Justices to Take Up Generic Drug Case





WASHINGTON — The Supreme Court said on Friday that it would decide whether a pharmaceutical company should be allowed to pay a competitor millions of dollars to keep a generic copy of a best-selling drug off the market.







Stephen Crowley/The New York Times

Ralph Neas, head of the Generic Pharmaceutical Association, said the case would alter the marketing of new generics.







The case could settle a decade-long battle between federal regulators, who say the deals violate antitrust law, and the pharmaceutical industry, which contends that they are really just settlements of disputes over patents that protect the billions of dollars they pour into research and development.


Three separate federal circuit courts of appeal have ruled over the last decade that the deals were allowable. But in July a federal appeals court in Philadelphia — which covers the territory where many big drug makers are based — said the arrangements were anticompetitive.


Both sides in the case supported the petition for the Supreme Court to decide the case, each arguing that the conflicting appeals court decisions would inject uncertainty into their operations.


By keeping lower-priced generic drugs off the market, drug companies are able to charge higher prices than they otherwise could. Last year, the Congressional Budget Office estimated that a Senate bill to outlaw those payments would lower drug costs in the United States by $11 billion and would save the federal government $4.8 billion over 10 years.


Senator Charles E. Grassley, an Iowa Republican who co-sponsored the Senate bill, which never came to the floor for a vote, praised the decision.


The Federal Trade Commission first filed the suit in question in 2009. Jon Leibowitz, chairman of the F.T.C., said, “These pay-for-delay deals are win-win for the drug companies, but big losers for U.S. consumers and taxpayers.”


Generic drug makers say that the payments preserve a system that has saved American consumers hundreds of billions of dollars.


“This case could determine how an entire industry does business because it would dramatically affect the economics of each decision to introduce a new generic drug,” Ralph G. Neas, president of the Generic Pharmaceutical Association, said in a statement. “The current industry paradigm of challenging patents on branded drugs in order to bring new generics to market as soon as possible has produced $1.06 trillion in savings over the past 10 years.”


The case will review a decision by the United States Court of Appeals for the 11th Circuit, based in Atlanta, which in the spring ruled in favor of the drug makers, Watson Pharmaceuticals and Solvay Pharmaceuticals. Watson had applied for federal approval to sell a generic version of AndroGel, a testosterone replacement drug made by Solvay.


While courts have long held that paying a competitor to stay off the market creates unfair competition, the pharmaceuticals case is different because it involves patents, whose essential purpose is to prevent competition.


When a generic manufacturer seeks approval to market a copy of a brand-name drug, it also often files a lawsuit challenging a patent that the drug’s originator says prevents competition.


Last year, for the third time since 2003, the 11th Circuit upheld the agreements as long as the allegedly anticompetitive behavior that results — in this case, keeping the generic drug off the market — is the same thing that would take place if the brand-name company’s patent were upheld.


Two other federal circuit courts, the Second Circuit and the Federal Circuit, have ruled similarly. But in July, the Third Circuit Court of Appeals said that those arrangements were anticompetitive on their face and violated antitrust law.


The agreements are also affected by a peculiar condition in the law that legalized generic competition for prescription drugs. That law, known as the Hatch-Waxman Act, gives a 180-day period of exclusivity to the first generic drug maker to file for approval of a generic copy and to file a lawsuit challenging the brand-name drug’s patent.


Brand-name drug companies have taken advantage of that law, finding that they can settle the patent suit by getting the generic company to agree to stay out of the market for a period of time. Because that generic company also has exclusivity rights, no other generic companies can enter the market.


Michael A. Carrier, a professor at Rutgers School of Law-Camden, said that while there were provisions in the law under which a generic company could forfeit that exclusivity, “they really are toothless in practice.”


One wild card could still prevent the Supreme Court from definitively settling the question. In granting the petition to hear the case, the Supreme Court said that Justice Samuel A. Alito Jr. recused himself, taking no part in the consideration or decision.


