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			Thursday, February 12, 2009 News Clipping Archives *Maryland / Regional* O'Malley presses Congressional delegation for more state aid (Baltimore Examiner) Former State Employee Gets 5 Years for $1.7M Theft (Southern Maryland Headline News) Autopsy: Centreville man’s death at Kent Co. facility a suicide (Star Democrat) Health Clinic In Nanjemoy Is at Risk Of Folding (Washington Post) In Md., a Quest to Toughen Domestic Violence Laws (Washington Post) Lieutenant governor promises better funding for crisis center (Prince George’s County Gazette) Foundations to fund prison drug-treatment pilot (Daily Record) *National / International* Highlights of compromise House-Senate economic stimulus plan (Baltimore Sun) Pursuing Charitable Mission Leaves a Hospital Struggling (Wall Street Journal) No butts about it: Study finds paying cigarette smokers to quit triples average success rate (Baltimore Sun) Disease Charities Pursue Cures by Investing in Drug Start-Ups (Wall Street Journal) Court Rules Autism Not Caused by Childhood Vaccines (Washington Post) Novartis Acquires Rights to Heart Drug (Wall Street Journal) More Smokers Quit if Paid, Study Shows (Wall Street Journal) Recession seems to put people in the mood for condoms (USA Today) *Opinion* --- *Maryland / Regional* O'Malley presses Congressional delegation for more state aid By Len Lazarick Baltimore Examiner Thursday, February 12, 2009 Gov. Martin O'Malley was preaching to the choir as he pitched the state's needs in the huge federal stimulus bill to the Maryland congressional delegation Wednesday, and they all knew the refrain: "Jobs, jobs, jobs," said Sen. Barbara Mikulski, head of Team Maryland, as she calls her fellow lawmakers. "We need to create jobs, jobs, jobs, jobs," O'Malley told the Democrats. He was backed up by nine of his cabinet secretaries at a crowded meeting room in the sumptuous new Capitol Visitors Center. "We've inherited a terrible mess," Mikulski, a powerful char of Appropriations subcommittee, said, "and I know you understand because you inherited one from your predecessor." "You're doing a great job with the hand you've been dealt," she said. House Majority Leader Steny Hoyer asked O'Malley how many jobs in Maryland would be lost "if we did not pass either Senate or House version or no bill at all?" The governor said that 70,000 to 100,000 jobs "created or retained is probably accurate for Maryland," with 700 layoffs in state government likely to go ahead without more federal funds for health care and education. "It's important not to lose jobs," Hoyer said, before he headed off to the conference committee negotiations to reconcile differences between the House and Senate versions of the American Recovery and Reinvestment Act. Hoyer, Mikulski, O'Malley and the other Democrats generally agree with the House version, which contains more money for state governments, health care and education. An hour after the session ended, House and Senate negotiators disappointed most of them by agreeing to $789 billion, less spending than was called for in either version of the bill. Mikulski was not on the conference committee, but she said, "My focus is going to be social infrastructure." O'Malley emphasized the number of road, transit and sewage treatment projects "shovel-ready" so the money can be spent in the next year. "We do not have to create a new program," the governor said. "We have $1 billion ready-to-go projects." He was disappointed that school construction funding had been cut from the Senate version. O'Malley emphasized the need for more operating money for special education and schools with poor children, along with money to keep up with the greater demands on Medicaid, the health insurance program for low-income people. Health Secretary John Colmers said 700,000 Marylanders rely on Medicaid, including 110,000 children. O'Malley repeatedly emphasized that Education Week rated Maryland as having the best schools in the nation. "I thank you for being a loud voice for the stimulus," said Rep. Elijah Cummings of Baltimore. He and others thought the state governors were particularly effective advocates for the heavy spending. "We're in crisis mode here," said Sen. Ben Cardin, who hoped for more money for state and local governments. "We're in this together." Copyright 2009 Baltimore Examiner. Former State Employee Gets 5 Years for $1.7M Theft Southern Maryland Headline News Wednesday, February 11, 2009 Claims Processor Stole from State Funded Health Program BALTIMORE (Feb. 11, 2009) – Attorney General Douglas F. Gansler announced today that Donna McRae Lam, 51, a former State employee convicted of stealing $1,768,726.00 from the Maryland Kidney Disease Program (KDP), was sentenced by Baltimore City Circuit Court Judge Sylvester B. Cox, Jr., to 10 years incarceration with five years suspended, and five years probation. The Judge also ordered Lam to pay restitution in the amount of $1,541,329.72. Lam was employed by the Department of Health and Mental Hygiene (DHMH) for 13 years before she moved into the position of claims processor for the agency’s Kidney Disease Program (KDP). The KDP is a state-funded program that assists Maryland residents struggling to pay the extraordinary medical bills associated with end-stage kidney disease. Beginning in May 1997, Lam added 14 fictitious providers to the KDP computer system and filed a total of 917 fake claims for payment. Lam and her husband, Wilson Allen Lam, opened numerous bank accounts and post office boxes throughout Maryland to collect the State checks that were subsequently issued. The Lams spent the stolen money on real estate, home improvements, motor vehicles, jewelry, and gifts to family members. Before imposing his sentence, Judge Cox stated that Lam’s actions were, “the highest form of the violation of trust by a public employee.” The Judge also stated that Lam’s actions were eclipsed only by recent acts on Wall Street. This guilty plea was the result of a multiple-agency investigation performed by the Criminal Division of the Attorney General’s Office, the DHMH Office of the Inspector General, and Maryland State Police. In making today’s announcement, Attorney General Gansler thanked Assistant Attorney General Kate O’Donnell for her work on the case. Source: Md. Attorney General Douglas F. Gansler. Autopsy: Centreville man’s death at Kent Co. facility a suicide Star Democrat Regional Thursday, February 12, 2009 CENTREVILLE – Maryland State Police from the Centreville Barrack are investigating an apparent suicide at the Upper Shore Community Mental Health Center. The victim was identified as John H. Bedford, 39, of the 400 block of North Commerce Street in Centreville. He pleaded guilty Jan. 31 in Talbot County Circuit Court to making bomb threats last July to Memorial Hospital at Easton, Norris Ford and Walgreens. At 11:30 a.m., Tfc. Phillip Nickerson responded to the Kent County facility and found Bedford being attended to by emergency medical personnel. He was taken to Chester River Hospital where he was pronounced dead. The State Medical Examiner’s Office in Baltimore inspected the body and ruled the cause of death as asphyxiation by hanging. Bedford’s death was ruled a suicide, Police are still waiting for the toxicology report. According to Nickerson, Bedford threatened suicide Feb. 5 while staying with his mother in Centreville and the Centreville Police Department submitted an emergency petition to have him admitted to the mental health facility. He was admitted and was checked by nurses every 15 minutes. A nurse went to check him in his room at 11:02 a.m. and he was fine, Nickerson said. Then at 11:11 a.m., he was found hanging in a bathroom next to his room. Police believe a nylon strap, found at the scene, may have been used by Bedford, but police are still investigating how he got the strap, Nickerson said. The Upper Shore Community Mental Health Center would not comment except to say they were sorry for the family’s loss. Bedford was facing a maximum penalty of up to 10 years in jail and up to a $10,000 fine following his plea. He was charged in the July 28 incident in which bomb threats were made to Memorial Hospital at Easton, Walgreens and Norris Ford from pay phones in Sherwood and Easton. No explosives were found at any of the locations. That morning Bedford was due in Talbot County District Court on a charge of changing the label on a prescription. His attorney, Sharon McClellan with the Office of the Public Defender, said it was the first time he had been in trouble and he panicked. Easton Police Det. David Rarmey said it is not uncommon for people to do things like call in bombs when they are trying to avoid court. Bedford did eventually appear in district court and received probation. At the time of his arrest in July, he was released on $2,500 bond. He was being treated for mental illness and was on medication at the time of the plea hearing. Born in Easton, Bedford grew