Faculty – Value-Based Strategies for Reimbursement & Formulary Success

Raquel Cabo
Vice President, Global Market Access, OVID THERAPEUTICS

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Raquel has over ten years of experience across a variety of healthcare industry sectors in the US and Europe. Raquel is passionate about working with patients, clinicians, and payers at all stages of product development to address true unmet needs and ensure access.

Prior to joining Ovid, Raquel was Director of Global Market Access at GE Healthcare, based in London. In this role, she led a global team responsible for market access and health economics for new product introductions from the company’s imaging technology portfolio across all therapy areas. At GE Healthcare, Raquel focused on demonstrating the value of innovative technology through research, customer partnerships, digital marketing, and sales support.

Prior to GE, Raquel was a member of Medtronic’s EMEA health economics and reimbursement team, based in Switzerland. Before joining the industry, she was a neuropsychology specialist at Cogstate, a cognitive science start-up, and Columbia University Medical Center where she led operations for federally funded studies that evaluated the specificity of cognitive testing to diagnose Alzheimer’s Disease among minorities.

Raquel earned her MSc in International Health Policy and Health Economics from the London School of Economics and earned her BA in Psychology and French, cum laude, from the University of Pennsylvania. She is also a member of the University of Pennsylvania Fund executive board.

Jesse Fishman, Pharm.D.
Scientific Alliance and Real World Data Lead, UCB

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Jesse Fishman currently leads the U.S. medical affairs organization Scientific & Real World Data Alliances Department at UCB by providing strategic development and oversight of scientific and database partnerships in their neurology patient value unit (NPVU). Our division of the NPVU seeks to communicate about the clinical and economic solutions that will serve patients with severe disease.

Jesse has 10 years of industry experience working in various roles in clinical development and medical affairs. Jesse has been responsible for developing evidence generation strategies, for medical affairs strategic planning, and for ensuring US payer customer needs are aligned with health outcomes research and communication plans. He has supported 7 new product launches for fortune 500 pharmaceutical companies such as Pfizer and Amgen by communicating about a product’s unique value proposition and supporting market access positions across various therapeutic areas that include oncology, neurology, and rare diseases.

His research and numerous publications focus on topics such as health outcomes, health policy and literacy, and ways to improve communication between patients and healthcare providers. Jesse holds a chemistry degree from Arizona State University and a Doctor of Pharmacy from the University of Arizona. He also completed a pediatric residency at Children’s Healthcare of Atlanta and practiced as a critical care pharmacist prior to entering the pharmaceutical industry.

Melinda Hanisch
Director, Research Dissemination, Center for Observational and Real World Evidence, MERCK

Natalie Heidrich, M.S.
Field Director, Health Economics Market Access, JOHNSON & JOHNSON MEDICAL DEVICE COMPANIES

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Natalie holds the position of Field Director, Health Economics Market Access for the Southeastern US for Johnson and Johnson Medical Device Companies (JJMDC). In this role, Natalie works with IDNs to monitor and advise on healthcare policy, disseminate JJMD device evidence and lead real-world evidence generation projects with IDNs.

Prior to that role, Natalie has held numerous roles with Johnson and Johnson.  She led the reimbursement and health economics strategy for the bariatric surgery portfolio, she served as the Field Director for the Health Policy and Reimbursement team for Ethicon and also held the National Payors & Strategic Initiatives Director position for Ethicon Endo-Surgery and Medical Devices.

Her successes include national coverage and expansion policies for bariatrics; Minimally Invasive Procedure initiatives with national payers; employer benefit plan differentials supporting value-based healthcare; the creation and development of 5 Shared Decision Making Surgery resources;  publications supporting Bariatric Surgery and Minimally Invasive Surgery Best Practices; a national Primary Care Physician obesity continuing education initiative; and a  national action plan for Minimally Invasive Procedures focused on Women’s Health within the health plans.  Natalie was recognized as the Community Leader of the Year by the Obesity Action Coalition in 2016 and has had several publications supporting bariatric surgery and value-based healthcare benefit designs.

Prior to coming to Johnson and Johnson, Natalie pursued a varied background in healthcare. Her start was in the field of corporate health and wellness where she worked for BlueCross BlueShield of South Carolina as Preventive Services Regional Administrator. She also managed reimbursement at Biolectron Inc. and Smith & Nephew, Inc. and was a Director in charge of Business Development at Palmetto Baptist Medical Center.

Natalie completed her master’s degree in Exercise and Sport Sciences from the University of Florida and has a bachelor’s degree in Business Administration with a concentration in Management from Texas Christian University. She resides in Greenville, SC with her two boys, Cole and Mitchell.