That opens the possibility that a 4-4 decision could result, upholding the lower court case that went against the F.T.C. and in favor of the drug makers. But it would leave the broader question for another day.


The case is Federal Trade Commission v. Watson Pharmaceuticals et al, No. 12-416.


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Integrys Energy Services tapped to supply Chicago's electricity









The same company that heats homes in Chicago has been picked to provide the electricity that powers them.


Integrys Energy Services, a sister company to Peoples Gas, on Friday was named the city's choice to supply electricity to about 1 million Chicagoans. It's the largest such deal negotiated by a city on behalf of its residents.


The City Council is to vote on the contract Wednesday after a Monday public hearing.





Chicagoans should see discounts of 20 to 25 percent from March through June. Afterward, savings are expected to drop. Overall, the average household is expected to save $130 to $150 through May 2015, when the contract ends, according to the mayor's office.


Mayor Rahm Emanuel said Friday the deal "will put money back into the pockets of Chicago families and small businesses."


The contract calls for the elimination of power produced from coal, the largest source of greenhouse gases. About 40 percent of Chicago's electricity is from coal.


"That's a giant step toward healthier air and clean, renewable energy that supports good paying jobs in the technologies of tomorrow," said Jack Darin, executive director of the Sierra Club's Illinois chapter and a member of the advisory committee that worked on the deal.


However, the no-coal provision is largely symbolic since there is no way to know the precise origin of electricity flowing into Chicago homes.


Integrys Energy Services, a subsidiary of Chicago-based Integrys Energy Group, was chosen from eight bidders and was the only company other than Exelon-owned Constellation NewEnergy that made it to the final round.


Integrys Energy Group's board includes William Brodsky, head of the Chicago Board Options Exchange and a member of World Business Chicago, which Emanuel chairs.


The Integrys unit won the electrical aggregation contract despite Emanuel's connection to Constellation through its parent company, Exelon, which also owns Commonwealth Edison. While working at investment banking firm Wasserstein Perella & Co. after leaving the Clinton White House in 1998, Emanuel helped set up the merger that created Exelon.


Price was the determining factor, the mayor's office said.


Bidding documents, including pricing and how the contract would be structured, were not made public Friday.


In picking a price, Integrys must account for a large number of customers that will come and go. If electricity prices rise, Integrys risks losing money. Still, Integrys stands to become a dominant player in the retail electricity business and gain about $300 million in yearly revenue.


"Scale is important in this business," said Travis Miller, a utilities analyst with Chicago-based Morningstar. "The winner is immediately going to gain a huge scale advantage within the retail market."


ComEd still will be responsible for delivering electricity and fixing outages. ComEd makes its money delivering electricity, not supplying it. Customers' new bills will look like the old bills, except that the portion titled "electricity supply services" will have a new rate and include the new supplier's name.


Chicagoans can opt out and stick with ComEd or choose their own supplier like thousands of people already have.


Tribune reporter John Byrne contributed.


jwernau@tribune.com


Twitter @littlewern





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Preckwinkle blasts Emanuel, quickly backs off









Cook County Board President Toni Preckwinkle on Thursday quickly backed off a public barb she tossed at Mayor Rahm Emanuel for his crime-fighting strategy, marking the second time in a little more than three months she has toned down off-the-cuff remarks.

This time, the first-term Democrat retreated after saying the mayor and his hand-picked police superintendent, Garry McCarthy, were too focused on arrests as a solution to rising violence and not enough on improving a "miserable" public school system and beefing up youth programs.

"Clearly this mayor and this police chief have decided the way in which they are going to deal with the terrible violence that faces our community is just arrest everybody," Preckwinkle said during a question-and-answer session after delivering a Union League Club luncheon speech on her second anniversary in office. "I don't think in the long term that's going to be successful.

"We're going to have to figure out how to have interventions that are more comprehensive than just police interventions in the communities where we have the highest rates of crime. And they're almost all in African-American and Latino communities."

