As the pioneers of systematic KOL engagement, Kendle Healthcare advises you how to create stronger, mutually beneficial relationships with key opinion leaders.

1. Building relationships

As more and more interactions with KOLs are virtual and companies embrace an omnichannel approach, the more valuable face-to-face interactions become for building relationships.

2. Community

Congresses are one of the few places where the scientific community in a particular therapy area are all in one place. As a company seeking to create partnerships with experts by being there you are putting yourself forward as part of that scientific community.

3. Information

Networking is an excellent way to gain insight both into the disease area, and into your product.

4. Know the KOLs

Conversations can reveal how approachable KOLs are, provide an insight into their opinions, how closely those are aligned to those of your organisation, and give you a feeling for whether they might be good future collaborators on studies or other activities.

But isn’t face-to-face networking dead?

Attending conferences became impossible during the pandemic, of course, when medical conferences were cancelled or became online only.

However, most major conferences have now moved to a hybrid format, offering both in person and online attendance.

There was a view that in person attendance at conferences might never get back to what it was and that most people would continue to access meetings online.

This doesn’t appear to be what’s happening, in person attendance is creeping back to pre-pandemic levels.

For example, ASCO (The American Society of Clinical Oncology) reports that 73% of attendance to their 2022 congress, the first hybrid one following COVID, was in person.

Most importantly, while virtual interactions are an incredible tool for engaging with anyone, there is still value in meeting someone face-to-face, especially in situations such as a conference where it is convenient to interact with lots of people easily.

How should you network at conferences?

One caveat about going to conferences: if you don’t know anyone and you just pitch up at a meeting, you’ll come home still not knowing anyone.

For successful KOL networking and engagement, you need to plan your meetings:

• Draw up a long list of those you feel you might want to see and contact them asking to meet you briefly.
• Most of them will ignore you but if you explain who you are and why you’d like to meet them, and importantly, why they might like to meet you, enough will accept to make your trip worthwhile.
• Make notes about each meeting, what was said, and what new knowledge you have gained from it.
• Let your colleagues know about any KOLs who you think they should follow up with.

The other great thing about networking is that conferences are exciting places to be.

Personally, I always feel privileged to rub shoulders with experts, particularly in a place where a lot of the latest thinking and research is revealed or explained.

I think enthusiasm for the event and for KOLs’ expertise and knowledge can only improve your networking.

Tip 2 – Start engaging with KOLs as early as possible

Why start early?

The relationship with a key opinion leader (KOL) should be a mutually beneficial long-term one. The earlier you can start this the better your KOL engagement will be:

1. It takes a long time for trust to develop between a KOL and a company.
2. The input of KOLs is beneficial at all stages of a product’s lifecycle.

Do companies start KOL engagement early?

Some companies state that they start their KOL engagement programs as early as the pre-clinical phase, though I suspect that many of them are conducting activities with a few KOLs at this stage, rather than implementing a planned KOL program.

Although the main role of opinion leaders at this stage is to input clinical advice, their commercial input can be underestimated.

In an analysis in the US, almost 90% of pharmacy companies claimed to have started their opinion leader management activities by the end of Phase II.

There may be some wishful thinking here, but it shows the increasing importance companies are giving to starting KOL engagement early.

How to make the most of an early start?

In the early stages of KOL engagement, the relationship will be mainly facilitated by clinical, and the roles of the KOL will also be mostly involved with clinical aspects – advising on medical needs, advising on studies, as well as taking part in trials.

Even at this stage, however, the input of KOLs into such things as assessing market needs and competitive analysis is valuable.

To make the most of an early start, it is essential that there is good cooperation and communication between clinical, marketing, and medical affairs.

When selecting investigators for clinical trials, the most important thing is choosing people who will be effective investigators. However, thought should also be given to including investigators who can be KOLs you work with in the long-term.

In the past, but thankfully less so now, too often there was little continuity in the relationship between pharma and KOLs, with the result that medical affairs and marketing were not informed about potentially valuable KOL relationships developed through trials and other clinical activities.

Clear communication between clinical, medical affairs and marketing can create valuable long-term relationships with KOLs.

What if I haven’t started early?