Sachin Kamal-Bahl
Vice President and Innovation Center Head, Global Health and Value, PFIZER

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Sachin Kamal-Bahl is currently Vice President and Head of the Global Health and Value Innovation Center at Pfizer Inc. — a newly created organization under Dr Kamal-Bahl’s leadership — that develops and integrates innovative approaches based on well-considered risks and strong technical underpinnings to address the access, pricing or valuation of challenges and opportunities. Dr Kamal-Bahl oversees the group’s strategic efforts aimed to a) help the organization recognize the strategic implications of environmental issues impacting valuation of and access to Pfizer therapies; b) develop and test prototypes and consider systematically embedding them within internal processes of the organization in order to better position Pfizer to demonstrate value and gain market access for assets at launch; c) develop, execute and evaluate innovative experimental approaches in order to address access, pricing or valuation challenges for Pfizer assets being raised by payers and; d) spearhead efforts with strong technical underpinnings to develop and/or support Pfizer’s approach to access, value and shape external practices over time.

Dr. Kamal-Bahl previously was the Executive Director and Global HTA Strategy Head at Merck & Co., Inc., where he provided strategic guidance to senior leadership on aspects related to HTA and its evolving landscape and was responsible for the development of Merck’s positions on key HTA topics. His group was also responsible for translating and executing HTA concepts across all of Merck’s franchises and geographies/regions.

Prior to this role, Dr. Kamal-Bahl was the Global Access Team Leader for the Diabetes and Obesity Franchise in the Global Market Access division at Merck & Co., Inc. In this key strategic role he led a companywide global cross-functional team that was responsible for developing an integrated market access strategy that includes pricing, reimbursement, health economics and outcomes research, health technology assessment, and payer and stakeholder engagement strategies to optimize profitability and market access and coordinate the implementation of this strategy for the entire portfolio of products under the Diabetes and Obesity Franchise.

In other previous roles within the company, Dr. Kamal-Bahl has worked in the Global Strategic Pricing area where he was a Global Strategic Pricing Leader responsible for developing the pricing strategies for all products under the diabetes and obesity franchise. In the past he has also led the development of health economics, outcomes research, market access and reimbursement strategies supporting the cardiovascular and metabolic franchises in leveraging the value proposition for cardiovascular, diabetes and obesity products within the US Outcomes Research & Management and Global Outcomes Research departments at Merck & Co., Inc.

Dr. Kamal-Bahl is a clinically trained pharmacist who obtained a Ph.D. in pharmaceutical health services research at the University of Maryland, Baltimore, MD. He currently also holds positions as Adjunct Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and as Adjunct Assistant Professor at the University of Maryland School of Pharmacy.

Dr. Kamal-Bahl is actively involved with several professional organizations such as AcademyHealth, American Heart Association, American Diabetes Association and International Society for Pharmacoeconomics and Outcomes Research. He has also published in several journals such as American Journal of Cardiology, American Heart Journal, Archives of Internal Medicine, Archives of Pediatrics and Adolescent Medicine, Diabetes Care, Endocrine Practice, Health Affairs, International Journal of Obesity, Journal of the American Geriatrics Society, Obesity, and Preventing Chronic Disease.

Timothy Mizak, Pharm.D.
Manager, Clinical Operations, Value-Based Purchasing, GATEWAY HEALTH PLAN

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Timothy Mizak, Pharm.D., currently leads the Clinical Operations & Value-Based Purchasing team within in the Pharmacy Department at Gateway Health, a nationally ranked managed care organization based in Pittsburgh, PA, providing healthcare to Medicaid and Medicare Advantage consumers. His team is responsible for the implementation and maintenance of pharmacy benefits, including Formulary, Utilization Management, and Specialty Pharmacy. Additionally, Timothy is primarily responsible for pharmaceutical manufacturer relations, rebate contract negotiation, and identifying opportunities to reduce net cost and create value for Gateway’s customers. He also chairs Gateway’s Value Evaluation Committee.

In various roles at Gateway Health, Timothy has been responsible for several functional areas within the growing pharmacy department, including utilization management, pharmacy policy development and implementation, Pharmacy & Therapeutics Committee leadership, high-cost medication management, and drug pipeline monitoring.

Timothy holds a Doctor of Pharmacy from the University of Pittsburgh and is currently working towards a Master of Science in Pharmaceutical Outcomes & Policy at the University of Florida in addition to a Master of Business Administration at Stetson University. He completed a Managed Care Pharmacy Residency at Highmark Inc. in Pittsburgh, PA.

Wanmei Ou, Ph.D.
Director, Precision Medicine and Data Science, Center for Observational and Real-World Evidence, MERCK

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Wanmei Ou is currently a Director in Precision Medicine and Data Science at Merck’s Center for Observational and Real-World Evidence (CORE) department. At Merck, She has dual responsibilities to address the pricing and affordability issues of medicine through value-based payment models and to accelerate target discovery using real-world data. In this role, she develops and executes analysis plans for observational studies across the company’s product franchises. Prior to this, Wanmei led a technology team at Oracle to develop a genomic-focus application, which has been deployed by many leading healthcare institutes in support of their precision medicine initiatives.

Wanmei was a member of the Health IT Standards Committee in the Office of the National Coordinator for Health Information Technology, part of the U.S. Department of Health and Human Services. In this role, she recommended standards, implementation, and certification criteria for health IT infrastructure.