When Preckwinkle faced reporters minutes later, she said Emanuel is working to improve schools and youth programs. She added that her criticism of the public schools controlled by Emanuel was aimed at society as a whole and not the mayor personally.

The Emanuel flap follows Preckwinkle's remarks about former President Ronald Reagan. In late August, the blunt-talking Preckwinkle took aim at Reagan's legacy. Later she said she regretted saying he deserved "a special place in hell" for his role in the war on drugs.

At the luncheon Thursday, Preckwinkle was asked what she could do to address city violence, which has drawn national attention this year with a spike in the city's murder rate and brazen incidents like the fatal shooting of a young man at a funeral for a reputed gang member.

Preckwinkle said much of the problem results from a Chicago school system with a low high school graduation rate.

"We have contented ourselves with a miserable education system that has failed many of our children," Preckwinkle said, adding that more after-school enrichment and job-training programs were needed. "I'm talking about the kids who don't graduate, let alone the kids who graduate (who) don't get a very good education, even with a high school diploma."

Emanuel aides offered a restrained response.

"Mayor Emanuel strenuously agrees that a holistic approach is necessary to successfully address crime," Emanuel spokeswoman Sarah Hamilton said in a statement. "His multipart strategy ranges from improving early childhood education, providing a longer school day and creating re-engagement centers for youth, to delivering wraparound services, revitalizing the community policing program and working to prevent retaliatory actions by gangs.

"All of these work in tandem, but let's make no mistake, criminals deserve to be arrested," Hamilton wrote.

Emanuel and McCarthy have directed additional police resources into troubled South Side and West Side neighborhoods, combined with additional social services and community-building efforts. Emanuel also dedicated $9 million in additional funding next year for early childhood education, after-school programs and jobs, children's eye exams and programs that address domestic violence.

Reminded of those initiatives, Preckwinkle acknowledged that Emanuel is putting more city money into such programs, some of which are coordinated with the county. She said her criticism of schools wasn't directed at Emanuel, who appoints the Chicago Public Schools board and picks the system's CEO.

"This was a critique of all of us. It wasn't aimed at the mayor," said Preckwinkle, a former CPS high school history teacher.

The point, Preckwinkle said, is that education over the long run will do more to quell violence than arresting people and locking them up.

"You know unfortunately we live in a country in which we are much more willing to spend money on keeping people in prison than we are on educating them in our public schools," she said. "And that's disgraceful. It reflects badly on all of us."

She added, "I don't think we are going to arrest our way out of our violence problems."

Preckwinkle has frequently criticized a justice system that she says locks up African-American and Latino men in far greater numbers than their white counterparts, particularly for drug crimes, when studies show drugs are used in equal numbers across ethnic and racial boundaries.

<em><a href="mailto:hdardick@tribune.com">hdardick@tribune.com</a></em>

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Minecraft sells almost 4.5 million copies on Xbox 360 as other indie games continue to struggle












Big-budget games such as Halo 4 and Call of Duty: Black Ops II might brag about how they rule the Xbox 360 in terms of sales, but indie games can also compete – if they’re addictive enough and offer enough value. Take Minecraft, an indie game developed by Markus “Notch” Persson’s company Mojang. According to Mojang, Minecraftan indie game originally made for PC and ported to the Xbox 360 seven months ago has sold 4,476,904 copies as of the end of November with 40,000 to 60,000 copies sold every week. Minecraft is an anomaly because it doesn’t boast high-definition graphics that ooze of detailed lighting effects and didn’t cost millions of dollars to make, and yet it is the third-most played game on Xbox LIVE.


According to Gamasutra’s analysis and breakdown of November’s Xbox Live Arcade sales, only three other indie games managed to break 1 million copies downloaded last month. See below for the chart.












As you can see, every other game on Xbox Live Arcade other than Castle Crashers, Fruit Ninja Kinect, Happy Wars and Counter Strike: GO isn’t seeing the same type of success Minecraft is.


The lesson here is developers should always focus on the product and the users. If the gameplay mechanics are solid, the experience is fluid and bug-free, the gamers will come.