Don’t despair if you haven’t started your KOL engagement and you’re only a few months away from launch, however, or even if you have an in-line product.

You can still establish strong relationships with opinion leaders, gain valuable insight, and cultivate advocates by following our tips.

Tip 3 – Consider the KOL’s point of view

Considering the KOL’s point of view leads to an improved KOL relationship and KOL engagement, stronger partnership, and better patient outcomes.

The competitive advantage of ethical and honest relationships with KOLs cannot be overstated.

Benefits of considering the KOL’s point of view

There are many benefits to considering the KOL’s point of view when it comes to KOL engagement:

• KOLs are more likely to want to work with you.
• Better communication with KOLs you already work with.
• Stronger performance from KOLs in activities.
• More useful insight from KOLs.
• Stronger partnership with KOLs.

Doesn’t everyone already consider the KOL’s point of view?

When the benefits are so obvious, you may assume that everyone is considering KOLs’ points of view.

Of course, you know that your own goals and reasons to work with a KOL are essential, but sometimes we remind our clients that this is a collaborative partnership and that part of this is considering why the KOL may be choosing to work with them.

For example, when inviting a KOL to participate in an activity, it is possible to make the mistake of assuming that you invite KOLs and if they attend you pay them a fair market honorarium, rather than thinking about why a KOL would want to attend.

If you are working for a major pharmaceutical company, you will often get away with this because you already have a reputation and KOLs may see an advisory board as an opportunity to develop a relationship with a view to access to involvement in later activities.

If you are representing a less well know organization, however, you will probably need to work harder to motivate KOLs to attend.

This general lack of thought about what KOLs want, and why they would choose to work with you, leads to KOL dissatisfaction with their relationships with industry.

Evidence of this dissatisfaction is apparent in KOL surveys, such as a 2021 CenterWatch study, in which KOLs rated 91% of companies as performing worse in their engagement with them than in the previous year.

While there may be several factors that contribute to this, it is likely that if those engaging with KOLs considered things from the KOL’s point of view more frequently, then their relationships with KOLs would improve.

Why don’t people consider the KOL’s point of view?

When it comes to KOL engagement, everyone thinks they are considering the KOL’s point of view, and often they will be.

But there are several factors that encourage an approach to KOL relationships that considers only what is in it for the pharma company:

• Often people’s initial interaction with a KOL is as information on a spreadsheet or in a CRM or insight management program, which can lead to us not to consider KOLs as people.
• In business, there is a natural propensity to focus in the short-term on our own immediate goals, even when our long-term aims are for mutually beneficial partnerships.

For this reason, it is good to pause and consider whether you really are considering things from the KOL’s point of view.

What do we mean by considering a KOL’s point of view?

Considering a KOL’s point of view means thinking about the sweet spot where your mutual goals and wants coincide.

As your relationship develops and the trust between you and the KOL grows, you will discover that the area of mutual goals and wants grows.

For the relationship to develop in this way, it is important that the KOL can see that you are not driven exclusively by your own goals but recognize theirs as well. 

And this approach to KOL engagement is the ideal ethical KOL engagement we want. When both parties are devoted to better patient outcomes, it is easy to find areas in which your interests coincide.

What do KOLs want from their relationship with industry?

If we go back to the advisory board we mentioned earlier where someone has assumed that KOLs will attend without considering why they would want to attend, it is worth considering reasons a KOL may wish to attend an advisory board:

• An opportunity to have a high-level discussion with their peers.
• An opportunity to be one of the first to see clinical trial data or information about a new treatment.
• Recognition of their expertise and knowledge.
• Opportunity to further a relationship with a company with a thought to future activities.
• Previous well-organized activities are excellent motivators for KOLs to work with you again.

Human interactions

The difficulty when writing about this topic is that the advice may come off as sounding manipulative: think about the KOL’s point of view in order to achieve your own ends.

However, this isn’t what I am trying to communicate.

Don’t see every interaction with a KOL through the prism of your own goals.

Instead act with compassion and authenticity.

A KOL we worked with said the following about us:

“Kendle Healthcare are a bit different. They take the time to properly get to know and understand KOLs to develop an honest mutually beneficial working relationship.”

