The function we know today as Medical Affairs (MA) has undergone a quiet but powerful transformation over the past 50+ years. What started as a peripheral support function has slowly evolved into a strategic cornerstone within life sciences organizations.
The story began in 1967 when Upjohn (now part of Pfizer) launched the industry’s first Medical Science Liaison (MSL) team.
At the time, the goal was simple but essential: empower scientifically trained professionals to engage with physicians in a more credible, education-focused way than their commercial counterparts could.
Since then, the MSL role – and the MA function as a whole – has steadily evolved, expanding across pharma through the 1990s, separating from promotional activity in the early 2000s, and by the 2010s and 2020s, becoming a strategic, cross-functional driver fueled by complex science, global regulations, and the demand for real-world evidence (RWE).
Now, Medical Affairs is considered by many to be a third strategic pillar next to R&D and Commercial functions, with some organizations even tapping MA teams as the strategic leaders when launching innovative therapies.
How Medical Affairs Drives Commercial Success
At the heart of the Medical Affairs evolution is the Field Medical team, including MSLs and other field-facing professionals, which plays a pivotal role in engaging Key Opinion Leaders (KOLs) and building long-term scientific relationships.
These aren’t just nice-to-have interactions; they’re measurable drivers of launch readiness, uptake, and physician confidence.
A 2024 Bain & Company survey highlights just how important this engagement has become, finding that:
- 64% of physicians recognize the value of partnering with MSLs during the launch of products in new disease states.
- 50% of physicians say they want more time with MSLs, which is double the percentage who want more time with commercial representatives.
- 1 in 3 physicians report that MSL interactions have changed how they treat patients.
These figures underscore what many life sciences organizations have come to recognize: MSLs are often the most trusted link between emerging science and clinical practice.
But beyond relationship-building, Medical Affairs professionals also serve as scientific storytellers, translating complex trial data, mechanistic insights, and RWE into clear, tailored narratives for different stakeholders.
Done well, scientific storytelling helps to engage key stakeholders across the product lifecycle:
Payers
see the clinical and economic rationale
Physicians
understand the therapeutic value and application
Patients
and caregivers get access to more meaningful information
To enable this kind of impact, however, MA talent must bring more than scientific acumen; they must be strong communicators, skilled in tailoring messages without losing accuracy or nuance.
And yet, while the need for these skills is clear, building a Medical Affairs function that actually delivers them – at the right time, with the right talent – remains one of the most underappreciated challenges in emerging biopharma.
The Planning Gap: Why Emerging Biopharma Struggles to Properly Staff Their Medical Affairs Teams
Despite the growing strategic importance of Medical Affairs, many life sciences organizations still fall into the trap of reactive hiring, waiting until a launch is on the horizon, or worse, already in motion, before thinking seriously about the team that needs to support it.
There are several reasons for this gap, especially in emerging biopharma:
1. Budget-first planning
Many companies structure headcount growth around financing rounds or clinical milestones – not around when insights or evidence will actually be needed. This means that even when leadership recognizes the value of MA, hiring often happens too late to influence strategy.
2. Underestimating complexity
Because Medical Affairs doesn’t generate revenue directly, its impact can be harder to quantify, especially for founders or early executive teams unfamiliar with the inner workings of the function. As a result, critical roles like Medical Directors or MSLs are seen as “nice-to-haves” rather than launch-essential.
3. Compliance blind spots
Scientific exchange is heavily regulated. In the U.S., the FDA and OIG define strict boundaries between what is considered promotional and what is not. In Europe, bodies like EFPIA and PMCPA add even more layers of oversight. For teams without senior MA leadership, these lines can be hard to see – and easy to cross.
While these challenges are understandable, companies that delay MA hiring often find themselves facing additional challenges, including:
- Weak or inconsistent scientific narratives
- Delayed or incomplete KOL engagement
- Limited payer and provider readiness
- A lack of internal insight flow during key decision-making phases
And once those gaps emerge, even strong talent can’t always close them fast enough. Scientific credibility – like trust – takes time to build.
When to Build Your Medical Affairs Team
The question shouldn’t be whether or not to invest in Medical Affairs but instead when. And for most companies, the answer is earlier than you think.