up in Centreville and was a graduate of Queen Anne’s County High School. He worked for Brooks Brother and LL Bean in Queenstown and previously for Bob Smith Automotive. In 2003, the family moved to Sherwood. A funeral service will be held at 11 a.m. Friday, Feb. 13, at Fellows, Helfenbein & Newman Funderal Home, P.A., 408 S. Liberty St., Centreville, where friends and family may call from 6 to 8 p.m., Thursday, Feb. 12. Interment will follow at Chesterfield Cemetery. Online condolences may be made at www.fhnfuneralhome.com. Copyright 2009 Star Democrat. Health Clinic In Nanjemoy Is at Risk Of Folding Facility in Rural Charles Lacks Adequate Funding By Megan Greenwell Washington Post Thursday, February 12, 2009; SM01 The public health clinic at the Nanjemoy Community Center, which serves many of Charles County's most impoverished residents, will close within a few months unless the center can find sufficient funding, officials said. The executive director of Greater Baden Medical Services, which operates seven clinics in Prince George's, Charles and St. Mary's counties, said Tuesday that its board of directors plans to close Nanjemoy Health Services, which operates out of a county-owned community center. The center is the only health clinic in the rural southwestern part of the county. For most residents, the next closest one is in La Plata, about 15 miles away. "Nanjemoy has been operating at a loss of about $150,000 each year since it opened" in 1995, said Sarah Leonhard, Greater Baden's executive director. The board "has reluctantly concluded that we will have to close the center unless we can find some other means of support for it." About 750 people, including many without public or private insurance, are served by the clinic, Leonhard said. It accepts insurance payments through Medicare and Medicaid. Patients who don't have insurance can also pay according to a sliding scale based on family income. Other funding comes from local and federal governments and private grants."Grant funding is harder and harder to come by, and we've had a couple of unforeseen large expenses," Leonhard said. Greater Baden had a 17 percent increase in the number of people receiving care last year, she said. It also lost funding from the Prince George's County Health Department and had no increase in revenue from other sources. Charles does not give Greater Baden money to operate the Nanjemoy center, but it provides and maintains the building in which the clinic operates. Leonhard said the board of directors is also considering closing the Suitland Health and Wellness Center in Prince George's. Many Nanjemoy residents cannot afford private insurance, and dozens have chronic health problems complicated by a lack of running water, dental care and other basic needs. Some live in unheated trailers or shacks. Sixty percent of Greater Baden clients have incomes below the federal poverty level, Leonhard said. Local leaders reacted to news of the possible closing with dismay, saying that Nanjemoy residents have fewer health-care options than other county residents. Health Partners, a community health clinic based in Waldorf, plans to send a dentist to schools and community centers in and around Nanjemoy, but the nearest full-service health clinic for many residents would still be in La Plata. "There's not much there in terms of assistance, so anything that closes its doors is a great detriment," said the Rev. Lowell H. Hancock, pastor of Oak Grove Missionary Baptist Church in Nanjemoy. "What we need is more aid, not closings." Wayne Cooper, president of the Charles Board of Commissioners, said that he plans to seek state funding to keep the clinic open but that he is not optimistic, given budget shortfalls. "We're trying to find options, but it all comes down to finances," said Cooper (D-At Large). "That's the area that needs it most, and it's not the right time to have a closure like that." Leonhard said that a 2005 analysis indicated that a community health clinic in a more populated and centrally located area such as La Plata or White Plains could be more financially viable than the Nanjemoy location. "We're kind of hanging by our fingernails right now," Leonhard said. "Hopefully we can at least see our chronic patients one more time before we have to close for good." Copyright 2009 Wasington Post. In Md., a Quest to Toughen Domestic Violence Laws O'Malley Seeks to Ease Removal of Guns From People Under Protective Orders By Lisa Rein Washington Post Thursday, February 12, 2009; B01 Even when they are ordered to stay away from the partner they assaulted or threatened, many domestic abuse suspects in Maryland and Virginia get to keep their guns. Advocates for victims in Maryland have fought for a decade to tighten the law, ever since Francseea Batts of Baltimore was killed by the father of her child two days after she unsuccessfully asked a judge to take away his gun. But they have been rebuffed by a House of Delegates committee dominated by gun-rights supporters and defense attorneys who fiercely guard the rights of the accused. Today, Maryland Lt. Gov. Anthony G. Brown (D) will urge the Senate Judicial Proceedings Committee to support what would be the biggest change to the state's domestic violence laws in a decade. Two bills introduced by Gov. Martin O'Malley (D) would give judges more authority to remove firearms when a victim seeks temporary and final protective orders. Similar legislation sailed through the Senate last year but was killed in the House Judiciary Committee by lopsided votes. Any changes would come too late for Gail Pumphrey and her three children, David, Megan and Brandon, who were fatally shot Thanksgiving Day 2007 by her ex-husband during a custody handoff in a Damascus park. Or Destiny and Richard Spicknall, ages 3 and 2, who were shot to death by their father after he bought a handgun in Howard County. Or Mary Crawford, whose ex-husband fired a shotgun at her in their Carroll County home, narrowly missing her. Each woman had obtained a protective order, but the men either were allowed to keep their guns or to purchase another one. Pumphrey's former husband killed himself; Richard Spicknall and Steve Crawford were convicted. "My niece and nephews couldn't outrun a bullet," said Janet Blackburn, Pumphrey's sister, who will testify at today's bill hearing. "He was able to get all four of them because he had a gun." Pumphrey took a photograph of David Brockdorff's rifle, which he bought for target practice, and kept it in her files, her sister recalled, because she was so afraid that he would use it against her. Judges in Maryland and Virginia are allowed to order firearms removed after a court hearing in which a final protective order is issued, but the law does not require it. In Maryland, that authority is limited to handguns; judges can't take rifles. Nor can Maryland judges confiscate guns when a judge issues a temporary protective order limiting a suspect's contact with a victim for a week, a time when passions in domestic conflicts can be red hot and violence is possible. The law is stricter in the District and in Virginia, a state that holds dear the rights of gun owners. Anyone subject to a protective order in Virginia can't buy or carry a gun, and courts have the discretion to take guns when they issue a temporary order. O'Malley wants to require anyone under a final protective order, which is limited to a year, to surrender all firearms, including rifles. He also wants to allow, but not require, a judge to remove guns when a victim seeks temporary protection. First lady Katie O'Malley has stepped into the debate, drawing on the accounts of gun violence she hears every day in Baltimore, where she is a District Court judge. "Why would you give matches to an arsonist?" she said in an interview. "We should not be protecting the abuser." While she said she routinely orders suspects to get rid of their guns, other judges might not. Domestic violence claimed the lives of 52 women and children in Maryland in 2006-07, 21 of them by guns, according to the Maryland Network Against Domestic Violence. As of Jan. 29, there were 7,230 final and temporary protective orders open in Maryland. Of the people under such orders, 132 had firearms registered with the state police. It is uncertain how the House committee will lean, despite the governor's advocacy. Members who oppose a stricter law say they must balance the state's right to protect victims against property rights, particularly when a victim seeks temporary protection. When a hearing on a temporary order is conducted, the victim appears in court without the estranged spouse or partner. Opponents say it would be wrong to deprive people of guns based on accusations they do not have a chance to rebut. "I don't know if the governor can get the votes," said committee Chairman Joseph F. Vallario Jr. (D-Prince George's), who has a criminal defense practice in Suitland. "It's up to the committee. I don't make a decision on the bills