Leadership 2019-10-22T15:56:19+00:00

President and Managing Partner John Guarino has over 28 years of experience in market access on both the agency and manufacturer sides.

John brings a career’s worth of insight to the organization, along with a successful track record of working with commercial payers, Medicaid, Medicare, specialty retail and mail order, global access teams, trade hospital systems, IDNs, access & reimbursement, and HUB services. His specialties also include launching new products, developing and implementing strategic marketing plans, and navigating FDAMA 114 issues regarding formulary decision-maker strategy and marketing. He has unparalleled experience in payer strategy and marketing.

Most recently, John created and ran Guarino Haskins Market Access, Omnicom’s premier full-service market access agency. His vision and leadership enabled GHMA to deliver on strategy, communications deliverables, research and analytics, payer public relations, digital modeling, and digital communications platforms. Prior to GHMA, John was Managing Director, Managed Markets, at inVentiv Health, where he oversaw the growth of a small division within Palio into an enterprise-level agency with an unrivaled ability to win and service payer business. He was eventually transferred into corporate and made responsible for all market access for the

John spent 20 years at Amgen. As the Director of Payer Segment Marketing at Amgen, John was responsible for overseeing his team’s implementation of all marketing to corporate payer customers, including commercial payers, Medicaid, Medicare, specialty retail, PBM, and IDN/Institutional customers. He worked with a global team to create corporate strategy for all Amgen brands. Together, John and his team managed the development and execution of all marketing messages to corporate customers.

Additionally, John led the execution of marketing strategy and the development of national POA, as well as national-, regional-, and account-level business plans and profiles. Not only was John one of Amgen’s first seven National Account Managers calling on payers, but he also was Segment Director, Launch Manager, and ran the distribution business in the trade group. John has worked with Amgen, Genentech, Celgene, Boehringer-Ingelheim, Biogen-Idec, Nextwave, Daiichi-Sankyo, Pfizer, Eisai, Collegium, Vertex, Intarcia, AstraZeneca, BMS, Amylin, Endo, Merck, AAA, Teva, Sanofi, and Regeneron. John is an industry-recognized leader in the area of managed markets and is passionate about his work. He is an Adjunct Professor of Clinical Pharmacy at the University of Southern California, Graduate School of Pharmacy. For his leadership in market access, John was named by PharmaVOICE as one of the 100 most inspiring leaders in the healthcare industry in 2013. He also earned the PM360 2016 Industry Elite award.

Chetan has worked closely with clients and faculty in a variety of therapeutic areas for over 15 years ensuring that the development and translation of scientific positioning, strategic platforms and visual assets are accurate and relevant to target audiences. His experience includes positioning, branding, critical messaging, MOA/MOD video, and opinion leader development.

Chetan’s experience focuses on targeted molecular therapeutics in a variety of therapeutic areas, including inflammatory, cardiologic, oncologic and neurologic disorders. Leveraging his expertise in cellular and molecular pathways, Chetan contributes significant clinical insight and understanding of the mechanisms that underlie the pathobiology in these therapeutic areas.

Chetan was the director of strategy for the global launch of Savaysa/Lixiana (edoxaban), the latest addition to the blockbuster the novel oral anticoagulant (NOAC) category. Edoxaban faced the challenge of being a fourth-to-market ‘me too’ agent in a category were physicians perceived all NOACs to be the same reinforcing the need to understand what drivers beyond data influenced prescribing behaviors.

Chetan also served as the lead strategist for Humira in IBD, a category facing the imminent threat of biosimilars due to competitive and brand LOE. In addition to an increasingly complex patent strategy, the brand focused on maintaining loyalty by creating value beyond the molecule through first class services for patient and caregiver support.

Chetan completed his BA in biology from the University of Texas in Austin and subsequently earned his PhD in neuroscience from the Weill Graduate School of Medical Sciences of Cornell University/Sloan Kettering Institute (SKI), where his thesis work focused on mitochondrial dysfunction in neurodegenerative disorders. Chetan has published scientific articles in The Journal of Neuroscience, Biochemistry, and Human Molecular Genetics.

Dr. Mittler is a well-versed medical strategist who provides clinical, scientific, and health economic insights that drive marketing and advertising communications for physicians, patients, and payers. He has expertise in many therapeutic areas, including multiple sclerosis, HIV, nephrology, oncology, diabetes, and respiratory disease. Mittler’s 14 years of experience in pharmaceutical advertising extends through all phases of the product life cycle – from market development and launch positioning to late life-cycle management for both US and global brands.

Mittler came to Peregrine Market Access from inVentiv Health Managed Markets, where he was Senior Vice President, Director of Medical Strategy and a member of the Senior Leadership Team helping to guide the overall direction of the agency. Prior to this, Mittler held medical strategy positions at Palio Communications and advanced to become the lead medical strategist for Palio+Ignite’s West Coast offices. Mittler has worked at the Selva Group on promotional medical education, scientific advisory boards, and thought leader engagement and development.

