When Medical Affairs Becomes Commercial in Disguise

Send us Fan MailDarshan explores a critical question for life sciences companies: is your medical affairs team truly independent from commercial—or are you just pretending?In this episode of KLF Deep Dive, Darshan highlights why organizational charts alone are not enough to satisfy regulators. He explains that regulators focus on conduct, process, and intent, not PowerPoint slides. Using the 2013 GlaxoSmithKline settlement as a cautionary example, he demonstrates how blurred lines between medical and commercial functions contributed to a $3 billion resolution. Advisory boards, medical information responses, and even scientific exchanges were scrutinized because they appeared promotional rather than purely scientific. The lesson is clear: medical affairs does not receive a free pass—regulators evaluate independence based on actual behavior, not just policy statements.Darshan also addresses misconceptions around First Amendment protections, such as those recognized in the Coronia and Amarin cases. While these rulings allow certain truthful, non-misleading communications about off-label uses, they do not shield companies from regulatory risk when the intent behind medical affairs activities is commercial. Intended use begins long before promotional materials are drafted—it is reflected in team training, engagement strategies, patient targeting, and the creation of scientific content. If medical affairs is influenced by commercial goals, the safe harbor evaporates, leaving both the company and individuals exposed to liability under the False Claims Act, Anti-Kickback Statute, and other regulatory frameworks.One practical solution Darshan emphasizes is leveraging tools like Ceres. Such systems enforce firewalls, track document access, and generate auditable evidence that medical affairs operates independently. This ensures that scientific exchange remains in medical’s hands, not commercial’s, providing defensible documentation when regulators inquire about separation.Patient engagement is another critical area. While increasing patient education and support is essential, programs can inadvertently cross into promotional territory if they are influenced by sales objectives, target specific high-value prescribers, or prioritize commercial outcomes over educational goals. Properly designed, patient engagement is a compliance asset; improperly executed, it becomes a liability.Darshan concludes with key questions medical affairs teams must ask themselves: Do we have documented processes that prove independence from commercial? Can we defend our workflows if regulators question intent? Are patient programs science-driven rather than sales-driven? Do systems like Ceres provide tangible evidence of separation, or do we rely solely on trust?The overarching message: medical affairs is the conscience of the company, and its independence must be real, not performative. Blurring lines between commercial and medical functions carries severe consequences, from regulatory penalties to reputational damage. Companies must implement robust systems, governance, and culture to ensure genuine independence—because in today’s environment, pretending isn’t just risky; it’s potentially dangerous.Support the showwww.kulkarnilawfirm.com