until I hear them." Vallario said his biggest concern is that police and other law enforcement officers accused of domestic violence who carry guns for their jobs would not be able to work. Other members said removing guns would be unfair in cases in which an estranged couple argues but violence or threats are not involved. "There are cases where you come over to pick up the children and she says, 'They don't want to go with you today,' " said Del. Michael D. Smigiel Sr. (R-Cecil), also a defense attorney. "Maybe he yells. Now you're going to take all the man's weapons?" The administration's point man to lobby the House panel is Brown, a former vice chairman with a stake in the legislation. Catherine Brown, a cousin and first-grade teacher, was killed by an ex-boyfriend at her home in Montgomery Village in August. Catherine Brown had not sought a protective order against him. The ex-boyfriend was fatally shot by police. In recent days, the lieutenant governor has met with most committee members. "My goal has been to fully understand what the nature of the opposition is," Brown said. Copyright 2009 Washington Post. Lieutenant governor promises better funding for crisis center Safe haven for domestic violence victims reeling from current economy By Liz Skalski Prince George’s County Gazette Thursday, February 12, 2009 A Prince George's County shelter that serves as a safe haven for domestic violence survivors has reached out to Lt. Gov. Anthony Brown (D), who agreed to take steps to secure a steady stream of money to keep its doors open. "I can't say there will be an increase in the money but [we] will work on making it more reliable," Brown said Feb. 4 after touring the Family Crisis Center Inc. of Prince George's County, which has a confidential location. "You guys are doing important work." Former center resident Chinonye Nwokoro, 35, who spoke with Brown during his visit, recalled coming to the center from Bowie in May 2007 with her four children after leaving a 14-year abusive marriage. The family lived at the center until May 2008, gaining the support to now live on their own in secure housing in the county. "They really helped us tremendously - I can't thank them enough," Nwokoro said to Brown. Nwokoro said the center provided everything imaginable for her and her four children: counseling, summer camp, beds, food and clothing. "They saved our life. Without them we would have been on the street, that's for sure," she said. "Additional funding would definitely help-not only help [the]people in the building, also helping people like me that have temporary housing outside the shelter." Brown met with Eloise Foster, Maryland's secretary of budget and management, on Feb. 5 and asked her to look into how crisis centers are funded to better understand where their incomes come from and what it will take to stabilize those funds. "It's too early to say what the fix is," Brown said. "I need to better understand what the situation is." Lou Oertly, chairman of the center's board of directors, said the center currently receives donations, small grants and money through fundraising, but the economy's current slump means the center isn't receiving as much funding, at the same time demand for its services is on the rise. "We're having a hard time making payroll," Oertly said. "We need to try to sell this program." Since June, the shelter has been at or near capacity with 25 residents and operating on a budget of $1.3 million, but with funding shortfalls expects a $300,000 deficit, Oertly said. Nearly 200 people have been turned away since June and were referred to other county shelters or helped with a safety plan and alternate housing options. Kenya Fairley, the center's director of resident services, said the facility, which provides housing and support services and operates a 24-hour hotline, has been struggling to pay for trash pick-up, utilities, groceries and other necessities. The center is also seeking money to open a new wing, which has 10 bedrooms and 34 beds. The addition was initially projected to open this spring, but the opening will be delayed until directors can secure $700,000 to staff the wing with counselors, case managers, a cook, housekeeper and hotline staff. Oertly told Brown the center needs more people from the private sector on the board of directors, and Brown agreed to commit one board member. "What I'm committed to doing is reaching out to members of the business community in Prince George's County who would be interested in serving on a nonprofit board, such as the crisis center," Brown said. "They're looking for board members who can help them raise private dollars to support their work and supplement the public dollars they receive." Dick Conti, the center's interim executive director, said he wants to see the center funded on Gov. Martin O'Malley's (D) line-item budget. Brown has personal ties to support for domestic violence victims. Brown's cousin, Catherine Brown, of Montgomery Village in Montgomery County, 40, was shot and killed in August by estranged boyfriend Michael Wilson, who was shot and killed by Montgomery County police. "Whatever we can do to eliminate the threat, support the victims, the women and children, is a good thing." In addition to trying to secure more money for programs such as the Family Crisis Center, Brown and O'Malley are talking to lawmakers about bolstering O'Malley's domestic violence initiatives. Brown and O'Malley are asking Maryland judges to remove guns from domestic abusers with temporary protective orders against them and also require the removal of guns after final protective orders are issued. "Today, [judges] can't take them away-our legislation will mandate that judges take away firearms and guns from abusers," Brown said. E-mail Liz Skalski at eskalski@gazette.net. To reach the Family Crisis Center Inc. of Prince George's County 24-hour hotline, call 301-731-1203. Copyright 2009 The Gazette. Foundations to fund prison drug-treatment pilot By Caryn Tamber Daily Record Wednesday, February 11, 2009 The state and a coalition of private groups are launching a substance abuse treatment program they hope will get convicts off drugs and save Maryland millions. The project, which is slated to begin within a few months, will provide drug-addicted inmates with at least a year of treatment while they are in prison. The idea is that these inmates will make good candidates for parole, getting them released early. After their release, they will get more substance abuse treatment and access to help with housing, job training, education and other services. “The beauty of the whole thing is that because incarceration is so expensive, we can take the money saved from the incarceration and use those savings to pay for the treatment,” said Diana Morris, director of the Open Society Institute-Baltimore, a foundation that works on social justice issues. OSI-Baltimore helped design the program and will work to implement it, along with the Department of Public Safety and Correctional Services and the Safe and Sound Campaign of Baltimore. Safe and Sound, a foundation that works on child and family issues, will administer it. Five foundations have pledged a total of $2.2 million to cover the upfront treatment costs. However, organizers believe the project will pay for itself eventually. They project that the program will save the state $3.2 million over its first three-and-a-half years because inmates’ earlier release dates will relieve Maryland of the cost of caring for them. The program will serve 250 prisoners in those first few years. Murderers, rapists and child abusers will not be eligible for the program. Morris said the average yearly cost of incarceration in the state is $25,000 per inmate. She said not all of that cost will be erased because the state still has overhead expenses, such as maintaining prison buildings. But if the program works and starts making a dent in the number of people incarcerated in Maryland, the state could “close down a whole wing” in the prison, Morris said. The state may see additional financial benefits if the drug treatment decreases the re-offense rate, she said. Tomi Hiers, assistant secretary and chief of staff at Public Safety and Correctional Services, said the program will let her department expand its anti-drug abuse efforts beyond the prison walls, something it could not afford to do on its own. “We all know that programs and services and any intervention will only be as effective as the follow-up they get in the community,” Hiers said. After hearing a description of the program, a University of Maryland professor who studies addiction said it sounds like a solid plan. “We know that people who have been in prison are likely to have substantial substance abuse problems, and the research has shown that programs that begin in prison and then continue after release in the community have the highest success rates,” said Eric Wish, director of the university’s Center for Substance Abuse