United States
Accomplished Market Access professional with 20 + years of proven success in rare disease, gene therapy, and specialty categories. Recognized for driving market access strategy, payer engagement, and business development across National/Regional health plans, PBM/GPO's, Specialty Pharmacies, IDN's, Employers, and Stop Loss Carriers. Adept at forging strategic, high impact partnerships that unlock access and maximize success in competitive, fast-evolving markets. Thrives in dynamic, high stakes environments where adaptability and leadership fuel breakthrough results. Therapeutic experience includes Gene Therapy, Biologics, Devices, and small molecules. Core Competencies: • Strategic Planning • Innovative Payment Models / Analysis / Negotiations • Product launch and Payer Marketing • Buy and Bill / Specialty Expertise • Medical Policy/Formulary Mgmt. • Commercial/Medicare/Medicaid • Cross Functional Leadersip • C-Suite presentations/Strategic Partnerships
• Leads all strategic development and execution initiatives to meet Spark objectives for LUXTURNA coverage, advancement of Spark’s innovative payment and outcomes model, and entrenching Spark as a trusted leader in gene therapy across the commercial payer ecosystem. • Provides strategic insights to Spark’s leadership on market dynamics, payer ecosystem shifts, and potential impacts to the organization’s current and future products. • Leads the advancement of Spark’s commercial capabilities with emerging stakeholders and influencers for coverage and reimbursement • Directs all Spark contract initiatives/negotiations with appropriate risk bearing entities. • Guides all cross functional coordination of Spark’s outcomes program ensuring alignment of goals and timing amongst payers, treatment centers, patient services, medical affairs, and external vendors. Key Accomplishments: • Provided cross functional leadership around complex coverage and payment issues for > 80% of total patient treatments and vials sold in 2023 and 2024. • Drove the successful negotiation of all 38 Spark contract renewals with 100% success rate while addressing gene therapy cost mitigation initiatives, contract language, and price increase challenges. • Successfully protected LUXTURNA’s coverage (95% of lives with medical policy reasonably aligned to package insert) in Commercial book of business. • Guaranteed Spark participation in panel discussions at key gene therapy meetings along with participation in different gene therapy task force groups. • Successfully addressed gene therapy cost mitigation initiatives by key payers, gaining agreement for cross walking impacted members into Spark’s innovative payment and outcomes model.
• Developed and executed the LUXTURNA market access marketing strategy to advance Spark’s leadership position in gene therapy, protect LUXTURNA coverage, and promote Spark’s innovative payment and outcomes model. • Assumed leadership of the entire US Commercial payer ecosystem in 2H 2022, overseeing all stakeholder engagements to drive coverage and payment outcomes for LUXTURNA. • Led negotiations and execution of all Spark PATH Pricing and Outcomes contracts with commercial payers. • Led cross functional coordination of Spark’s outcomes program ensuring alignment of goals and timing amongst payers, treatment centers, patient services, and external vendors. • Ensured alignment across field teams to streamline complex patient journey to treatment. Key Accomplishments: • Directed process for in-depth segmentation analysis of the Market Access Ecosystem as well as corresponding engagement model, messaging development, and implementation by impacted account directors. • Successfully, protected Spark Commercial Payer coverage (95% of lives covered) • Shepherded patients through reimbursement barriers that accounted for >75% of vials sold during 2H of 22 and 2023. • Developed Spark Gene Therapy Leadership campaign to advance Spark’s expertise and leadership within Gene Therapy for continued collaborative relationships across the commercial payer ecosystem. • Secured Spark’s involvement at key national meetings for both traditional and emerging payers to communicate key issues and potential solutions @ gene therapy coverage and payment challenges through key LUXTURNA launch learnings. • Established C-Suite relationships with all targeted stop loss carriers resulting in the inclusion of key components of Spark’s programs being integrated into SLC’s gene therapy coverage initiatives.
