strategy. MSLs, as the owners of KOL engagement plans, may rank opinion leaders in their database in order to justify resource allocation in their therapeutic fields. Classifying and prioritizing KOLs will clarify which of them can have a significant impact on the success of the changes that MSLs are driving on the market.

2. Have an individual KOL engagement plan.

A KOL engagement plan is an important component of KOL management in the company, as it describes how the company should deal with KOLs and provides a comprehensive picture that both KOLs and employees can count on. When preparing an engagement plan, it’s important to examine how your company is currently addressing KOL scientific and medical needs, and what other methods you employ to maintain KOL relationships. Investigate how your competition handles KOL relations. Determine who in the company will be responsible for each part of your KOL engagement plan (MSL, Medical Affairs, Medical Information, Sales, etc.). Describe how you will measure results (a KOL survey, number of interactions, etc.) and involve KOLs to plan preparation and bring them into the discussion. Also, a KOL engagement plan should stay transparent to your internal stakeholders.

3. Come to ask for consultation, not for engagement.

Asking for consultation and timely follow up indirectly leads to anchoring the KOL relationships and engagement deepening. Don’t hesitate to be transparent, share your goals and ask for advice. Open, clear and deep discussions between company and non-company experts can significantly advance the development of product strategy and medical content—and earn the trust of your advisors. Asking powerful questions leads to better understandings of medical practices and habits and patient needs, and garners feedback on the work the company is doing to bring value to the medical community. Questions will eventually improve patient access to new therapies. Asking questions bridges the industry with the medical community and helps to gain mutually valuable insights.

4. Take the opportunity to anticipate KOL needs.

The survey notes that KOLs consider MSLs to be more objective and knowledgeable in specific diseases and more resourceful in finding new information than sales representatives (see Figure 2). This gives MSLs an opportunity to fulfill KOL needs by demonstrating a customer-oriented approach—and that earns more trust. MSLs have to strive for a holistic understanding of their customers and their needs.


Some KOL needs will be emotional rather than rational. That is obvious: The more trustworthy you are, the more emotional needs KOLs may reveal to you. The longer you know them, the better you can anticipate their needs. To preserve that trust, communicate regularly so that you are aware of problems or upcoming expectations. Normally KOLs “buy” solutions for their problems, so make your engagement story a solution efficiently matching their specific needs.

5. Become an opportunity creator.

Create new proposals by combining existing ideas, concepts and opportunities (even unrelated to medicine). Look outside pharma, read entrepreneurship blogs and magazines, follow industry thought leaders. MSLs have to keep in mind that engagements should allow KOLs and industry to pursue common aspirations: Advance medical science; fulfill unmet medical needs; and provide real benefit to patients. Create cross-functional expert work groups, welcome international networking, collaborate with your colleagues in other therapeutic areas, and do benchmarking with other disengaged industries.

6. Embrace KOL feedback.

Encourage and welcome suggestions to improve your company services. Greater engagement with KOLs—rooted in meaningful, bi-directional dialogue—can drive high-level drug development and commercialization, while enhancing the company’s status as a partner of choice. Any feedback from KOLs is a basis for improving engagement and service quality. Even negative feedback will bring insight into why KOLs might experience a collaboration as unsatisfactory.

Capturing customer opinions and complaints will increase the quality and relevancy of recommendations that can reshape concepts, services and messages. Thank customers for their input when responding to complaints. Even the most angry customers are easy to placate—and they may turn into loyal customers later. When you receive negative feedback, get to the root of the problem by asking questions without making leading statements. Be sympathetic or at least neutral.

7. Do less, but do the most crucial things.

Keep the link between KOL engagement and your strategic goals, finding and focusing on the 20% of activities that will provide 80% of the success. The MSL job is very diverse and a lack of focus on important things leads to reactivity and a bogging down in routine. KOL ranking might be helpful to learn which KOL requires the highest time investments. This kind of ranking can be done as per KOL regional influence (national, regional, local) and loyalty to company or brand (negative, neutral, advocate).

Use the matrix in Figure 3 below to do a quick and rough estimation of an engagement strategy that has to be implemented in a KOL segment. During varying phases of product lifecycle there might be a different balance of stakeholder percentage that belong to these categories, i.e., at launch phase, “Manage Closely” probably should prevail; on plateau, “Keep Satisfied” or “Keep Informed,” etc. To “do less” means engaging your KOLs, giving them a voice and decreasing your control and involvement. This empowers KOLs, builds trust and also provides a critical service to the organization by keeping interaction compliant.


8. High level scientific content is everything.

Providing high-level clinical and scientific data will make you a trusted partner playing on the side of medical communities. Any medical content company communicating externally has to be fair-balanced and not false or misleading in the communication of benefit and risk data. Medical data must be consistent with the prescribing information as approved by local regulatory authorities. Info provided to KOLs should not surprise physicians or patients. It should meet educational needs and be free from bias.

The objectivity of messages has to be based on clinical trials, so messages cannot be separated from the scientific context. Also, any content must be substantiated by reference to prescribing information as approved by local regulatory authorities or by additional scientific evidence meeting the requirements of regulatory authorities. Such additional evidence should be made available to KOLs upon their request.

Dr. Alexander Tolmachev’s opinions expressed here do not necessarily reflect practices of his present or past employers.


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