Research. Wish is not involved in the program. He said ex-offenders who are on parole and receiving treatment should be given urine tests to make sure they are clean. Programs that couple testing with sanctions, such as a few days in jail, for those who fail are proving effective, he said. Copyright 2009 Daily Record. *National / International* Highlights of compromise House-Senate economic stimulus plan By Associated Press Baltimore Sun Thursday, February 12, 2009 Highlights of a nearly $789 billion compromise version of President Barack Obama's economic recovery plan agreed to by Democrats and moderate Senate Republicans. Additional debt costs would add about $330 billion over 10 years. Many provisions expire in two years. ___ Spending AID TO POOR AND UNEMPLOYED - $40 billion to provide extended unemployment benefits through Dec. 31, and increase them by $25 a week; $20 billion to increase food stamp benefits by 14 percent; $4 billion for job training; $3 billion in temporary welfare payments. DIRECT CASH PAYMENTS - $14 billion to give one-time $250 payments to Social Security recipients, poor people on Supplemental Security Income, and veterans receiving disability and pensions. INFRASTRUCTURE - $46 billion for transportation projects, including $27 billion for highway and bridge construction and repair; $8.4 billion for mass transit; $8 billion for construction of high-speed railways and $1.3 billion for Amtrak; $4.6 billion for the Army Corps of Engineers; $4 billion for public housing improvements; $6.4 billion for clean and drinking water projects; $7 billion to bring broadband Internet service to underserved areas. HEALTH CARE - $21 billion to provide a 60 percent subsidy of health care insurance premiums for the unemployed under the COBRA program; $87 billion to help states with Medicaid; $19 billion to modernize health information technology systems; $10 billion for health research and construction of National Institutes of Health facilities. STATE BLOCK GRANTS - $8 billion in aid to states to defray budget cuts. ENERGY - About $50 billion for energy programs, focused chiefly on efficiency and renewable energy, including $5 billion to weatherize modest-income homes; $6.4 billion to clean up nuclear weapons production sites; $11 billion toward a so-called "smart electricity grid" to reduce waste; $13.9 billion to subsidize loans for renewable energy projects; $6.3 billion in state energy efficiency and clean energy grants; and $4.5 billion make federal buildings more energy efficient. EDUCATION - $47 billion in state fiscal relief to prevent cuts in state aid to school districts, with great flexibility to use the funds for school modernization and repair; $25 billion to school districts to fund special education and the No Child Left Behind law for students in K-12; $17 billion to boost the maximum Pell Grant by $500 to $5,350; $2 billion for Head Start. SCIENCE - $3 billion for the National Science Foundation for basic science and engineering research; $1 billion for NASA; $1.6 billion research in areas such as climate science, biofuels, high-energy physics and nuclear physics. HOMELAND SECURITY - $2.8 billion for homeland security programs, including $1 billion for airport screening equipment. LAW ENFORCEMENT - $4 billion in grants to state and local law enforcement to hire officers and purchase equipment. ___ Taxes NEW TAX CREDIT - Approximately $115 billion for a $400 per-worker, $800 per-couple tax credits in 2009 and 2010. For the last half of 2009, workers could expect to see perhaps $13 a week less withheld from their paychecks starting around June. Millions of Americans who don't make enough money to pay federal income taxes could file returns next year and receive checks. Individuals making more than $75,000 and couples making more than $150,000 would receive reduced amounts. ALTERNATIVE MINIMUM TAX - About $70 billion to spare about 24 million taxpayers from being hit with the alternative minimum tax in 2009. The change would save a family of four an average of $2,300. The tax was designed to make sure wealthy taxpayers can't use credits and deductions to avoid paying any taxes. But it was never indexed to inflation, so families making as little as $45,000 could get significant increases without the change. Congress addresses it each year, usually in the fall. EXPANDED COLLEGE CREDIT - About $13 billion to provide a $2,500 expanded tax credit for college tuition and related expenses for 2009 and 2010. The credit is phased out for couples making more than $160,000. RENEWABLE ENERGY INCENTIVES - $20 billion in tax incentives for renewable energy and energy efficiency over 10 years, including: extending tax credits for energy produced from wind, geothermal, hydropower and landfill gas; grants to build renewable energy facilities; tax credits for purchases of energy-efficient furnaces, windows and doors, or insulation; tax credit for families that purchase plug-in hybrid vehicles. HOMEBUYER CREDIT - $3.7 billion to repeal a requirement that a $8,000 first-time home buyer tax credit be paid back over time for homes purchased from Jan. 1 to August 31, unless the home is sold within three years. BONUS DEPRECIATION - $5 billion to extend a provision allowing businesses buying equipment such as computers to speed up its depreciation through 2009. AUTO SALES - $2.5 billion to makes sales tax on paid on new car purchases tax deductible. Copyright 2009 Associated Press. All rights reserved. Pursuing Charitable Mission Leaves a Hospital Struggling By Barbara Martinez Wall Street Journal Thursday, February 12, 2009 CHICAGO -- Pa Than's chest hurt so much that friends drove him to the emergency room. The hospital they took him to that day last summer diagnosed the Burmese refugee with advanced lung cancer and gave him a prescription for hospice care. Today, Mr. Than, who is 28 years old and speaks almost no English, is responding to a cocktail of two chemotherapy drugs and a third medicine at a different hospital -- Mount Sinai Hospital in Chicago. His doctor there says the treatment may not cure him, but it should at least give him a shot at surviving another couple of years. "A young man with a potentially treatable cancer should have the right to choose life-saving therapy," says the doctor, Pam Khosla, division head of the department of hematology and oncology at Mount Sinai. Mount Sinai has become the medical safety net for a large segment of Chicago's destitute. Providing all patients, rich or poor, the same standards of care is one way that Mount Sinai tries to live up to its obligations as a nonprofit hospital exempt from taxes. Located amid the blight of Chicago's West Side, Mount Sinai also tries to tackle its community's social ills. It employs former gang members to warn children away from street violence. Two full-time employees' sole responsibility is to get neighborhood residents to quit smoking. Another group of employees is charged with monitoring teenage mothers to try to delay a second pregnancy and the downward spiral that often accompanies it. "We can't be part of this community if we're not trying to change people's lives and make it better," says Alan H. Channing, Mount Sinai's chief executive. While a number of nonprofit hospitals have grown into profit machines in recent years, some, like Mount Sinai, have stuck to their charitable mission but struggled financially. These institutions are usually located in inner cities and not anchored to big nonprofit systems, nor can they rely on government support the way county or state hospitals can. In return for exemption from local, state and federal taxes, nonprofit hospitals are expected to provide benefits to their community, including charity care for the poor. Surplus revenues are supposed to be channeled back into operations. Mount Sinai has teetered between a small net income and annual losses as high as $15 million over the past five years. While some large nonprofit hospitals have amassed billions of dollars in reserves, Mount Sinai's days of cash on hand -- a common gauge of a hospital's solvency -- is sometimes measured in hours. video Mount Sinai's struggles reflect in part a paucity of government incentives for nonprofit hospitals to operate in inner cities. Earlier this decade, Illinois introduced a subsidy program to offset losses hospitals incur from accepting Medicaid, the government health-insurance plan for the poor, which often doesn't cover costs. Because of the way it is designed, the program makes higher payments to one of Chicago's richest nonprofit hospitals, University of Chicago Hospitals, than it does to Mount Sinai. Mount Sinai's precarious finances are reflected in its ramshackle facilities. Paint peels from some ceilings, baseboards are cracked and dingy, and the maintenance chief sometimes jump-starts the antiquated radiator-heat system with a few bangs of his hammer. In one part of the hospital sit the remains of three 1940s-era sit-in phone booths. Earlier this decade, the federal government threatened to suspend Medicare payments to the hospital unless it made upgrades, including a new sprinkler system in the event of a fire. Mount Sinai couldn't afford the $8 million investment, so the state ended up giving it the money. "Our good work is not reflected in the cosmetics of our facility," a Mount Sinai spokeswoman says. Mount Sinai opened in 1919 to serve two goals: provide medical care to Chicago's poor Eastern European Jewish immigrants and give the city's Jewish doctors, who were then discriminated against, a place to train and practice. In the 1960s, the hospital's neighborhood, known as Lawndale, experienced a dramatic demographic shift that mirrored similar changes occurring across many American cities. The Eastern European Jewish residents left for the suburbs, and African-Americans moved in. 