A high-level glance at what we do, using the grounding example of a recent case study. See how Best Practices, LLC helped a client establish the potential impact of a Corporate Integrity Agreement and explore trends in MSL management.

1. Case Study: Medical Science Liaisons
With the advent of Corporate
Integrity Agreements, our client
came to Best Practices, LLC with
several questions.
Our team of experts explored
ways to deliver exceptional MSL
Services to various customer
groups and stakeholders in an
increasingly challenging
business environment.
Here’s what they found.
1

2. The Challenge: explore MSL management options
and potential impact of a CIA
What do MSLs What MSL management
What do Medical How do MSLs develop
provide to Key changes and risks have
Science Liaisons
Opinion Leaders arisen? How do and manage internal
(MSLs) Services look
(KOLs)? How do they Corporate Integrity and external
like? What methods
do so, and how Agreements impact relationships?
do they employ?
often? companies?
Gather data and Improve MSL
establish best management and
practices from create value for
benchmarking various customer
class segments
Your Problem Our Research Your Solutions 2

3. Case Study Focus: MSL management
trends and mitigating CIA-inducing risks
• General Observations
Research Focus Areas
• KOL management
• Internal services and activities
• Payer group support and education
• Hospital and health care access
• Emerging trends and mitigating risks
• MSL group structure and oversight
Your Problem Our Research Your Solutions 3

4. Our initial assumption that those companies with CIAs would
be much less restrictive turned out to be untrue.
“How restrictive is your company now compared to 12-24 months ago and how will it be in the next 12-24 months in
regards to MSL interaction with healthcare providers?”
Total Benchmark Class CIA Companies
80% Compared to 12-24
(n=32) (n=8) Months ago
Next 12-24 Months
63%
60% 58%
54%
50%
42%
40% 38% 38%
25%
20%
13% 13%
4% 4%
0%
More Restrictive No Change Less Restrictive More Restrictive No Change Less Restrictive
Your Problem Our Research Your Solutions 4

5. Using statistical analyses, we discovered that the correlation lay
instead with risk perception
A perception of low risk correlates with a much lower likelihood of increased restrictions on MSL
activities, and vice versa, suggesting that those who fear a changing environment are more
likely to react with more stringent measures.
Last 12 Months Next 2-3 Years
100% 0%
7%
15% 13%
80% 26%
52% Less
61% Restriction
40%
60% 75%
No
Change
77%
40% More
67%
Restriction
46% 48%
20%
39%
25%
0% 10%
High Risk Medium Risk Low Risk
High Risk Medium Risk Low Risk
Perceived Risk Level
Your Problem Our Research Your Solutions 5

6. Best Practices Key Industry Insight: “Corporation’s
response” has greater impact than the CIA itself
“Even the parts of the organization that had no role
in the malfeasance that caused the CIA to be put in
place reacted in a way that neutered the organization.
“It comes down to the corporation’s response to
what is going on. If you get down to it the rules
we play by are just suggestions by OIG, but if you
cross the line and can document that money changed
hands or something was done that was wrong or
illegal.
“Organizations get to that point, get slapped on the
wrist that causes the pendulum to swing so far back
the other way that the companies become
ineffective.”
– Director, Medical Affairs
Your Problem Our Research Your Solutions 6

7. Therefore, we recommended that the Client must decide room for risk
aversion in the future to set restrictions for MSL/KOL interactions
Risk aversion and regulatory intention metrics reveal that those forecasting an unfavorable
environment will mitigate these risks by further restricting MSL activities.
Likelihood respondents will become more restrictive with MSL activities over next two years, by risk
group:
S.D. = 16%
As a high-risk 21%
company, client
Medium Risk Low Risk
should consider
further policies
to mitigate risk High Risk -10%
-14%
over the next S.D. = 9%
S.D. = 13%
few years.
Your Problem Our Research Your Solutions 7

8. Our research allowed us to establish the client’s
positioning and make a recommendation
However,
• Company sees potential • Rather than make
CIA on horizon decisions based on
• Stricter regulations • CIA companies seem to be potential CIA, client should
anticipated for industry minimally impacted act as do industry leaders:
• Risk perception dominant in reaction to anticipated
in companies’ MSL risks
restriction decisions
Now Future
Your Problem Our Research Your Solutions 8

9. About Us: Best Practices, LLC
We are a research and consulting firm that conducts work based on the
simple yet profound principle that organizations can chart a course to
superior economic performance by studying the best business practices,
operating tactics and winning strategies of world-class companies.
Best Practices, LLC
6350 Quadrangle Drive, Suite 200, Chapel Hill, NC 27517
919-403-0251
best@best-in-class.com
www.best-in-class.com