Ivan Tosques Email & Phone Number

Boston, Ma, Us

Greater Boston Area

Greater Boston Area

Greater Boston Area

Takeda acquired Shire.

Lead account management, contracting and pricing strategy for all government payers, for all products. Collaborated with Government Affairs, Advocacy, Investor Relations and Brand on political agenda, market access communication and pull-through. Partner with Commercial Development to determine market access landscape for launch products and acquisition targets.• Designed and executed Medicaid contracting strategy for ADHD product, leading to 90% of share nationally, despite introduction… Show more Lead account management, contracting and pricing strategy for all government payers, for all products. Collaborated with Government Affairs, Advocacy, Investor Relations and Brand on political agenda, market access communication and pull-through. Partner with Commercial Development to determine market access landscape for launch products and acquisition targets.• Designed and executed Medicaid contracting strategy for ADHD product, leading to 90% of share nationally, despite introduction of generics, preserving over $130 million in net sales, with heavy competition and pricing pressures.• Achieved multiple payer contract wins of more than $300 million across ADHD, Opthalmics, Rare Disease / Orphan Drugs and Hemophilia therapeutic classes.• Designed innovative non-contracting strategies for multiple products, with Medical Affairs, Government Affairs and Advocacy defending open access in Medicaid against new entrants, ICER reports and PBMs recommending non-preferred access.• Planned and implemented Medicaid coverage strategies for multiple product launches, leading to 90-100% coverage in all cases. Show less

Led team handling all contract, pricing and reporting operations, providing strategic analytics for all new payer contracts, product launches and commercial development due-diligence. Led market access in operationalizing new legislation affecting product access, measuring GTN impact to the company, drafting managed care sections in financial statements on impact to the company for investor relations.• Implemented MMA, DRA, ACA, NDAA and other federal and state legislation… Show more Led team handling all contract, pricing and reporting operations, providing strategic analytics for all new payer contracts, product launches and commercial development due-diligence. Led market access in operationalizing new legislation affecting product access, measuring GTN impact to the company, drafting managed care sections in financial statements on impact to the company for investor relations.• Implemented MMA, DRA, ACA, NDAA and other federal and state legislation, operationalizing new pharmacy industry fee, pricing rules and rebate programs via processes, SOPs and systems.• Formulated payer messaging and core analysis for payer value propositions on rebate, chargeback and other contract offers.• Advised Government Relations and Advocacy towards favorable resolution of Federal and State statutes affecting access, including 21st Century Cures, Texas Managed Medicaid regulations, Indiana Brand over Generic Savings Program and others.• Built government pricing, rebating and analytics experts and leaders in traditionally resource constrained areas of market access and government pricing, transforming department into first group consulted on financial upsides and downsides of any newly proposed government and commercial payer contracts. Show less

Led all contract, pricing and reporting operations, delivering financially accurate, risk-free execution of $800 million cost center. Responsible for measuring impact of new state / federal laws and regulations, and collaboration with Legal on qui tam / whistleblower lawsuits. Collaborated with International Pricing & Reimbursement on reference pricing negotiations with foreign national health services.• Implemented Corporate Integrity Agreement for US Market Access function and… Show more Led all contract, pricing and reporting operations, delivering financially accurate, risk-free execution of $800 million cost center. Responsible for measuring impact of new state / federal laws and regulations, and collaboration with Legal on qui tam / whistleblower lawsuits. Collaborated with International Pricing & Reimbursement on reference pricing negotiations with foreign national health services.• Implemented Corporate Integrity Agreement for US Market Access function and implemented function specific Independent Review Organization to audit compliance of processes and risks in contracts and pricing operations• Executed ROI, GTN and Revenue Leakage analysis for new commercial and government payer contracts, leading to “cost avoidance” on products of over $500 million• Flawlessly operated all payment, dispute resolution and restatements for $800 million cost center, consisting of commercial and government rebate programs, chargebacks, price reporting and systems and policies encompassing • Provided all inputs to Finance on accruals, reserves and financial reporting for the contracts, pricing and reporting cost center Show less

