Breaking Silos Between Commercial and Medical Teams

In this episode of Pharma Talks, Nataliya Andreychuk sits down with Elaine Gamble, Marketing Executive, Consultant, and Board Advisor at EGA Partners, whose career has run straight through the point where commercial and medical either collide or come together. She led omnichannel pharma strategy and engagement in one of the industry’s most demanding therapeutic areas at Otsuka, held leadership roles at Merck and Novartis, and serves on the American Marketing Association’s Future of Pharma expert panel.

The conversation covers what genuinely makes medical affairs collaboration stick, why MSL insight is pharma’s most underused signal, how technology quietly reinforces the organizational silos it was bought to remove, and why customer experience only works when it’s treated as a pharma operating model rather than a deliverable.

The HCP Doesn’t Need Pharma the Way They Used To

Nataliya opens with the uncomfortable version of the question: the HCP of 2026 has the data, the peer networks, and the clinical guidelines already at their fingertips. So what does that change about how commercial and medical need to show up?

For Elaine, the problem starts with a misreading of intent inside the organization itself.

“There’s often a misperception of different interests, when in fact those are shared interests. We just have to realize that through more listening, more collaboration, and having the right initiatives to partner on.”

What HCPs actually experience, she argues, is a set of teams competing with one another for the same attention — and a relationship that stays transactional. Sign here, and we’ll move to the next step. That’s the model breaking down, at exactly the moment when physicians are asking pharma to come to them as one organization. The fix isn’t a statement of intent; it’s defined process plus real shared work.

Cross-Functional Collaboration in Pharma: People, Process, Leadership — but Not Incentives

“Commercial and medical collaboration” is one of the most overused phrases in pharma and one of the least examined, Nataliya notes. Everyone claims it. Very few organizations sustain it. So when Elaine has seen it work as a way of operating rather than a pilot, what made it possible?

Her answer rules out the lever most companies reach for first. Incentives force the behavior without creating the shared goal underneath it. What matters is people who stop working in silos, processes that stop being transactional, and leadership that treats collaboration as culture rather than mandate — fostering the environment instead of legislating the outcome.

She gives a concrete shape to what that looks like. In many organizations, the MSL relationship is unbranded and stays that way. But it can be a self-contained experience for HCPs engaged by an MSL — followed over time, still MSL-owned, and still built in partnership with commercial. In an opinion leader program, commercial helps operationalize. The question becomes which message opens the door to the scientific engagement strategy, and where pure science broadens into access and support.

“You’re working to give the doctor the best experience, and everyone’s role comes to life in that journey. It cannot be done by one team.”

Feeding MSL Insight Back Into the Engine

Commercial CRM and medical affairs platforms are typically separate systems, which leaves field medical collaboration dependent on goodwill rather than infrastructure. Because they’re separate, data doesn’t move without manual effort — and the commercial plan keeps running on the assumptions it always did. Nataliya asks whether those medical insights could genuinely improve commercial engagement.

Elaine’s view is that pharma has already bought the omnichannel orchestration capability and is simply underusing it.

“In pharma we’ve invested a lot in operational capabilities — AI, orchestration, and others. And we’ve underutilized them.”

The change she describes is a loop rather than a handoff. MSL interactions feed back into those capabilities. AI identifies the engagements most likely to influence continued interest or improve field call quality. That’s shared with the field compliantly, to make the next call better. And the pearls of the engagement — not the raw record, not everything, but one or two useful signals — go to sales so they can build on them. Should we invite this HCP? Are there open questions we haven’t answered?

When Technology Becomes the Blocker

Medical and commercial often live in parallel technology universes — one of the quieter costs of pharma digital transformation happening function by function. Nataliya asks the direct question: is the stack itself now a blocker to the relationship?

Elaine says yes — because separate technology quietly manufactures separate data.

“Technology is often bought in silos and used in silos.”

Her recommended sequence is deliberately unambitious at the start. A master data integration plan is the aggressive route, and it takes time that most teams don’t have. The faster move is to build on what MSLs already use: push MSL engagements into their existing orchestration platform, then use that to predict next best engagement — is this physician interested, and what should the next scientific study or touchpoint be? In parallel, look for integration paths into other sources across the organization, including platforms like eWizard.

“Don’t wait to be perfect and ready.”

She adds that integrating data is meaningfully easier now than it was even a year ago — which removes one of the standard reasons for postponing.

Customer Experience as an Operating Model, Not a Deliverable

Customer expectations have moved: how the message arrives, how the meeting runs, what relevance looks like. Yet MSLs and sales reps often don’t appear to come from the same organization at all. Nataliya asks how you make teams not just collaborate but actually synchronize what they say.

Elaine is blunt that it can’t be solved on paper.

“To make them united, it can’t be a RACI chart. You have to have a real initiative that puts it into action.”

She describes two mechanisms for turning that into a customer-centric engagement model. The first is the task-level data loop above — a self-contained MSL community, with selected insights fed to the field. The second is an agile pod that collaborates around the real-world journey of the physician, from the moment a patient arrives through to therapy — customer journey mapping jointly governed by medical and commercial marketing.

That objective journey becomes the shared artifact. Overlay your data on it. Compare against competitors. Find the missed opportunities. And through that view, it becomes visible whose approach belongs where and when — with a governance team meeting weekly or monthly to keep it honest.

Next Best Action Is a Culture Problem

Most companies are actively working on next best action, and Nataliya frames it as the smart engine behind personalized HCP engagement and genuinely relevant conversations. Her question is how hard it really is to build the data foundation underneath one.

