Medical Affairs: What's Your Baseline?

Earlier this week, I came across another discussion about Medical Affairs ROI. It's a question we keep coming back to: How do we show the value of what we do? And I keep thinking we're starting the conversation too late.

Before we ask what Medical Affairs returned, shouldn't we be clear about what it was supposed to change? What scientific problem were we trying to solve? What evidence gap needed closing? What wasn't working, and how would we know if it improved?

Without that starting point, we can describe the work. Demonstrating what changed because of it is much harder.

I think we can all agree that not every Medical Affairs contribution can be tied to a financial return. Some scientific outcomes may take two or three years to materialize. But a longer timeline makes a baseline more important, not less.

People leave. Priorities shift. The market changes. By the time an outcome becomes visible, the record of what Medical Affairs contributed along the way may be incomplete or gone. Then we're left trying to reconstruct the story after the fact.

Here's an exercise worth trying before your next planning meeting. Pull up your medical strategy from three years ago and put it next to this year's. How different are they?

Maybe "establish" became "strengthen." "Educate" became "engage." The tactics changed, the slides were refreshed, and another plan was approved. Sometimes that continuity is appropriate. Scientific and clinical priorities don't necessarily change every year.

The question isn't whether the wording changed. It's whether we revisited the assumptions behind it.

A recurring priority might reflect a persistent scientific need. It might also reflect an approach that hasn't worked. Those are two very different situations. They shouldn't automatically produce the same plan.

And yet, this is the time of year when many Medical Affairs leadership teams are reviewing annual objectives and preparing their 2027 priorities. Interactions counted. Programs tallied. Insights summarized. Objectives marked complete, partially complete, or carried forward.

The objectives may genuinely have been met. But the problems those objectives were supposed to address may still be there.

The watermelon test? Cut it open and look inside.

If leadership asked, "What actually improved in Medical Affairs this year?" could you answer?

Not with how many more activities your team completed, but with which scientific questions you're better equipped to answer, which decisions became better informed, and which barriers you removed.

Something I've noticed over the years: we tend to evaluate Medical Affairs one function at a time. Publications has its deliverables. Medical Information has its metrics. Field Medical has its engagement targets. Evidence generation has its milestones.

Everyone is working hard to meet them. But individual functions meeting their objectives doesn't necessarily add up to organizational progress.

Take publications. I've seen publication plans generate multiple congress abstracts from different analyses of an existing dataset. Additional analyses can answer important scientific questions. But let's consider the work that also follows:

New findings may require updates to scientific materials, revisions to field tools, and additional training. Whether any of that changes the scientific conversations HCPs are having is another question.

The publication is one deliverable. The downstream work extends well beyond it.

If those analyses meaningfully advance scientific understanding, that effort may be well justified. But what if, after all that work, HCPs are still asking the same questions and the scientific conversations haven't really changed?

As an MSL, I saw that happen. Data updates were technically new but added little to the clinical discussion I was having. To HCPs, it often felt like data they’d already seen, just presented differently.

One function's productivity becomes another function's workload.

Of course, Field Medical isn't exempt from this problem. Suppose your MSL team conducted 100 scientific interactions last year and 200 this year.

You doubled the activity. What else changed? Did those interactions address a clearly identified medical need? Did the team uncover something the organization didn't already understand? Did an insight inform an evidence-generation priority or another decision?

Or did we conduct more interactions because a higher number was the objective?

Advisory boards can reveal a different version of the same issue.

When I was an MSL, we had medical directors traveling coast to coast, conducting one advisory board after another. It was a significant investment of time and money. But nothing came back to the field team. If you had asked us what scientific questions those meetings were intended to answer, or what the organization had learned, I don't think any of us could have told you.

I remember asking whether there were meeting reports I could read, even just for my own learning. I was told they were "top secret." There may have been legitimate reasons not to share the full reports. What bothered me was the disconnect. Ironically, I sometimes learned more about what happened at those advisory boards from my KOLs than from my own organization. That put me in an awkward position more than once.

The medical directors delivered their advisory boards. Reports were prepared, but from where we sat in the field, we couldn't see how that learning was being used or whether it was informing the work we were doing.

And that's what connects these examples. Publications delivered. Advisory boards completed. Scientific interactions increased. Every scorecard can be green while the same unanswered questions and unresolved barriers carry into the next planning cycle.

This isn't just a reporting problem. It affects what we fund, where we deploy people, and which capabilities we protect. We might continue funding programs because they reliably produce deliverables, without revisiting whether those deliverables still address the scientific needs of the market.

We might request additional headcount when the underlying problem is an inefficient process. Or we might cut a valuable capability because we never adequately documented its contribution.

Here's a harder test: If leadership asked you to reduce your Medical Affairs budget by 20%, could you explain which capabilities should be protected, what could change, and what the organization would lose?

Could you connect those choices to the problems your organization needs to solve? Or would the discussion come down to whose scorecard looks best and who makes the strongest case in the room?

Without a clear understanding of what's working and why, resource allocation risks becoming a budget negotiation rather than a strategic decision.

Before approving another year of activities, establish a clear picture of where your organization stands. Not just activity totals, but the scientific needs, evidence gaps, and organizational barriers your strategy is meant to address.

Document what you've learned, what remains unresolved, and what needs to change. Otherwise, you risk carrying the same problems into 2027, with updated targets and refreshed slides.

As you prepare your 2027 medical strategy, can you explain what actually changed this year, what didn't, and why?

If you can't, that's where your baseline assessment begins.

How to establish your Medical Affairs baseline. Five questions to answer before setting 2027 priorities, and why it matters even more when you inherit an organization you didn't build.

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