If KOLs feel this way about you, you will achieve better KOL engagement and better patient outcomes for everyone.

Tip 4 – Communicate openly and honestly with KOLs

I hope the need to practice our next tip for better KOL engagement, to communicate openly and honestly with KOLs, is clear after tip 3.

What do we mean by honest communication and why can it sometimes be very difficult?

Honest communication is very simple, and sometimes very difficult.

We mean simply that you act with integrity and do not betray the trust of any KOL you work with.

To help you understand why it can sometimes be difficult, I’ll provide you with two scenarios and ask you how you would respond to them.

Scenario 1

A KOL approaches you and asks for funding for an educational scheme they are involved in. You are enthusiastic about this educational scheme, you can see the value in it, and that it aligns with your company’s values.

However, when you request the funding, it is denied.

What do you say to the KOL?

Scenario 2

A local KOL that you have worked with frequently approaches you about wanting to do larger presentations for your company.

You already have several KOLs in mind for all your future speaking engagements and do not think this local KOL is more qualified than any of these other KOLs.

What do you say to the local KOL?

Several times we have heard from opinion leaders about their frustration when a decision has been made at a company, but the company hasn’t informed the KOL.

KOLs have told us, “It’s alright to say no.”

The KOL may not like the answer, but they will appreciate your honesty.

The benefits of open and honest communication with KOLs

The benefits of open and honest communication are trusted relationships with KOLs, a reputation, for both you as an individual and your employer, for integrity and credibility, and excellent KOL engagement.

Tip 5 – Make sure you are working with the correct KOLs

A client of ours, recognizing the importance of working with the right KOLs for effective KOL engagement, said:

“We don’t have the resources that our competitors do, and therefore we cannot afford not to pay for your insight. We cannot afford to waste our KOL engagement opportunities on people who are not the very best people for us to be engaging with.”

How do you know that you are engaging with the right KOLs?

The decision is important because you need KOLs’ expertise to carry out clinical trials, to interpret product data, and to help shape the story of your product.

You also need KOLs to help spread the story of a product’s use, and to ensure that it is prescribed when appropriate.

Often when it comes to working with KOLs you will work with those you, or members of your team, know. Or attend conferences and talk to the speakers and meet KOLs that way.

These methods have two advantages; they are cheap (though potentially costly in the long-run) and they are quick.

When it comes to working with KOLs you already know, it also has the advantage that there is a relationship already established.

But if this is the case, why did our old client say that they couldn’t afford not to commission a KOL identification and mapping?

The advantages of a professional KOL Identification and Mapping

There are several important advantages to an agency-conducted KOL identification and mapping:

1. Objective

We tend to overestimate the importance of the people we like and underestimate those we’re not so friendly with. For each KOL you engage with, you should be able to articulate why you are working with this KOL and not someone else.

2. More KOLs

It will provide you with more people to engage with. As another of our clients told us: “we’re doing this KOL mapping because we know who we know but we don’t know whether they are the people we should be engaging with, and we don’t know who we’re missing”.

3. More accurate insight

It ensures that the advice and insight you receive about a therapy area is representative. If you only engage with people you know, there is a danger that these people have similar views which are not representative of the overall area.

4. Smarter decision making

It can reveal not just who is influential, but who influences who, which KOLs are suitable for which activities, and when and how you should approach them.

With an agency-conducted KOL identification and mapping, you can transform your KOL engagement, maximizing the insight you receive and your ability to deliver the right message to the right people.

How do you choose a vendor for a formal KOL identification and mapping?

You need to consider the following questions:

1. Are they delivering insight specific to our context, or are they delivering data and asking me to sort it myself?
2. Is what they are delivering bespoke to us, and to what extent?
3. Will it be clear who the most influential people are?
4. How much information will there be on each KOL?
5. Will I know who influences who?
6. Will it be clear how I should engage with each KOL?
7. What sort of support is there to use the listing to transform my engagement?
8. Will interviews be used to check the objective data and provide expert insight into the therapy area?
9. What is the up-front cost?
10. Can it be updated cheaply each year, or will we need to pay an annual subscription cost?

I Have written about the process of choosing a vendor for KOL identification and mapping in more depth here.