Elaine splits the answer. The technical difficulty is falling — there are far more tools that pull data from scattered silos into a single repository, and you don’t need every piece of data from the beginning of time. It may be two silos out of ten that account for most of the engine’s integrity. Focus on those two.

The harder blocker is cultural.

“I don’t think it’s the integration of data. To some degree it’s culture and fear — I don’t want to mix with that silo, you’re going to interfere with the purity of my message.”

The reframe she offers: it isn’t interference, it’s helping the physician consume the message that’s most meaningful at a pivotal moment. Sometimes the next best engagement is an MSL. Sometimes it’s market access, or patient support resources, or field reimbursement removing friction before anyone earns the right to talk science again. Teams have to be culturally ready to accept that sequence.

“The most successful teams find a real job, a real deliverable around that experience, rather than making it a pilot or a project.”

Nataliya adds the practical corollary: MSL and commercial need a united professional profile of the same HCP — the same person, with the same needs, visible through both lenses and supported by the underlying systems.

Where to Start When the Budget Isn’t There

Structural change of this kind is chronically underfunded. Nataliya asks what Elaine would actually recommend changing first.

Ways of working, she says. Less siloed behavior, starting with something as simple as who’s in the room. When commercial reads out analytics, customer journey work, or media performance, medical should be there. In her experience, when the invitation is extended, people are glad to come.

The second change is pointing commercial capability at medical problems — letting pharma commercial strategy do work for medical affairs strategy rather than around it. Use predictive models to flag which physician should see an MSL next week for maximum impact. Do the same for patient support resources. That gives the MSL team a more holistic view of what the customer has already experienced — valuable in a role that’s typically stretched thin across a large geography.

“Where I’ve seen success is when people prioritize and don’t try to boil the ocean.”

Nataliya closes the section by naming the line that shouldn’t move: the firewalls between commercial and medical exist for real reasons — scientific credibility, regulatory integrity, and the trust of the HCP. The goal isn’t to dissolve them. It’s to design collaboration precisely enough that the HCP never feels the seam between where commercial ends and medical begins.

Hot or Not: Rapid-Fire Verdicts

Nataliya closes with a round of deliberately pointed statements; Elaine responds hot or not and explains why.

“The HCP of 2026 needs pharma for the relationship, not for the information.” — Hot, with a caveat.

They need both, just not in the way they once did. Pharma’s role is helping physicians navigate everything on offer, and that isn’t only selling — it’s patient support and market access too. Elaine notes that a strikingly small share of patients who could access support programs actually use them, which makes orchestration the real opportunity: being in front of the physician with the right resource at the moment they need it. [FLAG: Elaine cites a figure here — under 10% of eligible patients using support resources. Source unverified; either confirm and cite, or keep the general phrasing above.]

“Most commercial-medical collaboration in pharma is coordinated rather than integrated.” — Totally hot.

Coordinated means splitting a task. Integrated means a shared deliverable that requires working together. Waiting for the perfect world where the two functions align on everything guarantees disappointment. Find the specific deliverables instead. Progress, not perfection.

“MSL insights are the most underutilised signal in pharma’s channel strategy.” — Hot.

It’s usually siloed. The route out is a patient journey or customer experience effort where both parties have to be at the table, mapping which parts of the journey each side owns and where they genuinely overlap. But it has to be a specific job, not an ambition.

“The HCP data most pharma is acting on is months old, commercially biased, and medically blind.” — Hot.

What makes it frustrating is that it doesn’t have to be that way. The capability to make data more real-time exists. What’s missing is a champion of the operational process working alongside the strategist. And when people call it a massive undertaking, it comes back to which data actually matters — if the data comes from ten sources, you may only need two.

“Most pharma CX strategies are designed around what the company wants to say, not what the HCP needs to hear.” — Totally hot.

Teams build a brand vision, invest in capabilities to execute it, and then push out what they assume customers want. The point is relevance and context — what the customer wants from you, not what you want to say. Capability and culture move together, and since no one gets a perfect world, the practical path is finding pockets of customer-centricity: onboarding journeys, patient support journeys, asking what the customer wants to hear there, and transitioning to the brand message from there.

“The HCP who feels sold to by commercial and interrogated by medical is a CX failure.” — Hot.

Elaine is careful here: science is what earns credibility, trust, and genuine differentiation. But you have to earn the right to bring it, and sometimes that door opens through support rather than data. Studies still show lingering mistrust — stop selling to me, remove the friction between me and my patient. Onboarding a physician properly from the moment they first prescribe is a joint medical-commercial job, and doing it well reinforces confidence in both the science and the commitment behind it.

Final Words

The throughline of this conversation is that HCPs don’t experience your org chart — they experience the combined output of everything the organization does to support their clinical decisions. That means a unified customer experience isn’t a governance exercise; it’s a design problem: shared deliverables instead of coordinated tasks, MSL insight flowing back into the engine instead of dying in a separate platform, and enough cultural willingness to let the next best engagement be someone else’s.

As Elaine puts it, the teams that get there are the ones that prioritize rather than try to boil the ocean — starting with the two data sources that matter, the one shared journey both functions can govern, and the readouts everyone attends.

It’s also close to the thinking behind Kheiron and Viseven’s work on HCP engagement strategy and pharma customer experience: an integrated customer strategy supported by content and engagement operations that let medical and commercial work from the same view of the same person, compliantly.

Enjoyed this conversation? Want to talk about how commercial and medical alignment could work in your organization? Talk to us, and let’s explore it together.

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