While all the sub-functions we closely examined in this study are critical to a sound medical affairs effort, we found that research/clinical operations received the most backing from companies. Clearly the sub- function holds great value to medical affairs.

Medical affairs groups that have been removed from the grips of commercial bias must look elsewhere for funding. Medical affairs groups are oftentimes receiving their own dedicated budgets.

When executives express their dissatisfaction with their companies' portfolio management success, the problem often stems from internal politics or lack of support. Internal struggles will plague portfolio management groups until their corporate cultures accept their strategic value.

Portfolio management teams are doomed to failure without adequate support from senior executives. Internal struggles will plague portfolio management groups until their corporate cultures accept their strategic value.

The fact that thought leader management and MSL programs have developed in non-traditional healthcare sectors is a testament to the impact these pharmaceutical programs have had, not only on research progress, but also on product growth and corporate reputation.

Larger companies do not place as much weight on medical education. Medical education becomes a little fish in a big pond of promotional tools for companies with large portfolios.