'Felt Unwelcome' But rather than go to Mount Sinai, which had become known as a white hospital, the neighborhood's black population traveled farther to get treated at other institutions. "Whether it was true or not, they felt unwelcome," says Ruth Rothstein, who started working at Mount Sinai in 1966. With fewer patients seeking care there, the hospital's revenues fell to unsustainable levels. By 1972, when Ms. Rothstein became chief executive, the hospital's board faced a choice: follow its former clientele to the suburbs, or stay and renew its commitment to the community. The board voted to stick it out. Ms. Rothstein and her staff hit the streets. They joined community organizations and churches, and helped launch programs to help people purchase their own homes. "There was an understanding that a hospital is not an island to itself," Ms. Rothstein, now 85, recalls. Prescription for Profit The Journal explored the evolution of the nonprofit hospital sector into a big-money business in a series of stories this year. Today, Mount Sinai is the medical safety net for a large segment of Chicago's destitute. Seventy-two percent of its patients are either uninsured or covered by Medicaid. Only 10% have commercial health insurance -- the only type that gives the hospital a profit margin. The incidence of heart disease, infant mortality, asthma and HIV in the area surrounding the hospital far outpaces the rates in greater Chicago and the rest of the country. The life expectancy of local residents is a full decade less than the U.S. average. Poverty is rampant. To the north of the hospital, the neighborhood now referred to as North Lawndale is more than 90% black. In South Lawndale, about 85% are Hispanic. Their choices for health care have been dwindling. Two years ago, Advocate Health Care, a large nonprofit system with more than $1 billion in cash and investments, shut down neighboring Bethany Hospital and turned it into a long-term care facility. Advocate is in the middle of a $500 million expansion program in the Illinois suburbs. Spokeswoman Kelly Jo Golson says Advocate determined there was a "surplus of hospital beds and a significant duplication of health-care services" on the West Side of Chicago, and turning Bethany into a long-term care facility served an unmet need in that part of the city. Advocate is spending $60 million to upgrade one of its other inner-city hospitals in Chicago, she added. Bethany's closure strained an already stretched Mount Sinai. The hospital's emergency room saw an immediate surge in admissions, from 35,000 patients a year before Bethany closed to about 58,000 today. "We couldn't plan for something like that," says Leslie Zun, the hospital's chief of emergency medicine. Mount Sinai is considering limiting the number of patients it admits who don't live in the area. It spent $16.6 million on charity care last year and another $16.2 million to subsidize specialists, such as cardiologists, who wouldn't otherwise work in the neighborhood because reimbursements are so low. Those expenditures eat up nearly 10% of its revenues, forcing Mount Sinai to put off investments in new equipment, such as a second cardiac-catheterization laboratory to perform artery-clearing operations that help prevent heart attacks. The cath lab has "been on the table for four years," says Mount Sinai's chief financial officer, Charles Weis. "Heart disease is a community need, but we have to balance the resources." To try to collect on unpaid bills, Mount Sinai used to sue some patients, who had resources but weren't paying. It filed 119 such suits between 1999 and 2006. But it has since stopped the practice and raised its income threshold to allow more patients to qualify for charity care. Mount Sinai's emergency room reflects some of the challenge of doing business in one of Chicago's toughest neighborhoods. Digital thermometers are chained to the wall; even so, someone recently ripped one off and walked away with it. The hospital says it spends $20,000 a year replacing stolen equipment. Dr. Zun, who has worked at Mount Sinai for over 20 years, wants to buy his staff the cellphonelike devices that many ERs use to speed up communication between doctors and nurses. But, at $7,000 for a full set, "it's a luxury we can't afford," he says. Instead, he and his colleagues rely on bulky older cordless telephones with spotty reception. The Mount Sinai ER is sometimes referred to as the "knife and gun club" because of the frequent stabbings and shootings it handles. A few years ago, Dr. Zun hired a violence-prevention worker to help teenage gunshot victims treated at the hospital get back on track. He says the results were promising, but grant funding dried up and the program was canceled. The hospital continues to combat violence through another program that employs former gang members in wheelchairs to mentor neighborhood youth. The program's head, Devoy Boyd, was shot in the back when he was 17, paralyzing him from the waist down. On a chilly November afternoon, Mr. Boyd, now 31, wheeled himself into the cafeteria of Learn Charter School, a few miles from Mount Sinai, and faced four dozen sixth-graders. Holding up props, he went into excruciating detail about how he has to use a catheter to urinate. "If you're paralyzed, you have to do this every four to six hours, every day for the rest of your life," he told the children. "Do it hurt?" one girl asked. "If you feel below your waist then, yeah, it hurt," Mr. Boyd answered. It's difficult to know how much of an impact Mr. Boyd has on these children. When he spoke to a group of troubled teens about to be released from a juvenile detention center recently, he says half took his card but only one later reached out to him. Mount Sinai thinks such programs do pay dividends. By helping convince children to stay in school, get jobs and become productive members of society, the hospital says the programs cut down on crime and poverty, contributing to the community's welfare and health. Mr. Channing, the CEO, says some kids may even someday become paying clients. There's another economic incentive: Patching up gunshot wounds is an unprofitable line of work. Each shooting victim costs up to $12,000 to care for, and the patients rarely have health insurance or qualify for Medicaid. Some of Mount Sinai's other programs are actually detrimental to its bottom line. Because Mount Sinai is a designated children's hospital and level-one trauma center, Medicaid pays it higher rates for a small number of cases, such as children needing emergency attention. So when children with asthma come to its emergency room, Mount Sinai makes money caring for them. But the hospital employs educators to coach families of asthmatic children on how to control the disease and avoid emergency visits. One of the beneficiaries is 4-year-old Roberto Leanos, a frequent ER visitor since he was a baby. Ana Rosa Garcia, the educator assigned to his case, spotted problems when she walked into the Leanos family's apartment in 2007. There was wall-to-wall carpeting -- a breeding ground for dust mites, which can trigger asthma symptoms. Fluffy blankets on Roberto's bed were also problematic. Mrs. Garcia convinced Roberto's mother, Maria Leanos, to rip out the carpet and brought her hypoallergenic sheets and mattress covers. She also taught the 28-year-old mother how to administer an inhaler to Roberto and gave her an "asthma action plan." It came in handy one evening when Roberto became lethargic. Mrs. Leanos's instinct was to put him to bed, but the action plan said in capital letters to "call for an ambulance now." Minutes after he reached Mount Sinai, his condition worsened and he was put on a ventilator. But he recovered and hasn't had to return to the hospital. Second Opinion Mr. Than, the Burmese refugee, found his way to Mount Sinai in August when an internist who treats patients for World Relief, an agency that helps refugees resettle in the U.S., decided to get him a second opinion. Mount Sinai confirmed he had lung cancer and referred Mr. Than back to the hospital that originally diagnosed him, Provena Mercy Medical Center, for