Northeast District Performance Review — April 2026
Prepared by the Northeast Regional Sales Director. Distribution: VP Commercial, Launch Lead, Sales Operations, District Manager East.
Summary
The Northeast region closed April 2026 at 103% of YTD plan on TRx and 108% on NBRx, with strong performance in Boston (112%) and NYC (109%) offset by underperformance in Philadelphia (84%). Two territories remain open (Pittsburgh, Northern New Jersey) and are scheduled to close on June 1. Field activity metrics are largely on track with one exception: the sample-drop redemption rate has slipped to 41% (vs 58% national target), a leading indicator that warrants attention.
Territory-level results
Boston (Megan Hill): TRx 124% to plan, NBRx 118%, three IDN wins (Beth Israel, MGH, Lahey). Sample redemption 64%. Cadence compliance 96%.
NYC (Tony Alvarez): TRx 109% to plan, NBRx 112%, two IDN wins (NYU Langone, Mount Sinai). Sample redemption 52%. Cadence compliance 91%.
Boston North (open): no data for April; territory vacant since March 15. Coverage shared between Megan and Tony.
Long Island (Sam Robinson): TRx 98% to plan, NBRx 94%, zero IDN wins. Sample redemption 49%. Cadence compliance 88%.
Philadelphia (Daniel Park): TRx 84% to plan, NBRx 81%, pending pull-through at Penn Medicine and Jefferson Health. Sample redemption 38%. Cadence compliance 92%.
Pittsburgh (open): no data; territory vacant since February 28. UPMC coverage at risk.
Northern NJ (open): no data; territory vacant since April 8. Coverage shared with NYC.
Connecticut + Western Mass (Rachel Davis): TRx 101% to plan, NBRx 105%. Sample redemption 55%. Cadence compliance 94%.
IDN pull-through status
Beth Israel (Boston): Pull-through complete. P&T committee voted Zenvara onto the system formulary 2026-03-12; first orders flowed 2026-03-22. Megan is the primary contact; KAM coverage through Diane Holcombe.
MGH (Boston): Pull-through in progress. P&T preferred-tier vote scheduled May 22. Strong support from medical oncology section. Action: Megan + Diane to attend P&T meeting in person.
Lahey (Boston): Pull-through complete; formulary placement effective 2026-04-01. First two patients on therapy.
NYU Langone (NYC): Pull-through complete. Tony has access; orders flowing through specialty pharmacy.
Mount Sinai (NYC): Pull-through complete with restriction (oncologist consult required). Workaround documented in the rep playbook.
MSK (NYC): Not yet on formulary. P&T vote scheduled June 18. Karen Wu (MSL) is engaged with Dr. Mehta. Tony's call notes from the April 28 visit are aligned with the MSL strategy.
Penn Medicine (Philadelphia): On formulary but with strict prior-authorization requirements. First wave of patients abandoned starts due to PA delays (see Action 1 below).
Jefferson Health (Philadelphia): Not on formulary. P&T review September 2026.
UPMC (Pittsburgh): Not engaged due to territory vacancy. Significant risk to Q3 plan; need urgent KAM attention.
Top performers
Megan Hill (Boston): 124% to plan, three IDN wins, highest IDN penetration in the region. Megan has the strongest peer-to-peer program in the district, with five MSL-coordinated speaker programs in Q1.
Tony Alvarez (NYC): 109% to plan, two IDN wins, strong MSK relationship. Tony has been the most proactive on the #payer-escalations Slack channel, flagging the UHC PA pattern in late April.
Honorable mention: Rachel Davis (CT + Western Mass) at 101% to plan despite a smaller HCP universe.
Concerns
Daniel Park (Philadelphia): 84% to plan with sample redemption at 38%. The territory has a PA-heavy payer mix (Independence Blue Cross + Aetna) and Daniel has been newer to the region. Recommend an intensive coaching cycle in May, joint calls with the District Manager, and a focused KAM push at Penn and Jefferson.
Three open territories represent approximately 18% of regional planned NBRx for Q2. Pittsburgh in particular puts UPMC pull-through at risk; recommend interim coverage from Megan or Tony pending the June 1 fill.
Sample-drop redemption rate at 41% region-wide (vs 58% national target) is a leading indicator of access friction. Cross-referencing with the field's PA observations suggests UHC PA latency is the dominant cause. This is consistent with the WK19 launch tracker.
Action items
1. Convene a Philadelphia coaching session with Daniel Park, district manager Ben Ortiz, and Megan Hill (peer mentor). Target Week of May 11. Outcome: top-3 PA blocker list per practice for Penn and Jefferson, with KAM action plan.
2. Accelerate territory fills for Pittsburgh and Northern NJ. Confirm offers extended; arrange field ride-along schedule for the first two weeks of June.
3. Escalate UHC PA latency pattern to market access. Aisha is already aware (per Slack); confirm Northeast field-level data points are included in the UHC payer call pre-read.
4. Coordinate MSL coverage for MSK P&T meeting (Karen + Tony to align by May 14).
5. Review sample-drop policy in light of the 38% Philadelphia redemption rate — is the issue access friction or sample-allocation design?
Risks for May-June
If UHC PA latency does not normalize, the Northeast Q2 actuals could miss plan by 15-20%, materially impacting the regional year-end. Conservative estimate: a four-week recovery starting June 1 would recover approximately half of the Q2 gap.
If MSK P&T does not vote favorably on June 18, NYC plan attainment is at risk for Q3. Megan and Tony's combined coverage of MSK + NYU + Mount Sinai represents approximately 28% of regional volume.
Cross-references
Weekly Launch Tracker WK19 (1A2…), Field Force Activity Playbook v3.2 (1B5…), Formulary Win/Loss Log (1E7…).