The problem is not that medical affairs does not generate value. It is that most teams measure how much they do, not what they change. And in access, that difference is everything.

Ask a commercial director how the quarter went and they will give you a sales figure. Ask an R&D leader and they will talk about regulatory milestones. Ask a medical affairs leader how they demonstrated their value and, often, the answer will be a list of activities: number of interactions with opinion leaders, publications supported, advisory boards held. The problem is that this list answers "how much did we work," not "which decision did we move."

This tension is well documented. Measuring and demonstrating the value of medical affairs has always been a challenge, because the metrics that apply to clinical development (regulatory approvals) or to the commercial organization (revenue) do not apply directly to medical teams. And when the goal is to influence market access decisions, measuring only activity leaves invisible exactly what matters most.

1. The underlying problem: activity is not impact

The most recurrent critique in the literature on medical affairs metrics is that traditional measures capture quantity, not quality, and are not outcome-oriented. IQVIA puts it directly: medical affairs teams are under growing pressure to demonstrate value, internally and externally, but most traditional metrics capture only quantity and are not outcome-based.

An analysis of ROI in medical affairs sums it up with a phrase from a leader in the field: activity KPIs track the execution of the role, not its impact. The data that accompanies that observation is revealing: although only a small minority of medical affairs professionals prefer a purely quantitative assessment, nearly all organizations still emphasize those metrics. There is, then, a recognized mismatch between what is measured and what matters.

For market access, that mismatch is costly. A high number of interactions with a payer says nothing if you do not know whether those interactions changed their perception of the product's value, accelerated a coverage decision, or adjusted a formulary restriction.

2. Distinguish the three layers of measurement

To measure access impact, it helps to separate three levels, from lowest to highest value.

Activity layer (output). How many meetings, how many publications, how many dossiers delivered. These metrics are easy to track on dashboards and serve internal management and compliance, but they reflect effort, not result. They are necessary, but insufficient.

Quality layer (engagement). It is not enough how many interactions, but of what kind. As the literature notes, a high number of interactions with opinion leaders is only meaningful when accompanied by qualitative information about the nature of those interactions: were they one-way information dissemination, or did they generate genuine dialogue and knowledge exchange? In access, this translates into: was the conversation with the payer informative, or did it transform their understanding of value?

Impact layer (outcome). This is where what truly matters is measured: did the evidence or the interaction change a decision? Outcome-oriented metrics track how interactions shift perspectives, improve study recruitment, or influence practice. For access, the outcome is the payer's decision: formulary inclusion, reimbursement conditions, lifting of a restriction.

3. What access impact measurement looks like, in concrete terms

Bringing this framework to market access demands specific metrics. Some that do capture impact:

Changes in the payer's position. Document the state of a payer account before and after the medical intervention: value perception, objections raised, coverage conditions. The indicator is not "the meeting took place," but "objection X stopped appearing in the next round."
Insights that fed a decision. A recognized impact metric is how many times field-collected insights led to a tangible change in the company's strategy. In access: how many payer insights reoriented the value narrative or the evidence strategy.
Acceleration of decisions. The time between evidence submission and the payer's decision, compared against a baseline. If the medical intervention shortens that cycle, that is a measurable result.
Contribution to differentiation. Translate scientific success into business terms. The ROI literature insists that medical affairs must learn to speak the language of business strategy, translating scientific achievements into terms such as cost avoided, reduced pipeline risk, or market differentiation.

The most common mistake

Reporting activity volume as if it were impact. A high number of meetings with a payer proves nothing if you do not document which objection fell, which perception changed, or which decision was accelerated.

4. The practical rule: combine the quantitative and the qualitative

Neither dimension works alone. The consistent conclusion in the literature is that measuring medical affairs ROI requires a holistic approach, combining quantitative KPIs with qualitative outcomes. Numerical metrics give the "how much"; qualitative ones give the "what changed and why it mattered."

There is an additional point, critical for access: alignment with corporate objectives. The literature is clear that leadership should agree in advance what "return" is expected from medical affairs, whether accelerated R&D decisions, a stronger position with payers, or ultimate gains in patient health. If no one defined that the goal was to improve positioning with the payer, it is afterward impossible to measure whether it was achieved.

5. Why this matters for the access decision

Measuring the impact of medical affairs on access is not an internal reporting exercise. It is what makes it possible to know whether the investment in evidence, in payer interaction, and in value communication actually moved the needle where it matters: on the coverage and reimbursement decision that determines whether the product reaches the patient.

A team that only counts activities cannot answer the question that leadership truly asks it: did we change any access decision this year? A team that measures impact can, and that transforms medical affairs from a cost center that is hard to justify into a strategic function with demonstrable results.

At Quantus we work on this logic: structure the evidence and the value narrative so that their effect on the payer's decision is traceable, not just deliverable. The goal is not to produce more documents, but to increase the real access of the client's products. And what is not measured against the payer's decision cannot be improved.

References

IQVIA. Measuring the Impact and Conveying the Value of Medical Affairs. Available at: https://www.iqvia.com/locations/united-states/library/fact-sheets/measuring-the-impact-and-conveying-the-value-of-medical-affairs
Medical Affairs Specialist. Measuring ROI in Medical Affairs. 2025. Available at: https://medicalaffairsspecialist.org/blog/measuring-roi-in-medical-affairs
Definitive Healthcare. Look beyond numbers to measure the value of medical affairs. 2024. Available at: https://www.definitivehc.com/blog/beyond-numbers-value-medical-affairs
MSL Society. Field Medical Affairs KPI and Metrics Report (2024 Global KPI and Metrics Survey). Available at: https://themsls.org/field-medical-affairs-kpi-metrics-report/
The MSL Academy. Medical Affairs Metrics: Proving Impact Beyond Traditional KPIs. 2025. Available at: https://www.themslacademy.com/blog/medical-affairs-metrics-proving-impact-beyond-traditional-kpis