Melissa L. Paige

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Melissa serves as the Oncology Patient Access Principal Coordinator at the Emily Couric Clinical Cancer Center, UVA Health System. She is responsible for patient access integration within the HCP and implementing all patient access programs across the spectrum, in the form of co-pay assistance cards, grants, and other patient assistance avenues.

Melissa has over 13 years of experience in the pharmaceutical industry and serves as CEO and Director of Patient Access at Paige Consulting LLC. Melissa leverages her end-to-end experience in healthcare and her diverse pharmaceutical expertise to help clients achieve success. Melissa provides insightful consulting with major pharmaceutical manufacturers and healthcare systems to strategically increase patient access. 

Robert Popovian, Pharm.D.
Vice President, U.S. Government Relations, PFIZER

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Robert Popovian is Vice President, US Government Relations at Pfizer Inc. He brings almost two decades of experience in numerous facets of the biopharmaceutical and healthcare industry with a strong track record of expertise, innovation and results in Health Care Policy and Economics, Government Relations, Medical Affairs, and Strategic Planning.

Robert has published and presented extensively on the impact of biopharmaceuticals and health policies on healthcare costs and clinical outcomes, including authorship in clinical and healthcare delivery journals, and is a published expert source in Los Angeles Times, USA Today, Pink Sheet and Bloomberg News, amongst many others. He also writes a monthly column published in Morning Consult regarding health policy and economic issues relevant to the biopharmaceutical industry. He is a frequent speaker at healthcare policy and medical conferences on topics such as payment and delivery reform, the use of real-world data, policies that enable biopharmaceutical innovation, and health economics. He currently serves as a board member for the Global Healthy Living Foundation.

He is one of the few researchers who has studied and published both clinical and policy-related economic analysis as well as one of a handful who have studied and published empirical data regarding emerging payment mechanisms in the US healthcare system. He was also one of the first to secure inclusion of health outcomes data regarding labeled indication of a biopharmaceutical.

Robert completed his doctorate in pharmacy and Master of Science in pharmaceutical economics and policy degrees at the University of Southern California with honors. The degree in pharmaceutical economics and policy was the first one conferred by an accredited university in the US. He has also completed a residency in Pharmacy Practice/Adult Internal Medicine and Infectious Diseases at the Los Angeles County – University of Southern California Hospital, where he was the head pharmacy resident (primary area of research: gram negative bacteremia) and a fellowship in Pharmaceutical Economics and Policy at University of Southern California (primary area of research: payment reform).

Robert is married to Maylin Megran Popovian; they have two beautiful daughters, Katrina and Natalya. They have residences both in Los Angeles, CA and Washington, DC.

Aaron Shaw, RN-BSN
Director, Medical Affairs | Digital Innovation, PACIRA PHARMACEUTICALS, INC

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Mr. Shaw is a Medical Science Liaison Director at Pacira Pharmaceuticals, Inc. where he oversees a number of key initiatives in the medical affairs department. Mr. Shaw has been instrumental in the growth of Pacira’s MSL group and has led the team through its recent expansion. He leads the company’s innovative educational learning initiatives including Pacira’s digital and multimedia platforms. Mr. Shaw led the company through the development and implementation of a cutting edge virtual reality learning tool that allowed physicians to experience real time feedback in the infiltration of Pacira’s product, EXPAREL. This VR learning tool has been deployed nationally to reach both leading and grassroots clinicians. Mr. Shaw has also led the roll-out of the surgical training app resource, Touch Surgery. Through these efforts, Touch Surgery has been implemented in a targeted use case in Pacira’s RCTs. Mr. Shaw is also involved in the development of product administration videos for principal investigators in the company funded RCTs. Most recently, he has been working with internal and external stakeholders on the development of an augmented reality platform that will be used for collaborative learning programs.

Mr. Shaw is a registered nurse with extensive experience in Critical Care, Trauma, and Cardiac Surgery. He has clinical interests in perioperative pain management, Critical Care, and Cardiology. Mr. Shaw received his RN-BSN degree from St. Petersburg College in Florida. He is a veteran of the United States Coast Guard.

Greg Wujek
Vice President, Market Access, CASTLE CREEK PHARMA

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Greg has been deeply involved with both Commercial and Government Market Access for over 25 years. Working in Orphan, Specialty and other key areas Greg has built both managed care and sales departments that have successfully executed marketing plans for drug launches in a multitude of therapeutic areas. He utilizes his experience and deep knowledge of the complex architecture of the current healthcare system across payer, provider and distribution channels to develop his strategy. Additionally, he utilizes a myriad of data sources to gain insights into payer management, market nuances, and competitive landscapes to further enhance his plans. Greg orchestrated and executed his strategies at Forest, Andrx, Savient, Zimmer Biologics Paragon and Castle Creek.

Greg is an industry consultant for Third Bridge, Reuters, Gerson Lehrman Group. He is an associate member of the Academy of Managed Care Pharmacy.