treatment. Provena Mercy is located in Aurora, Ill., a small city an hour and a half west of Chicago where Mr. Than lives with three other recently arrived refugees. Mr. Than wanted to be treated in Aurora because he was making new friends there and could take the bus to the hospital. But Steve Wiggers, Mr. Than's case manager at World Relief, says Provena Mercy told him the cancer was "too far advanced" and recommended hospice care when Mr. Than was readmitted there. Mr. Than's medical file says Ramesh Kola, the Provena Mercy oncologist who examined him, wrote that he had an "incurable" cancer, "irrespective to treatment." Mr. Than was given a prescription for hospice care signed by another Provena doctor. While Mr. Than's Mount Sinai doctor says that Provena Mercy didn't give the patient the right to choose life-saving therapy, Provena says that it offered the full range of treatment options. In an interview, Dr. Kola says hospice care was one of three options he raised with Mr. Than, and that the other two were treatments. Dr. Kola says his consultation note also stated: "we discussed options of supportive care with hospice, treatment with Tarceva and IV chemotherapy." Provena Mercy is part of Provena Health, a Catholic nonprofit hospital system, that has been at the center of a debate over how much charity care tax-exempt hospitals should provide. Illinois stripped another Provena hospital, Provena Covenant, of its tax exemptions in 2004 after deeming that it provided too little free care to the poor. Provena fought the ruling, and the case wound its way through the state's courts. The Illinois Supreme Court agreed to hear it last month; a verdict isn't likely until next year. Provena Health maintains that its charity care is adequate. In a recent statement about the case, it said it provides "vital services every day to those in our community who have no other health care options." A spokeswoman for Provena Mercy said while she couldn't discuss specifics of Mr. Than's case, "the medical record clearly indicates that the physician did indeed offer this patient clinical options in addition to hospice." She said a "prescription for hospice does not indicate that other clinical care options were not presented to the patient." She also said Provena "does not deny care to any patient." Mr. Than ultimately received chemotherapy at Mount Sinai. Dr. Khosla, of Mount Sinai, says the cancer has shrunk mildly after two rounds of chemo. So far, Mr. Than's care has cost Mount Sinai about $34,500. Though he temporarily qualifies for Medicaid as a political refugee, the hospital doesn't expect the government program to reimburse it more than $22,700. Write to Barbara Martinez at Barbara.Martinez@wsj.com Printed in The Wall Street Journal, page A1 Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. No butts about it: Study finds paying cigarette smokers to quit triples average success rate Associated Press By Linda A. Johnson Baltimore Sun Thursday, February 12, 2009 Dangling enough dollars in front of smokers who want to quit helps many more succeed, an experiment with hundreds of General Electric Co. workers indicates. Among those paid up to $750 to quit and stay off cigarettes, 15 percent were still tobacco-free about a year later. That may not sound like much, but it's three times the success rate of a comparison group that got no such bonuses. GE was so impressed it plans to offer an incentive program nationwide next year, aiming to save some of the company's estimated $50 million annually in extra health and other costs for smoking employees. "This kind of reward system provides them with direct, positive feedback in the present," not just delayed, intangible health benefits, said Dr. Kevin Volpp, the lead researcher of the study. Volpp, who oversees the health incentives center at the University of Pennsylvania, called the study the largest ever of employer incentives to stop smoking. Several past studies failed to find higher quit rates linked to financial bonuses, but he said those included too few people or the financial incentives were too tiny, some as low as $10. The $750 was "a good incentive," said Dan Anzalone, a study participant who quit smoking cold turkey three years ago next month — after a 35-year habit. "I was getting rewarded for something that I should be doing anyway," said Anzalone, 54. "You'd be surprised at what that little incentive does." A logistics specialist at a GE plant in Schenectady, N.Y., Anzalone tried quitting with antidepressants about seven years ago but couldn't. He tried quitting on New Year's Day most years, but generally only lasted a couple days. So he signed up for Penn's federally funded study, unaware that he would be paid. Half the 878 participants, at about 85 U.S. GE sites, were put in the financial rewards group; the other half were just encouraged to join quit-smoking programs and use the company's health coverage for doctor visits and anti-smoking drugs. Results of the study, which began in 2005, were reported in Thursday's New England Journal of Medicine. The incentive group got increasingly higher payments the longer they stayed off tobacco, up to a total of $750 after 12 months. Anzalone said the incentive program was all he needed: He didn't go to smoking cessation classes or use nicotine patches or gum, or medicines. "Every week got easier and easier," he said. "Now it's been three years and I don't even think about it." The study showed that after nine to 12 months, about 15 percent of those being paid had stayed off cigarettes, compared to just 5 percent of the unpaid group. In addition, four times as many people getting cash completed a smoking cessation program. Volpp said similar numbers of people in the two groups used aids such as nicotine patches and the drug Zyban, which reduces irritability and depression. Dr. Norman Edelman, chief medical officer of the American Lung Association, said paying people for healthy behavior remains controversial. But he said the study was well done because it was "more real-world" than the tests drug companies run to get anti-smoking products approved. Study volunteers decided what classes to attend and which products to use, rather than having tightly controlled conditions and constant calls from nurses checking on them, he noted. Edelman said the 15 percent quit rate is pretty good and that employers should consider trying such a program, although it's not clear it would succeed in settings outside workplaces. GE's chief medical officer, Dr. Robert Galvin, said Wednesday that starting next January, the company will offer a quitting incentive program covering its 152,000 U.S. employees, at more than 250 sites. GE expects to recoup the costs of the smoking cessation program in three to five years. "We know that incentives work," Galvin said. "We're very excited about it." Not all those in the study saw the bonuses as crucial. Guy Ardizzone, 49, an engineer at a GE factory in Madisonville, Ky., smoked for "probably 30 years," then quit nearly three years ago. He said other factors were more important than the $750: completing a 12-week smoking cessation course, using Commit lozenges and his own motivation. "I was ready to quit," said Ardizzone, who has five young grandchildren. "I want to enjoy them." On the Net: New England Journal: http://www.nejm.org American Lung Association's Freedom From Smoking program: http://tinyurl.com/dej47r University of Pennsylvania's center for health incentives: http://www.med.upenn.edu/ldichi Copyright 2009 Baltimore Sun. Disease Charities Pursue Cures by Investing in Drug Start-Ups By Keith J. Winstein Wall Street Journal Wednesday, February 11, 2009 Disease philanthropy has entered the for-profit world. Until recently, groups like the Juvenile Diabetes Research Foundation and the National Multiple Sclerosis Society spent the money they raised from donors on counseling patients, advocacy in Washington and funding university researchers in the hopes they would discover cures. But charities, increasingly frustrated with the slow emergence of new disease treatments, are pouring millions of dollars into pharmaceutical start-ups to bring new drugs to market. Starting with a $76 million partnership between Vertex Pharmaceuticals Inc. and the Cystic Fibrosis Foundation, the practice has become an important new source of capital for small drug companies. It also creates potential conflicts for charities, which are called upon for impartial advice to patients but could end up with financial stakes in high-price treatments. Such investments are a "potential minefield," says Aaron Kesselheim, a doctor at Brigham and Women's Hospital in Boston who studies health policy. Last month, the Leukemia & Lymphoma Society, a blood-cancer charity, announced a $3.7 investment in closely held Celator Pharmaceuticals Inc., of Princeton, N.J. The charity will fund a midstage clinical trial on a drug to fight acute myeloid leukemia, a blood cancer that kills about 9,000 people