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George Zimmerman sues NBC and reporters












ORLANDO, Fla. (AP) — George Zimmerman sued NBC on Thursday, claiming he was defamed when the network edited his 911 call to police after the shooting of Trayvon Martin to make it sound like he was racist.


The former neighborhood watch volunteer filed the lawsuit seeking an undisclosed amount of money in Seminole County, outside Orlando. Also named in the complaint were three reporters covering the story for NBC or an NBC-owned television station.












The complaint said the airing of the edited call has inflicted emotional distress on Zimmerman, making him fear for his life and causing him to suffer nausea, insomnia and anxiety.


The lawsuit claims NBC edited his phone call to a dispatcher in February. In the call, Zimmerman describes following Martin in the gated community where he lived, just moments before he fatally shot the 17-year-old teen during a confrontation.


“NBC saw the death of Trayvon Martin not as a tragedy but as an opportunity to increase ratings, and so set about to create a myth that George Zimmerman was a racist and predatory villain,” the lawsuit claims.


NBC spokeswoman Kathy Kelly-Brown said the network strongly disagreed with the accusations made in the complaint.


“There was no intent to portray Mr. Zimmerman unfairly,” she said. “We intend to vigorously defend our position in court.”


Three employees of the network or its Miami affiliate lost their jobs because of the changes.


Zimmerman is charged with second-degree murder but has pleaded not guilty, claiming self-defense under Florida’s “stand your ground law.”


The call viewers heard was trimmed to suggest that Zimmerman volunteered to police, with no prompting, that Martin was black: “This guy looks like he’s up to no good. He looks black.”


But the portion of the tape that was deleted had the 911 dispatcher asking Zimmerman if the person who had raised his suspicion was “black, white or Hispanic,” to which Zimmerman responded, “He looks black.”


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Lurie Children's Hospital sees surge in patients at new Chicago building









Executives at the Ann & Robert H. Lurie Children's Hospital of Chicago expected a "bump" in patients when the $855 million hospital opened in June.


They weren't prepared for a mountain.


Since the former Children's Memorial traded its patchwork of aging buildings in Lincoln Park for a new high-rise in Streeterville on June 9, patient volume has surged, more than doubling hospital projections.





The number of patients is up about 16 percent in the first five months, according to hospital data, an increase driven by an influx of children with more acute health problems, including transplant patients, kids with heart problems and others in need of specialized care.


Revenue over that five-month period increased 12.9 percent to $222 million.


"We expected to have a new-hospital bump in (patients). We had a new-hospital mountain," said Michelle Stephenson, Lurie Children's chief patient care services officer and chief nurse executive. "We've had some months where the (number of inpatients) was 24 percent over what we expected. "


To meet the demand, the hospital hired 151 nurses to ensure full coverage, she said.


Those new hires came on top of about three dozen pediatric specialists and department heads Lurie Children's recruited in the run-up to the hospital opening.


Stephenson said the hospital has yet to determine the specific reasons behind the jump in patients, but said data shows it is drawing more children from the collar counties and downstate.


She also cited the location, adjacent to Northwestern Memorial Hospital, Northwestern University's Feinberg School of Medicine and Prentice Women's Hospital, which is connected to Lurie via an enclosed skyway.


Moving 31/2 miles south next to Prentice, which sends Lurie about a quarter of its patients, is likely a significant factor in the patient boom, said Jay Warden, a senior vice president at The Camden Group, a consulting firm.


"It used to be a challenge for moms to have a baby transferred to Children's while they had to stay at Prentice until they're discharged," Warden said. "Now it's the best of both worlds for both hospitals."


Warden said hospitals typically get a burst of new patients when they open facilities, in part because of the accompanying marketing and publicity blitz. That's not always the case with children's hospitals, which tend to serve the sickest and smallest of patients who have few other options.


He said limitations at the old hospital likely kept some patients away.