A good KOL identification and mapping solution, delivered by a credible supplier, can improve your KOL engagement decision-making.

And if each decision about KOL engagement is better, the cumulative benefit and improvement to your KOL engagement can be staggering.

Tip 6 – Use the latest knowledge about how KOLs work

In the based-on-a-true-story film Moneyball, Brad Pitt plays Billy Beane, who takes the lowly Oakland Athletics to the baseball World Series by building a team of unappreciated talent through a sophisticated sabermetric approach to analysing players.

There is a great scene early in the film where the old-fashioned scouts are discussing players Billy might be interested in signing, with all sorts of old-fashioned parameters for judging them including:

• The ‘eye-candy test’ – ‘he looks the part’.
• ‘He has an ugly girlfriend’ – he must lack confidence.

It is inconceivable that anyone working in sport management now does not have some knowledge of sabermetric approach that Beane pioneered, and which enabled him to identify value in players when none of his competitors could.

For marketing and medical affairs, a similarly transformative way of approaching their KOL engagement strategies is through diffusion studies and social network analysis, both of which analyse the adoption of new ideas and how influence moves through a network.

How can this knowledge improve KOL engagement?

With this knowledge and the correct analysis, you can use your resources more efficiently when engaging with KOLs, providing you with a vital competitive advantage.

To give you three examples, network analysis can reveal:

1. Which KOLs will probably be most open to new products and more likely to provide the most cutting-edge insight, the ‘Innovators’.
2. Which KOLs are likely to have similar views to each other, therefore making decisions about who to seek advice from much more efficient.
3. ‘Invisible Influencers’ – KOLs whose importance is not apparent through traditional markers of influence, but who know what everyone else is thinking and communicate widely.

By upgrading your insight and analysis, you too can punch above your weight when it comes to KOL engagement.

Tip 7 – Work with the correct number of KOLs

In our experience, many teams do not work with an optimum number of key opinion leaders.

During a recent discussion, a client revealed that they had been concerned not to overstretch their organisation’s capacity by working with too many KOLs.

However, they now realised they were probably working with too few KOLs.

The problem with working with too few KOLs

The downsides of working with too few KOLs are:

1. KOL unavailability

KOLs may become temporarily or permanently unavailable due to lack of time, institutional constraints, illness, or retirement. If you work with too few KOLs, this may be very damaging to you.

2. KOL change of opinion

KOLs will rightly follow what they perceive the science to be and if they no longer consider your product to be the best for patient care, they may choose not to work with you anymore.

3. Perceived credibility of your product

If you constantly work with the same few KOLs, there is a chance that other healthcare professionals may think that this is because very few KOLs support your product.

4. Perceived credibility of the KOL

A KOL is a KOL because they are perceived to be experts with sound judgement. If only a few people support your product, and this KOL is one of them, their judgement and objectivity may be questioned by other healthcare professionals.

How to make sure you work with an appropriate number of KOLs

Of course, there is no right answer to how many KOLs you should work with.

It will depend on what you are trying to achieve, your resources, the number of appropriate KOLs, and so on.

Many of our clients have a long list of those they will engage with a little bit, and a shorter core group who they wish to develop strong relationships with.

However, while there is no right answer as to the number of KOLs you should engage with, there can be a wrong answer.

The following two pieces of good practice should ensure that you are working with an appropriate number of KOLs:

1. Properly plan your KOL engagement

If you decide which KOLs to invite to each activity only when that activity approaches, you risk working with too few KOLs.

For example, you may look to set up an advisory board and invite the ten KOLs you feel are most appropriate.

Later you may set up a different, additional advisory board, a speaker panel, or an educational initiative and again pick the ten individuals you feel are most appropriate, which unsurprisingly are almost the same as the previous activity.

If you plan your activities in advance, you can plan to engage with more KOLs.

2. Identify enough KOLs

Sometimes, companies will only know of a small number of KOLs in their area and therefore they return again and again to the same KOLs.

If you have undertaken a formal identification and mapping, you should know all the KOLs in your area, and have enough information about them to know who is most suitable for you to work with, and for which activities.

Tip 8 – Create good channels of communication about KOLs

Our eighth tip on better KOL Engagement, is to prioritise internal communication about KOLs and the activities you conduct with them.

