The Term KOL: Keep It or Ditch It?

Listening to webinars and reading reports about the latest trends and developments in medical affairs is one of the things we do incessantly at H1 – after all we need to deeply understand the industry we are serving with our product.

Doing so, we have noticed a lot more diversity in nomenclature when it comes to referring to external professionals who advise drug and device companies at various stages throughout the product life cycle.

We all used to refer to these experts as key opinion leaders (KOLs) but that term is slowly falling out of favor. Terms like (key) external expert, scientific/medical leader, thought-leader or permutations of them are becoming more prevalent while some medical affairs professionals refer to their external experts as “customers” or simply as physicians.

Is it time to retire the term KOL or limit it to a narrow group of very influential experts?

The Case Against the Term KOL

The term KOL has come under increasing criticism for two main reasons:

• “Opinion” is a loaded word, it implies potential for undue influence of companies over medical and scientific professionals and an attempt to change their and the broader community’s mind about a commercial product.
• In addition, the word “opinion” carries the connotation of subjectivity which is not in the best interest of the experts who are known for their knowledge, experience and subject matter expertise rather than simply their opinions.

Another criticism is that one term – KOL or any other – does not adequately describe the diverse types of experts advising life science companies in different capacities. Therefore, just replacing KOL with a more neutral version, e.g. external expert, only solves part of the problem.

Despite these short-comings using a single, established term has advantages. It reduces confusion and simplifies discussions by providing one fairly broad umbrella term to refer to all of the experts that work with and advise life science companies. Also, the term is so ingrained in the industry that it will be difficult to change, even if everybody agrees.

The challenge is to find a better term. “External expert” seems to be what many companies agree on, “expert” implies expertise and knowledge and “external” stresses the point that the expert is not part of the company and therefore independent and objective. The term “physician” implies expertise and knowledge and broadly incorporates professionals with scientific, clinical and medical expertise. However, it does not capture groups such as pharmacists or registered nurses that can provide deep insights based on their experience treating patients but aren’t physicians. “Customer” while being a useful and broad term that has the advantage of driving home the importance of these experts and the need to put their needs and interests first, suffers from a highly commercial connotation.

Towards a More Nuanced Terminology

Adopting a more nuanced terminology that differentiates different types of experts is a way of avoiding misconceptions. For example:

• Scientific experts/leaders – experts with significant scientific expertise, e.g. related to mechanisms of action of certain drugs or certain types of compounds. Their expertise can also relate to methods, such as next generation sequencing.
• Clinical experts/leaders – professionals experienced in designing, conducting and overseeing clinical trials.
• Medical experts/leaders – healthcare professionals with significant experience treating patients.

Additional categories, such as therapeutic area expert/leader can be added to provide an even finer differentiation.

Identifying Experts

These categories are also useful in helping organizations map and select experts to advise them at various stages during drug development and commercialization.

• Scientific experts/leaders can be identified based on their publication record, speaking engagements at relevant congresses and potentially their social media activities and industry payments.
• Clinical experts/leaders have a significant record of clinical trial participation and can be identified based on clinical trial registration information. Selecting for professionals with a focus on a specific type or phase of a trial allows organizations to identify experts with highly relevant expertise. Open Payment information can add an additional dimension by providing insights into which other companies specific physicians have worked closely with and on what indications and drugs.
• Medical experts/leaders can be identified by considering the number of procedures and diagnoses they perform in a specific area of medical interest. Referral data can add an additional dimension to the picture: a large number of referrals identifies physicians which are considered leaders by their colleagues.

While the term KOL continues to linger, a more nuanced terminology helps avoid misconceptions about the role of these experts in the (bio)pharmaceutical and medical device industries. Clear definitions also make identifying experts with specific expertise easier. Using a comprehensive database like the one developed by H1 allows users to finely tune the characteristics they are looking for and identify highly relevant experts.

To learn more about how to use the H1 database to identify specialized experts, take a look at HCP Universe.