a year in the U.S. In December, an investment arm of the National Multiple Sclerosis Society paid $1 million in exchange for stock warrants in Apitope International NV, a closely held Belgian company. Apitope then sold the rights to its MS drug -- still in early laboratory testing -- to the German pharmaceutical giant Merck KGaA. All told, about a dozen disease-based charities recently have started funding early-stage drug research at start-up companies -- usually in exchange for royalties or stock options. Most of the charities say they were inspired by the success of the Cystic Fibrosis Foundation in spurring numerous companies to work on potential treatments for the rare genetic disease that kills most patients before the age of 40. "Academics are really not good at taking good understandings of the basic defect and translating it to new therapies," says Robert Beall, the Cystic Fibrosis Foundation's chief executive. "We had to get the drug companies to start to get involved with cystic fibrosis." Since 1999, the foundation has paid for most of Vertex's research on cystic fibrosis. In exchange, the foundation will receive an unspecified percentage of Vertex's sales on cystic-fibrosis drugs. Joshua Boger, Vertex's chief executive, says the fibrosis foundation's partnership had turned his company -- whose main focus is a drug candidate to treat hepatitis C -- into advocates for curing the disease. No drug has reached the market, but in a midstage clinical trial last year, a Vertex pill known as VX-770 improved lung function in a type of cystic fibrosis. Vertex says it plans to start a final-stage study this year that could lead to approval by the Food and Drug Administration. Another Vertex pill, aimed at about 60,000 fibrosis patients, is in earlier testing. Such investments complicate the role of disease-focused charities. Normally, a patient-advocacy group might be expected to argue for lower prices for pharmaceuticals -- but a group with a royalty stake or equity in a drug maker has the opposite interest as well. Disease-focused charities also often give recommendations to doctors, patients and the FDA. The fibrosis foundation runs a pharmacy network to dispense drugs, and accredits treatment centers. The impartiality of such activities might be questioned if a group had a stake in one of several competing drugs, says Dr. Kesselheim. "Equity relationships can create substantial unconscious biases in the way that these foundations conduct their business that might lead them away from the ideal public-health strategies," he says. "For example, a generic drug might be really useful for patients with MS, or epilepsy, and because the foundation has these sort of close ties with for-profit companies, then they might have subconscious biases against advocating for those sorts of outcomes that might lower costs." Several charities said they were sensitive to the issue. "I look forward to the day when there are so many things on the market that it becomes a big problem for us," said Timothy Coetzee, who runs the MS society's investment arm. "We talked about, 'How would we feel if we find a blockbuster drug, but it costs $100,000 for the treatment?'," he said. "That is a tricky situation." Dr. Coetzee said the foundation would probably sell its stake to avoid a conflict of interest. "The financial types will go, 'Well, why are you sacrificing huge royalties?," he said, but "knowing my board, we would exit out so we could avoid that." Dr. Beall said the fibrosis foundation has an unwritten policy to sell its stake in a drug as soon as it begins generating royalties, and has done this once already. "Our goal is to do anything that would minimize a conflict of interest and work to get these things off our books," he said. "I don't want to really hold the royalty rights to anything." Write to Keith J. Winstein at keith.winstein@wsj.com Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. Court Rules Autism Not Caused by Childhood Vaccines By Shankar Vedantam Washington Post Thursday, February 12, 2009 Thousands of parents who claimed that childhood vaccines had caused their children to develop autism are wrong and not entitled to federal compensation, a special court ruled today in three decisions with far-reaching implications for a bitterly fought medical controversy. The long-awaited decision on three test cases is a severe blow to a grass-roots movement that has argued -- predominantly through books, magazines and the Internet -- that children's shots have been responsible for the surge in autism diagnoses in the United States in recent decades. The vast majority of the scientific establishment, backed by federal health agencies, has strenuously argued there is no link between vaccines and autism, and warned that scaring parents away from vaccinating their youngsters places children at risk for a host of serious childhood diseases. The decision by three independent special masters is especially telling because the special court's rules did not require plaintiffs to prove their cases with scientific certainty -- all the parents needed to show was that a preponderance of the evidence, or "50 percent and a hair," supported their claims. The vaccine court effectively said today that the thousands of pending claims represented by the three test cases are on extremely shaky ground. In his ruling on one case, special master George Hastings said the parents of Michelle Cedillo -- who had charged that a measles, mumps and rubella (MMR) vaccine caused their child to develop autism -- had "been misled by physicians who are guilty, in my view, of gross medical misjudgment." Hastings said that he was deeply moved by the suffering autism imposed on families such as the Cedillos, but that "the evidence advanced by the petitioners has fallen far short of demonstrating . . . a link." The ruling today does not preclude appeals, and the lead lawyer in the Cedillo case has indicated that they would appeal if they lost. Two other special masters reached similar conclusions in their cases. The vaccine court was set up by Congress as part of what is known as the National Vaccine Injury Compensation Program. It was primarily designed to compensate the tiny fraction of people who suffer serious side effects from vaccines. Rather than have these victims sue vaccine makers in regular court -- potentially putting the manufacturers out of business and jeopardizing a major component of the country's public health infrastructure -- the court set up a "no-fault" system that required victims to prove to a special master only that vaccines harmed them, and not that anyone intentionally caused the harm. Thousands of cases charging childhood vaccines cause autism have been filed in the vaccine court in recent years. To simplify proceedings, the court initially decided to hear three cases that suggested different mechanisms by which vaccines might have caused autism. It was the rulings on those three cases that were announced today. Copyright 2009 Washington Post. Novartis Acquires Rights to Heart Drug By Ron Winslow Wall Street Journal Thursday, Friday 12, 2009 Novartis AG plans to announce Thursday it has obtained world-wide rights to an experimental heart drug that it hopes will rival the blockbuster Plavix and other medicines in the multibillion-dollar market for anticlotting agents. [plavix] Getty Images Plastic bottles of Plavix lie on a shelf in Ballin Pharmacy in Chicago. The Swiss pharmaceutical giant will pay Portola Pharmaceuticals Inc., a closely held South San Francisco, Calif., biopharmaceutical concern, $75 million to license the drug, called elinogrel. Portola said it would be entitled to additional payments of as much as $500 million based on meeting certain regulatory and commercial milestones, plus royalties on sales. If the drug is successfully developed, it would enter a lucrative but increasingly crowded and competitive market. Plavix, marketed jointly by Bristol-Myers Squibb Co. and Sanofi-Aventis SA, racked up $8.22 billion in sales last year and is currently the world's second best-selling drug after the cholesterol fighter Lipitor. Plavix is expected to face generic competition in the U.S. by 2011. Meantime, a new entry in the anticlotting market, to be called Effient and which will be co-marketed by Eli Lilly & Co. and Daiichi Sankyo Co. of Japan, is expected to be approved soon by the Food and Drug Administration in the wake of a favorable recommendation last week from an FDA advisory panel. Each of the anticlotting drugs reduces blood clots that can cause heart attacks and strokes by preventing the clumping together of blood platelets. Elinogrel is currently in midstage, or Phase II, tests among patients with heart blockages that are treated with balloon angioplasty procedures and propped open with tiny metal scaffolds called stents. Under terms of its agreement, Novartis will take over responsibility for late, or Phase III, testing, manufacturing and commercialization of the drug. The