Mittler has extensive experience in developing impactful value propositions for pharmaceutical brands by combining strong clinical differentiation and rationale for use with the associated economic impact in a way that is highly relevant to payers. His proven expertise in creating innovative FDAMA 114 promotion and digital modeling tools brings a unique offering to Peregrine Market Access.

An immunologist by training, Mittler has more than 12 years of clinical- and research-based experience in both immunology and oncology and is an expert in the area of cellular immunity.

For over 20 years, Rafael has been leading and designing high visibility-branding programs across key industry categories with domestic and global reach. As a former SVP Director of Design at Palio, Rafael co-founded the DXL (Design Experience Lab) where he fused AOR capability with transformational Brand Design and User Experience resulting in 20% annual growth for the parent agency over 8 consecutive years. At the agency’s peak, he was responsible for overseeing multi-disciplinary projects among three different offices (Saratoga Springs, NY, NYC and Irvine, CA) and managing 4-6 people per location for 7 different accounts, with agency-wide annual revenues of $37 million.

Rafael’s experience includes creative brand identity concept development, design systems and execution, production management, oversight, and business development for global and domestic corporate and consumer brands for top ten pharmaceutical clients including Abbott, AstraZeneca, Baxter, Merck and Gilead. Prior to joining Palio, Holguin was project director/senior designer at Futurebrand; vice president/ design director at Y Brand/GSWNY; principal at Arismendi Knox Ltd.; and art director at Gruner Jahr USA Publishing. In these positions, he oversaw brand identity development, creative design and global implementations.

Leah Warner brings extensive client management and account services expertise to Peregrine Market Access. She has worked in the pharmaceutical marketing industry for over 20 years and has experience managed markets, HCP and patient communication strategies. She has worked in the market access space for the last 10 years. Her skillset includes strategic and brand planning, launch planning and execution, business development, tactical execution and client relationship oversight.

Warner has worked as a senior account lead for holding companies including WPP, inVentiv Health and Syneos Health. Most recently she served as an SPV of Account Services leading the managed markets and patient access solutions workstreams for a major hematology/oncology franchise. Warner has extensive launch experience as well as experience overseeing above brand leadership initiatives for a number of market access clients. She has supported development of market access strategies for the following therapeutic categories: hematology, oncology, opioid and alcohol dependence, obesity, cardiovascular disease, type 2 diabetes, and chronic obstructive pulmonary disease. 

While working in the HCP space, Warner gained experience in a number of therapeutic categories including kidney disease, types 1 & 2 diabetes, chronic pain and sleep apnea. Warner also led a multicultural pilot program for a pain franchise and was instrumental in helping to launch the client’s first DTC print/online campaign. 

Her responsibilities as EVP of Client Engagement include oversight of all Peregrine Market Access customer facing initiatives, strategic planning, account oversight, launch planning and tactical execution. 

Simply put, Eric Delnicki designs communications that get noticed and have impact. His facility for delivering complex information in accessible, understandable visible executions has driven his success in a wide range of communication fields, especially healthcare. He has developed materials for every phase of the product life-cycle, from pre-launch market conditioning and disease awareness through complete launch suites, label expansions, patient retention, and sales training. He’s worked in esoteric specialties such as HIV, oncology, infectious diseases, pain management, and neurology. His work has won regional, national, and international awards. His vast pharmaceutical industry experience encompasses high-science specialties with a focus in market access communications.

Delnicki was with Syneos Health for more than 19 years, including 4 years on the leadership team of the Market Access consultancy. He has also worked in HCP and consumer advertising for a wide range of brands and disease states for patients, healthcare providers, and payers. Previously, he supervised catalog creation and national advertising campaigns for the Orvis Company, and worked at consumer and B2B agencies.

Delnicki has extensive experience in the recruitment and management of a wide range of creative vendors, including photographers, freelance artists, and illustrators.

Scott Neverett, SHRM-CP is a Partner, Director of Human Resources and Corporate Culture at Peregrine Market Access. In this role, Scott is responsible for overseeing all aspects of human resources management. He has been in the HR field for nearly 20 years, with the majority of his experience being in recruitment/talent acquisition. Prior to Peregrine, Scott worked for the last 10 years in the field of advertising and marketing; holding positions of increased responsibility at Syneos Health.

Scott has a BA in Psychology/Elementary Education and a M. Ed. from The State University of New York at Potsdam where he was also a member of the men’s soccer team. Scott holds a SHRM Certified Professional (SHRM-CP) Certification.

Amy Roman is the Chief Financial Officer at Peregrine Market Access where she is responsible for the Company’s financial strategy and systems. Amy also owns a consulting firm where she assists local businesses in a similar capacity.

Amy’s has spent the better part of 20 years working with high profile companies owned by private equity firms or publicly traded companies. She has successfully managed both buy and sell side merger and acquisition activity, has led capital funding campaigns and worked closely with CEO’s and their Boards to establish and measure successful strategy plans. When Amy is not working, she enjoys traveling, spending time riding her motorcycle and entertaining friends.