Medical Affairs Vs Commercial: What If We Started Again?

What makes medical and commercial teams clash?

The tension between medical and commercial is not necessarily driven by bad intentions. In many cases, it comes from the labels, assumptions and systems that have developed around each function. 

Medical teams can perceive commercial activity as being too focused on selling products, while commercial teams can see medical activity as disconnected from the realities of the business. A valuable medical interaction may be dismissed as a “wasted interaction” because it did not actively promote the product. Equally, someone working in commercial may feel unfairly judged as though generating sales is their only motivation. 

These assumptions are reinforced by established working practices. Brand meetings frequently begin with market share, difficult accounts or competitive threats. That starting point shapes the language and priorities of everything that follows. KPIs, reporting structures and established processes can also reward teams for pursuing separate functional goals rather than solving a shared customer or healthcare problem. 

The clash, therefore, is not simply about personalities. It is built into how teams are named, measured, rewarded and encouraged to think. 

Why is the medical and commercial conversation important for HCPs and pharma employees? 

For healthcare professionals, a disconnected medical and commercial model can create a fragmented and confusing experience. One team may be building a trusted relationship around clinical needs while another tries to reach the same person through a separate campaign, channel or product message. Useful information may sit in different systems, and insights captured through one relationship may not meaningfully influence the next interaction. 

The discussion also matters deeply to the people working inside pharma. Many employees enter the industry because they want to contribute to healthcare and make a meaningful difference. However, company meetings and senior communications often focus on quarterly performance, competitors and market threats rather than showing the real difference that the organisation has made to patients or clinicians. 

This can leave people feeling disconnected from the purpose of their work. Medical colleagues may feel that the relationships and initiatives they have worked hard to build are not properly valued. Commercial colleagues may feel that their contribution is treated as less worthy because it has an associated financial outcome. When teams cannot demonstrate the impact of their work—or invest significant effort in activities that attract very little engagement—it can create frustration, disappointment and a lack of commitment to the wider business. 

Who would lead if we built a pharmaceutical company from scratch? 

At the beginning of the conversation, two slightly different models emerge. One is an integrated marketing team containing strong medical, marketing, communications, channel and customer-service expertise. The other is a medically led communications team, built around scientific understanding and supported by people who know how to communicate effectively. 

By the end of the discussion, however, there is broad agreement that medical would provide the strongest foundation. 

If forced to choose between a company led only by its existing medical team or one led only by its commercial team, Dan argues that he would choose medical; however, he still sees the actual job to be done as classic marketing. Maaike similarly sees medical taking responsibility for personal communication, clinical relationships and projects that can help shape the care system. 

If medical values were to take the lead, it does not mean simply leaving medical affairs exactly as it operates today. A medically led organisation would need significant support and development in areas such as communication strategy, storytelling, digital engagement, congress design, customer journeys, advertising, CRM and ongoing relationship management. And, of course, an acceptance that commercial impact is necessary. 

The aim would not be to turn medical colleagues into traditional salespeople. It would be to combine medical credibility and scientific depth with the tools required to communicate clearly, reach people at scale and ensure that every relevant clinician understands where a medicine fits and when it may be appropriate. 

Why do medical affairs teams sometimes feel undervalued? 

Medical affairs teams frequently create value that is difficult to connect to an immediate commercial result. They develop scientific relationships, answer questions, gather clinical insights, support evidence generation and remain open to discussing all available treatment options—even when another product may be more appropriate. 

That openness is essential to trust, but it can be misunderstood within a commercially oriented system. When medical colleagues do not directly push the company’s product, their interactions may be viewed as missed opportunities. Their wider contribution can then be reduced to questions about business acumen or whether their activity has influenced sales. 

Medical information provides a particularly clear example. It may be one of the few places where a physician, patient or caregiver proactively contacts a pharmaceutical company with a genuine need, question or problem. Yet medical information teams have traditionally been perceived as reactive and relatively invisible, rather than recognised as a strategically important point of customer engagement. 

The issue is not that medical lacks value. It is that the organisation may not have developed the language, measures or processes required to recognise that value. 

What makes medical affairs essential to HCP engagement? 

Medical affairs brings the scientific depth, clinical understanding and credibility required to have meaningful conversations with healthcare professionals. Medical teams can identify gaps in practice, understand emerging clinical needs, answer complex questions and build relationships that are not dependent on immediately discussing a product. 

They also contribute to more than communication. Through studies, early-access programmes, evidence generation and collaborative projects, medical teams can help influence and improve the wider care system. 

This creates a strong foundation for trust. When an organisation begins with the problem that a clinician is trying to solve, rather than the message it wants to deliver, it becomes more relevant. Medical teams are already accustomed to discussing disease, evidence and different treatment options without forcing every conversation towards one predetermined conclusion. 

The opportunity is to connect that credibility more effectively with the wider engagement capabilities of the organisation. Medical insight should not remain within medical affairs. It should shape brand meetings, communication priorities, customer journeys and the overall experience the company creates for healthcare professionals. 

Why is pharma marketing so often misunderstood? 

Marketing is frequently reduced to selling, promotion or persuading someone to choose a product. That narrow definition contributes significantly to the tension between medical and commercial teams. 