The benefits of communicating effectively about KOLs

Disjointed KOL interaction leads to a dissatisfied KOL, and many missed opportunities for insight and influence.

A few years ago, a client told us that as a company three different product teams working in the same therapy area each organized an advisory board to take place at the same conference on different days.

The only people who knew there were three advisory boards organized were the KOLs who were attending all three.

I don’t have to tell you how this makes your organization look, or the resources that are wasted by it.

To summarize:

• KOLs tell us that they value companies that have effective internal communication.
• KOL management is more effective when it is long-term.
• You make better decisions about KOLs with more data, and internal communication is an excellent source of data.
• Insight gleaned from expert KOLs is often valuable to more than one department.

If you don’t communicate effectively, you won’t engage effectively.

Why is it sometimes hard to communicate with colleagues?

Almost every company we work with admits to having difficulties with internal communication about KOLs, so don’t be despondent if you feel this is an area that you need to improve.

The first step is to consider why communication is not working effectively but also to find examples of best practice within your organization that you can share.

When it comes to reasons why communication is not working, it is likely that one or more of the following will be contributing to inefficient communication about KOLs:

• Firewalls that are created for compliance reasons preventing communication.
• A lack of processes in place that encourage communication.
• KPIs that do not reward communication.
• Inertia – people don’t plan to not communicate, but it is not urgent.

Once you have identified why people are not communicating, it becomes easier to develop a solution and improve your KOL engagement.

How can you improve internal communication around KOL engagement?

There is no stock solution to the problem of internal communication – what works will be specific to your company’s needs, processes, and resources – but processes do need to be created that ensure that all areas communicate with each other about who has engaged with which KOLs.

One way to create these internal processes is to set up a working group to create KOL engagement processes, either brand or therapy area specific, or across the whole company.

This working group is an opportunity to diagnose the problems with the current system, identify areas where you are working effectively, and decide which processes will be needed.

When Kendle Healthcare works with clients to build KOL systems and processes for better KOL engagement, we often like to focus on the following:

1. How is local knowledge of KOLs, and information about the activities that local teams have conducted with them, shared with marketing and medical affairs?
2. How is information shared from global with regional and local teams?
3. How do you ensure continuity in relationships between early phase, when KOLs are involved in clinical trials, pre-launch, when you are working with KOLs to understand clinical data, and at launch and beyond?
4. How is insight captured and shared?
5. With a limited number of engagements possible with each KOL, how do you decide which activities across different teams and geographies, are priority?

How do you ensure that these processes are followed?

Once you have decided on these processes, you need to ensure that they are adhered to.

In our experience, the three most important elements to ensure these processes are followed are:

• The culture at the top – if everyone can see that internal communication about KOLs is valued, they will value it too.
• Continual communication about the rationale for effective internal communication about KOLs.
• KPIs reflecting the value of following the processes you have created.

Bonus tip – Plan your KOL engagement activities

Of course, your focus is going to be on the immediate future, but planning your long and medium-term KOL management activities and strategies is a must if you want your KOL activities to be coherent and effective, and you want effective KOL engagement.

What are the benefits of a KOL engagement plan?

A KOL engagement plan has the following profound benefits:

1. You’ll have a clear understanding of what you are trying to achieve in your KOL engagement program, and the purpose of each individual activity as it contributes to this.
2. Prevents too frequent engagement with a few KOLs.
3. Allows you to build relationships with KOLs over the lifecycle of a product – for example, some investigator will become important for later communications activities.
4. Builds trust with KOLs if they understand how you’d like to collaborate with them in the future.
5. Knowing your KOLs well helps you choose the KOLs who are best for each activity, which has a transformative effect on KOL engagement.

How to plan your KOL engagement

We will be releasing our step-by-step guide to creating a KOL engagement plan shortly.

If you sign up for our newsletter you will be informed as soon as it is available, and you will have everything you need to plan effective KOL engagement.

Conclusion

We hope these tips prove useful for you and can help you develop more rewarding KOL relationships, better KOL engagement, improved patient care and growing your product’s place in the market.

If you would like to understand how Kendle Healthcare can help you with all your KOL engagement needs, please get in touch.