• Launched first approved Gene Therapy (LUXTURNA) for an inherited ultra-rare orphan disease in National, Regional, and Stop Loss Carrier accounts, advancing the understanding of Spark’s mission, IRD, and innovative payment and outcomes model in alignment with 21st century cures act. • Coordinated and led Sr. Executive exchanges between Spark, Aetna, Humana, key Blue’s plans focusing on challenges and solutions for coverage and payment of the US’ first approved gene therapy. • Educated and positioned Spark’s first innovative payment and outcomes contracts with key national and regional payers. • Assumed responsibilities for 1/3 of US commercial payers and 100% of targeted stop loss carriers. Key Accomplishments: • Secured the first nationally executed innovative payment and outcomes contracts and led the company in the number of payers/patients participating in this program. • Guided the first 2 patients treated in the US cross functionally within Spark, Health Plan, SP, and COE to insure a seamless patient journey via Spark’s innovative distribution and payment model • Achieved 100% reasonably aligned coverage in first year of launch (138% to national) for assigned accounts.
- Led all reimbursement initiatives for specialty product portfolio across National and Regional Accounts, SP's, MAC's, and state medicaid programs across pharmacy and medical benefits. - Account coverage included United Health Care, BCBS MI, BCBS MN, Health Partners, and other mid west accounts.
• Led all corporate initiatives related to formulary status and medical policy development for Allergan’s product portfolio across Aetna, Coventry (Commercial, Part D, Medicaid, Exchanges, SPP), and Humana (Commercial, Part D, Medicaid, Exchanges, SPP), driving $330M in product sales in 2014.Established long-term strategic partnerships with key decision-makers in Trade Relations, Medical, and Pharmacy teams to secure optimal formulary positioning and least restrictive medical policy language for Allergan products. • Facilitated executive leadership exchanges to align corporate objectives and identify mutually beneficial strategies. • Conducted in-depth financial analysis and modeling to develop effective contract negotiation strategies. • Led cross-functional teams—including Legal Compliance, Contract Administration, Medical Affairs, Health Outcomes, RAMs, RHPs, RBMs, Sales Management (across four divisions), Customer Marketing, Brand Marketing, and Managed Markets Leadership—to achieve business plan objectives. Key Accomplishments • Mitigated a major rebate exposure following Aetna’s acquisition of Coventry, devising a strategy that saved $3.5M in rebates while maintaining PBT and exclusivity statuses. • Preserved $20M in Botox product revenue by preventing a restrictive policy change at Aetna despite competitor’ rebate offering. • Partnered with Aetna, NaviNet, CoverMyMeds, to develop automated claim adjudication logic, reducing BOTOX claim approval times from three weeks to under one week. Simultaneously trained RBM teams on electronic claim submission systems to enhance their expertise in Aetna provider offices. • Secured exclusive preferred brand-tier placement for COMBIGAN on Walmart PDP’s PDL, generating over $9M in incremental sales despite a competitor’s product launch. • Achieved unrestricted medical policy coverage for OZURDEX for DME, removing prior restrictions and enabling seamless claim approvals in the retinal injectable category.
• Led corporate strategy development for the Medicare Modernization Act. • Developed and executed the strategic marketing plan for the PBM/Health Plan channel. • Directed Managed Markets marketing initiatives for the Glaucoma and Dry Eye portfolio (LUMIGAN, ALPHAGAN-P, COMBIGAN, RESTASIS), driving $500M in contract sales. Key Accomplishments • Created presentation materials, contract modeling tools, and budget impact models to support national and regional teams in securing optimal reimbursement terms. • Developed the managed markets launch plan for COMBIGAN, supporting NAM, RAM, DSG, and OPC teams. • Designed and launched an intranet web portal to enhance information sharing within the managed markets team. • Standardized branding across Allergan’s managed markets portfolio, collaborating with an agency to develop a unified campaign for managed care publications and internal/external materials. • Created PROSIGHT and GVC value-added screening programs to support HEDIS score initiatives for Diabetic Retinopathy and Glaucoma under the “Playing Bigger” initiative.
• Led all corporate initiatives pertaining to formulary coverage and medical policy reimbursement of all Allergan products. (Express Scripts and Eckerds), National Payor (Humana), SE Regional Accounts (Blues Plans – FL, NC, GA, and Avmed), State Medicaid Programs (FL & Puerto Rico), and SP’s (CuraScript, Priority) Key Accomplishments • Developed, implemented contracting strategy at ESI that lowered rebates from 7.5% to 5% of gross sales. • Improved BOTOX reimbursement in 3 key accounts (Humana, BCBS NC, and BCBS FL) • Gained PBT access to FL Medicaid for glaucoma products