Tasked with building team, systems, business rules and SOPs for government pricing function for Shire, from scratch. Responsibility for researching and implementing industry best practices for all aspects of complex government price reporting function. Also had lead market access responsibility for operationalizing Sarbanes Oxley requirements for market access, in collaboration with Internal Audit.• Primary responsibility for all government price reporting, restatements and risk… Show more Tasked with building team, systems, business rules and SOPs for government pricing function for Shire, from scratch. Responsibility for researching and implementing industry best practices for all aspects of complex government price reporting function. Also had lead market access responsibility for operationalizing Sarbanes Oxley requirements for market access, in collaboration with Internal Audit.• Primary responsibility for all government price reporting, restatements and risk management and mitigation, related to Sarbanes Oxley regulations• Thought leader for operationalizing all government price statute and regulation, collaborating with Legal in interpretation and leading the way on providing actionable and practical guidance for implementation to the organization.• First time implementation of Revitas (IMany) and Model N systems to handle all government price reporting, as well as rebate and chargeback payments.• Implemented all systems, business rules, data, SOP and policy changes required to implement government pricing, including OBRA 1990 and 1993, MMA, DRA, ACA and all other CMS regulatory guidance. Show less

Lead for engagements focused on mitigating fraud and pricing risk for pharmaceutical clients. Relied on by clients for producing legal documentation and audit trail for investigations and reviews by CMS and DOJ. Specialized in remediation of clients’ current government pricing practices, and helping new biotechnology companies experiencing the complexities of government pricing for the first time.• Mentored senior leadership at clients, and team members, to understand laws and… Show more Lead for engagements focused on mitigating fraud and pricing risk for pharmaceutical clients. Relied on by clients for producing legal documentation and audit trail for investigations and reviews by CMS and DOJ. Specialized in remediation of clients’ current government pricing practices, and helping new biotechnology companies experiencing the complexities of government pricing for the first time.• Mentored senior leadership at clients, and team members, to understand laws and regulations affecting compliant government price reporting. Audited government pricing systems for clients, for accuracy, with independent calculations.• Drafted or updated SOPs and business rules for multiple clients, for all areas of government price reporting (AMP, BP, NFAMP, FCP, PHS/340B, ASP)• Helped clients defend themselves in investigations / audits of their government pricing calculations. Engaged by multiple clients for Medicaid and FSS restatements, in order to mitigate long-term risk and consult CMS over issues. Show less

Consultant focused on helping pharmaceutical, provider and government agency clients resolve major systems, data, regulatory, process and organizational issues. Worked in project management and business expert roles, as well as business development with partners.• Led team consulting NY State Department of Health on implementation of HIPAA requirements, including training of key personnel and drafting of SOPs.• Built new website for major children’s hospital in Philadelphia… Show more Consultant focused on helping pharmaceutical, provider and government agency clients resolve major systems, data, regulatory, process and organizational issues. Worked in project management and business expert roles, as well as business development with partners.• Led team consulting NY State Department of Health on implementation of HIPAA requirements, including training of key personnel and drafting of SOPs.• Built new website for major children’s hospital in Philadelphia, including physician referral, appointment and donation functions that resulted in more than $8 million in additional revenue in the first 3 months.• Helped a major health system in the Boston area reduce its non-labor supply costs by more than $2 million, including careful review and selection of medical devices in the GI and Cardiac surgery divisions.• Helped multiple clients implement government pricing systems for Medicaid and FSS pricing. Show less

Master Of Business Administration - Mba, Strategy & Technology Management

Activities and Societies: Johnson School Merit Scholarship

Doctor Of Philosophy - Phd, Microbiology

Activities and Societies: SUNY Fellowship Graduate Student Representative for Section of Microbiology

Bachelor Of Science - Bs, Biology And Swedish

Activities and Societies: Cal Grant A Scholarship, Exchange Year at Lund University in Sweden (U.C. Education Abroad Program)

Master Of Science - Ms, Oceanography

Activities and Societies: Office of Naval Research Fellowship, Graduate Student Senator for School of Oceanography