company expects to begin Phase III tests in 2010. Officials at both Novartis and Portola said early tests show that elinogrel acts almost immediately to prevent clots and that its anticlotting action can be quickly reversed. If those findings are replicated in larger trials, elinogrel would offer advantages over both Plavix and Effient, the officials said. In addition, elinogrel is being developed as both an intravenous drug and a pill, allowing it to be used for both patients with immediate blockages as well as for long-term clot prevention, said Mardi Dier, Portola's chief financial officer. "We believe this was a natural fit," said Joe Jimenez, chief executive of Novartis's pharmaceutical business. "The compound appears to be differentiated" from its rivals. He said that after FDA approval, elinogrel would expand the company's cardiovascular franchise beyond its current line of drugs for hypertension. Write to Ron Winslow at ron.winslow@wsj.com Copyright 2009 Wall Street Journal. More Smokers Quit if Paid, Study Shows By Robert Tomsho Wall Street Journal Thursday, February 12, 2009 Smokers who are paid to quit succeed far more often than those who get no cash reward, according to a new study that provides some of the strongest evidence yet that financial incentives can help change such behavior. The study, one of the largest of its kind, comes at a time when more employers, schools and other institutions are paying people to do everything from lose weight to improve their grades. The latest findings were published in this week's New England Journal of Medicine. Smoking is one of the nation's biggest causes of premature death. It is believed to kill about 480,000 Americans a year. About 20% of all U.S. adults smoke, which is down from about 25% 10 years ago. Although most smokers say they want to quit, research in recent years indicates that less than 3% of those who try every year succeed in doing so permanently. For the new study, researchers, led by a team from the University of Pennsylvania, tracked 878 General Electric Co. employees from around the country for a year and a half in 2005 and 2006. Participants, who smoked an average of one pack of cigarettes a day, were divided into two groups of roughly equal size. All received information about smoking-cessation programs. Members of one group also got as much as $750 in cash, with the payments spread out over time to encourage longer-term abstinence. Those participants got $100 for completing a smoking-cessation program, $250 if they stopped smoking within six months after enrolling in the study, and $400 for continuing to abstain from smoking for an additional six months. All participants were contacted three months after they enrolled in the study and periodically after that. Those who said they had stopped smoking at any point during the study were asked to submit saliva or urine samples for testing so that their claims could be verified. About 14.7% of the group offered financial incentives said they had stopped smoking within the first year of the study, compared with 5% of the other group. At the time of their last interview for the 18-month study, 9.4% of the paid group was still abstaining compared with 3.6% of those who got no money. Loretta Massie-Eaton, a 53-year-old administrative assistant who works for GE in Atlanta, said encouragement from her 14-year-old son, Harrison, was the main reason she decided to participate. But money was also a motivation, she said. "It was the satisfaction of sticking to the commitment and getting reimbursed for doing it," said Ms. Massie-Eaton, who says she hasn't had a cigarette since taking part in the study more than two years ago. Ric Barton, a GE lighting specialist from Cleveland, said he had been thinking about quitting before the study. A smoker for four decades, the 62-year-old said finding places to light up had become increasingly difficult and he was tired of rising cigarette prices. "It was icing for me to get a monetary reward for something I was already planning to do," Mr. Barton said. Smoking experts say previous studies have found little clear evidence that such financial incentives help in getting smokers to quit, although most have involved far fewer patients and much smaller incentives. According to the federal Centers for Disease Control and Prevention, which helped fund the study, smoking costs companies about $3,400 per smoking employee annually, or about $7.18 per pack of cigarettes, in health-care bills, reduced productivity and absenteeism. The study "shows that incentives work," said Steven Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco, who wasn't involved with the research. Helen Darling, president of the National Business Group on Health, a professional organization, said the findings give employers solid evidence that such incentives can help them save money on health-care costs for employees. "You'd prefer not to pay them, but it's worth it," she said. Robert Galvin, chief medical officer for GE and part of the study's research team, said that, as a result of the findings, his company is putting together a version of the incentive plan for all 152,000 of its U.S. employees, which it hopes to launch next year. Lead researcher Kevin Volpp, a professor at the University of Pennsylvania School of Medicine, said that while many employers already pay workers for behavioral changes, very few gather data in a way that allows them to measure the effectiveness of such efforts over time. Dr. Volpp acknowledged that his group's research has limits. The vast majority of study participants were similar demographically -- relatively well-educated, white and with higher incomes. He said that raises questions about how such programs would work with other groups of smokers. Kenneth Warner, director of the University of Michigan Tobacco Research Network, who wasn't part of the study, said the results were "very strong." But, he said, the recidivism rate suggests companies might have to keep paying ex-smokers to help deter them from starting up again. Write to Robert Tomsho at rob.tomsho@wsj.com Printed in The Wall Street Journal, page D1 Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. Recession seems to put people in the mood for condoms By Charisse Jones USA Today Wednesday, February 11, 2009 With a crippled economy forcing millions of cash-strapped Americans to entertain themselves at home, it's not surprising that one particular product is seeing a sales increase — condoms. While car purchases plummeted and designer clothes mostly stayed on the racks, sales of condoms in the U.S. rose 5% in the fourth quarter of 2008, and 6% in January vs. the same time periods the previous year, The Nielsen Co. reports The sales bump squares solidly with one of the nation's most common trends during any recession: nesting. At the same time, condoms make for a relatively inexpensive form of birth control at a time many cash-strapped families are hesitant to grow. "If people don't have the money to go out to a fancy dinner or are looking to cut back, Trojan gives them some real affordable ways to stay in and make some great memories together," says Jim Daniels, vice president of marketing for Trojan, the nation's No. 1 condom maker. Contraception may also be more popular during a time when families are stretching dollars and want to avoid having more mouths to feed. "Obviously people in general want to avoid … unintended pregnancies," Daniels says. "But in a down economy those costs are even more burdensome to bear." Pam Piligian of Fitzgerald+CO, the ad agency for Durex condoms, says that condoms are "recession resistant." Still, condom sales increased at a slower rate in 2008, going up 2.3% over the previous year, compared with a 5.5% increase just three years ago, according to research firm Information Resources. Marketers say they are aware of the need to continue reminding consumers that condoms are an inexpensive and healthy way to have fun. Piligian says that in a nod to the poor economy, Durex placed coupons last weekend in newspapers and is making more coupon offers on its website, trydurex.com. Carol Carrozza, vice president of marketing for Ansell Healthcare, maker of LifeStyles condoms, says that her company may incorporate the idea of nesting into future campaigns, along with a focus on new products. "We're mulling both … and trying to determine what kind of products and marketing strategies we can come out with that will help people during these recessionary times," she says. Trojan says the message that it's good to cocoon is already part of its promotions, and it will spend more on advertising this year than last as it launches a multimedia campaign to promote two new products. Trojan 2Go, a thin plastic case with a condom inside, hits store shelves this month while a new condom, Trojan Ecstasy, is scheduled for sale in the spring. Copyright 2009 USA Today. *Opinion* --- BACK TO TOP


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