Industry consensus suggests that organizations should begin laying the groundwork for Medical Affairs at least two years before launch, though some recommend that strategic planning start as early as five years pre-launch, especially for companies working in complex, high-science categories.
That may sound too early, but the reality is that Medical Affairs isn’t plug-and-play. Scientific relationships, evidence planning, and cross-functional alignment take time. And building MA capabilities too late doesn’t just compress timelines, it limits what the function can actually achieve.
A phased approach can help teams stay lean without falling behind. Here’s an example of what that might look like:
24–18 Months Pre-Launch
- Hire a small, senior core: a Head of MA, VP, or Medical Director
- Begin KOL mapping and early scientific engagement
- Inform clinical and evidence-generation strategies
- Collaborate with cross-functional teams to shape the scientific narrative
18–6 Months Pre-Launch
- Expand to include MSLs and scientific communications staff
- Initiate field engagement and build trust with priority HCPs
- Develop scientific materials for congresses and payer discussions
6–0 Months Pre-Launch
- Add Medical Information and medical education functions
- Prepare to handle increasing volume of HCP inquiries
- Launch disease-state education and peer-to-peer programs
Post-Launch
It’s crucial to recognize that MA doesn’t end with approval. In fact, post-launch is when Medical Affairs often becomes most valuable, driving impact across:
- Evidence generation for new indications
- Safety surveillance and real-world outcomes tracking
- Label expansions and payer re-negotiations
- Lifecycle management and long-term stakeholder engagement
Ultimately, Medical Affairs must scale in sync with your pipeline, your market ambitions, and your organizational maturity if it is to be as effective as it can – and should – be.
How to Set Your MA Team Up for Success
To unlock the full value of the function and ensure it’s contributing meaningfully across the organization, companies need to think about structure, integration, and long-term development.
A few of the most important things to plan for include:
1) Embedding MA into Cross-Functional Strategy from Day One
Medical Affairs operates best when it’s positioned as a strategic partner, not an afterthought. That means integrating MA into:
- Cross-functional launch planning
- Evidence generation discussions
- Advisory board planning and KOL identification
- Omnichannel strategy and content development
When Medical, Clinical, Regulatory, and Commercial are working in silos, the result is often mixed messages, redundant outreach, and wasted insight. But when these teams co-plan, the scientific narrative is stronger – and the market is more ready.
2) Defining Metrics that Matter
One of the most common questions from executive teams is: How do we know MA is working?
While Medical Affairs doesn’t operate on the same KPIs as Sales, there are clear metrics that reflect effectiveness, including
- Insight-to-action rate: how often KOL feedback is translated into internal strategy
- Field coverage: percentage of target HCPs engaged
- Evidence productivity: number and impact of RWE studies initiated and completed
- Scientific communication milestones: timeliness and quality of publications, congress activity, and payer dossiers
Establishing these metrics early and aligning them with broader launch or lifecycle goals helps MA show its impact in terms that stakeholders understand.
3) Investing in Talent Development and Retention
Retention matters, especially in field medical, where trusted relationships and institutional knowledge are built over time. High turnover can erode credibility and disrupt momentum.
To avoid that, high-performing organizations are:
- Providing structured onboarding that includes compliance, systems, and soft-skills training
- Using behavioral assessments (like the ones we use at Mix) to identify growth opportunities and tailor coaching
- Defining clear career pathways, such as MSL → Senior MSL → Field Medical Director → TA Lead
Ultimately, a well-supported team performs better, stays longer, and contributes more strategically, meaning these investments are well worth it.
Starting to Build or Operationalize Your Medical Affairs Plan?
Whether you’re preparing for your first launch, expanding a field team, or thinking through global market entry, the right Medical Affairs talent strategy can make or break your success.
At Mix Talent, having supported more than 15 field medical team builds in the past two years, ranging from 5 to 28 MSLs per team, we understand that it takes a focused approach to find the right fit, fast, with precision and insight.
Whether you need to build, scale, or optimize your Medical Affairs function – reach out anytime to learn how we can help you accomplish your goals.