In the discussion, marketing is described differently: as identifying a problem, reaching the people who want to solve it and helping them move towards a better outcome. The solution might be a medicine, but it could also be education, information, a publication, a service or another useful resource. 

Commercial value does not automatically make an activity bad, just as medical value does not mean an activity can have no commercial effect. A useful medical initiative may eventually contribute to the success of a product. A well-designed marketing activity may create genuine medical impact. Both outcomes can exist at the same time. 

The problem is that much pharmaceutical marketing does not consistently live up to this definition. Teams often begin with the competitive landscape and try to demonstrate superiority across every available product attribute. This creates large numbers of messages, competitive claims and points of differentiation. Rather than helping healthcare professionals make decisions, the resulting noise can create confusion—and when people are confused, they are more likely to continue doing what they have always done. 

A more useful approach would be to define clearly who a medicine is for, what specific problem it helps address and when it is relevant. This still supports commercialisation, but does so by helping the right people recognise the right situation rather than attempting to make one product appear better in every possible circumstance. 

How do KPIs and top-down strategy affect HCP engagement and employee experience?

Small strategic decisions at the top of an organisation can change the behaviour of hundreds of people further down. 

When meetings begin with market share, competitive pressure and account performance, the rest of the conversation naturally becomes focused on defending the product and delivering short-term results. When meetings begin with clinical insights, unmet needs and what is happening in practice, teams are more likely to ask different questions and develop different solutions. 

KPIs reinforce these priorities. Even where an organisation publicly talks about patients, purpose and collaboration, its measurement systems may continue to push people towards established functional activities. Teams then return to what feels familiar and safe—not because they are deliberately ignoring customers, but because the existing processes quietly pull them back towards the way things have always been done. 

This affects the quality of engagement. It can encourage product-led narratives, generic campaigns and expensive activities with little evidence of value. It also affects employees. People can work extremely hard on an initiative, relationship or event, only to discover that very few healthcare professionals engaged with it and that the organisation cannot demonstrate any meaningful impact. 

Changing the final customer experience therefore requires more than asking teams to collaborate. It requires leaders to examine the goals, meeting structures, KPIs and strategic assumptions that determine how people behave. 

Why is an aligned medical and commercial culture important for employees and customers?

Medical and commercial teams each have strengths, but either discipline can create ineffective engagement when operating in isolation. 

A traditionally designed medical symposium may contain strong data and credible speakers but lack a clear story, compelling experience or plan for continuing the relationship afterwards. A commercially driven activity may be professionally promoted and carefully measured but introduce the product too early, reducing its relevance and credibility with the audience. 

An aligned approach could begin with a topic that healthcare professionals genuinely want to understand. It could use medical expertise to ensure the content is valuable and scientifically credible, while drawing on communication, storytelling and digital expertise to make the session engaging and accessible. 

The organisation could then continue the relationship: learning more about the clinician’s needs, helping them access further information and recognising when a future product conversation might become relevant. The commercial intent would exist within the overall relationship, but would not need to dominate every individual interaction. 

For this to work, both sides must move beyond the belief that one contribution is inherently more worthy than the other. Medical teams need to feel comfortable using communication and engagement techniques that may previously have “smelled commercial.” Commercial teams need to recognise that trust, education and problem-solving can create value even when a product is not immediately discussed. 

The result would be a more coherent experience for healthcare professionals and a more purposeful working environment for the people creating it. 

What can pharma teams do to start changing the relationship between medical and commercial?

The conversation does not claim to have solved the medical-versus-commercial challenge. It does, however, suggest several places where teams can begin. 

A brand team could start its next meeting with ten minutes of clinical insight: what is happening in practice, what needs are emerging and where patients or clinicians are experiencing gaps. Leaders could review whether current KPIs genuinely encourage collaboration or simply reinforce established functional behaviours. Teams could also examine where valuable medical relationships, customer insights and engagement data are being separated unnecessarily. 

Medical colleagues can consider which communication, storytelling and digital techniques would help their expertise reach more people effectively. Commercial colleagues can consider where beginning with the customer’s problem—rather than the product—could create stronger and more sustainable engagement. 

Most importantly, people experiencing these tensions should talk openly about them. Changing the model will require people from medical, commercial and other functions to share what is happening inside real companies, challenge the status quo and test different ways of working. 

The question is not simply whether medical or commercial should win. It is whether pharma can build a model in which scientific expertise, communication skill, customer understanding and commercial responsibility work together around a much clearer purpose. 

Things Can Only Get Better (Now we’ve found you) 

The way Medical and Commercial work together shapes how decisions are made, how teams collaborate, and how HCP engagement is delivered in practice. 

Right now, things aren’t working as well as they could. But this community consistently shows up with honesty, insight, and ideas for change. 

That’s why we want to rebuild this conversation with you.

Join The Conversation

We’re speaking to people working in and around Medical Affairs about how the Medical–Commercial relationship really works today, and what we would change if we could start again.

Sign up using the form below ⬇️ and we’ll invite you to share your perspective through a short survey. We’ll bring those experiences together into a report exploring the current state of the relationship, emerging areas of consensus and practical ideas for moving forward.

We’ll also invite a small number of contributors to continue the conversation in a roundtable discussion.

---

Contribute your perspective NOW 🗣️