Indeed, Children's Memorial had a listed capacity of 247 beds, but with shared rooms and other factors, executives considered the hospital full at 220 patients, Stephenson said. The Lurie hospital has a capacity of 288 beds in all-private rooms, which it has come close to filling on a few occasions.


One ward that's consistently bursting at the seams is the neonatal intensive care unit, which was built to handle 44 patients but is averaging about 50. Some of the children have been bumped into shared space in the hospital's cardiac care unit, Stephenson said.


As for patients, the new facility has been a hit, with satisfaction scores up an average of 10 percent, hospital officials said.


Tina Sneed, whose 18-year-old daughter Whitney Ballard recently underwent a liver transplant at the hospital, said she's happy with the expanded rooms and new areas for parents.


She and her daughter have made several 7-hour trips from Kentucky in the last 18 months to see specialists, including overnight stays at both facilities.


Her only complaint?


"The waiting room was kind of crowded," she said. "It was nothing too bad, they just have so many (surgeries) going on at the same time we barely had room to move in there."


pfrost@tribune.com


Twitter @peterfrost





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Police break up dog fight in Dolton













Tribune illustration


Tribune illustration
(Tribune illustration / March 19, 2012)




















































Police rescued up to ten dogs from a dog fighting ring in Dolton on Wednesday night, authorities said.

Someone called police in the south suburb and told them about the dog fighting in the 1500 block of East 142nd Street and responding officers "were able to observe the incident and apprehend suspects at the scene," said TaQuoya Kennedy, a spokeswoman for Dolton.

“The dogs (pit bulls) showed signs of improper care and abuse / indications of dogfighting,” she said in a statement late Wednesday.“We have numerous suspects in custody, and we have called out the Cook County unit that investigats dog fighting to assist us with the charges and ongoing investigation.”

Cook County sheriff’s police were alerted to the dog fights by Dolton police and are assisting in the investigation.

“They called us immediately, knowing we handle this stuff all the time,” said Frank Bilecki, spokesman for the Cook County Sheriff’s Office.

Evidence technicians, animal crimes investigators and animal control are still at the scene, Bilecki said. 

"When police hit the building people fled out of there ... We’re told that there might be cameras. Police are going to be out there for a little bit gathering evidence," Bilecki said.

Two males are in custody, but their ages weren't immediately available, Bilecki said.

Kennedy said at least four dogs were found along with a makeshift ring. Bilecki said police found as many as 10.

pnickeas@tribune.com
Twitter: @peternickeas


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Obama leads heads of state atop Forbes 2012 power list












NEW YORK (Reuters) – When it comes to power, politics trumps business, according to a new Forbes ranking on Wednesday that found heads of state occupying six of the top 10 spots among the world’s most powerful people, led by President Barack Obama.


The annual list selected what Forbes said were the world’s 71 most-powerful people from among the roughly 7.1 billion global populace, based on factors ranging from wealth to global influence.












Obama was joined in the top 10 by German Chancellor Angela Merkel, Russian President Vladimir Putin, King Abdullah bin Abdulaziz al Saud of Saudi Arabia and British Prime Minister David Cameron.


The list’s highest-ranked businessman was Microsoft co-founder Bill Gates at No. 4. U.S. Federal Reserve Chairman Ben Bernanke and European Central Bank President Mario Draghi, both public officials, also made the top 10.


“This year’s list reflects the changing of the guard in the world’s two most powerful countries: the United States and China,” Michael Noer, Forbes‘ executive editor, told Reuters in an email.


Noer noted that China’s President Hu Jintao, last year’s third most-powerful person, fell off the list as he is leaving power, and his successor, Xi Jinping, ranked ninth instead.


Both U.S. Treasury Secretary Timothy Geithner and Secretary of State Hillary Clinton, who have stated they will not be serving in Obama’s second term, were not in this year’s rankings.


While elected and appointed officials and business people made up the vast majority of Forbes’ most powerful, Pope Benedict XVI placed fifth in the rankings.


Among the oddities was Joaquin Guzman Loera at No. 63.


