Quantifying the Return on Investment of Medical Affairs in the AI Era

Artificial intelligence (AI) is entering pharmaceutical Medical Affairs (MA) across medical writing, evidence generation, medical information, medical education, scientific communications, and field medical operations, changing how the function creates and delivers value. Yet MA has never had a standardised financial framework for measuring return on investment (ROI) comparable to those established in R&D and Commercial. Without such a framework, the additional value generated through AI adoption, and whether it justifies the associated investment, cannot be quantified. This paper presents the Medical Affairs Value Index (MAVI), a tool to quantify MA's ROI and assess how AI modifies it. MAVI integrates a Positive ROI model capturing value creation through revenue acceleration, cost avoidance, pipeline de-risking, and strategic option value, operationalised as a benefit–cost ratio, with a Reverse ROI model that quantifies the enterprise cost of MA underinvestment through probability-weighted loss estimation. Attribution coefficients for both upside (αMA) and downside (βMA) are introduced with governance safeguards. The primary output is a two-dimensional value map. AI is unlikely to materially reduce the cost of MA operations; it reallocates spending from manual activities to AI-augmented workflows, keeping the cost denominator approximately flat while the benefit numerator grows. An illustrative scenario demonstrates that under evidence-based assumptions, MAVI reveals a Positive ROI above breakeven before AI adoption, with AI further amplifying the return. The Reverse ROI, capturing enterprise losses MA helps prevent, remains broadly stable across both scenarios. MAVI provides the financial architecture to quantify both dimensions and track how AI modifies them over time.