Loera, far from a household name, is a billionaire nicknamed “El Chapo” who as head of Mexico’s Sinaloa cartel is the world’s most powerful drug trafficker, according to Forbes.


Age was also not a barrier, with two of the youngest and oldest of this year’s most powerful — 28-year-old Facebook CEO Mark Zuckerberg and 81-year-old News Corp CEO Rupert Murdoch — back-to-back at numbers 25 and 26, respectively.


Forbes noted that Zuckerberg fell out of last year’s top 10 after Facebook’s IPO disappointed. A gainer, meanwhile, was Brazilian President Dilma Rousseff, who moved up four spots to No. 18 despite being only halfway into her first term of office.


To create the rankings, which Forbes readily concedes bore a measure of subjectivity, editors graded candidates on four criteria for power and averaged the four grades:


– Power over many people


– Control over financial and other valuable resources


– Power in multiple spheres or arenas


– Active use of power


Some measures, such as power over many people, favored leaders such as the Pope, while the world’s richest man — Mexican telecom magnate Carlos Slim Hula, worth a reported $ 72 billion — placed 11th on the strength of his wealth.


Others, such as New York’s billionaire Mayor Michael Bloomberg, scored high in all areas, placing him at No. 16.


Noer said that Elon Musk, one of the co-founders of Paypal and Tesla Motors, was “one of the more interesting newcomers” on the list due to his SpaceX company, a private space exploration venture.


“With NASA retiring the space shuttle fleet, private companies like SpaceX have been awarded huge contracts to do things like resupply the International Space Station. The commercialization of space is just beginning, but we expect it to be big business,” Noer said.


Former President Bill Clinton placed 50th, with editors noting that by hitting the campaign trail for Obama, Clinton “cemented his status as a kingmaker”, along with his nonpartisan Global Initiative raising more than $ 71 billion in commitments to fund charitable action worldwide.


Other high-ranking heads of state included French President Francois Hollande at No. 14, Indian Prime Minister Manmohan Singh at No. 19 and Iran’s Grand Ayatollah Ali Hoseini-Khamenei at No. 21.


Among businessmen in the top 20 were Berkshire Hathaway CEO Warren Buffett at No. 15, Wal-Mart CEO Michael Duke at No. 17 and Google co-founders Larry Page and Sergey Brin at No. 20.


The entire list can be found at www.forbes.com/power as well as the December 24 issue of the magazine.


(Reporting by Chris Michaud, Editing by Piya Sinha-Roy and Andrew Hay)


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Extended Use of Breast Cancer Drug Suggested


The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.


In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.


“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.


Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.


“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”


Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.


Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.


About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.


The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.


In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.


About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.


There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.


Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.


“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.


Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.


Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.


“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.


Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.


“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”


Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.


Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.


The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.


Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.


Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.


Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.


The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.


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Bill passes to fast-track foreclosure of abandoned properties in Ill.









The Illinois General Assembly passed a bill Wednesday that would fast-track the foreclosure process for abandoned, vacant homes while funding foreclosure prevention efforts throughout the state.

The legislation, which now will be considered by Gov. Pat Quinn, could shrink to 90 to 100 days a residential foreclosure process that can take as long as two years in Illinois. It also would require lenders to pay additional fees to file foreclosure actions, and the estimated $41 million in fees collected annually would be used to fund homeowner foreclosure counseling and prevention efforts.

The measure was passed by the Senate Wednesday and the House Tuesday.

"It empowers communities and municipalities to have the funding necessary to maintain and stabilize communities," said Sen. Jacqueline Collins, D-Chicago, the chief sponsor of the bill in the Senate. "It's the first step to putting some stability in the housing market."

Lenders could ask courts to fast-track foreclosures for abandoned single-family homes and multifamily buildings that have six units or fewer and are not legally occupied by a homeowner or another occupant. The shortened timeline could also apply to homes under construction where no activity has taken place for at least six months and there has been damage to the property. It would not apply to vacant buildings that are secured but are either for sale, part of a probate action or comply with local regulations.
 
"In most neighborhoods, there is still some kind of market," said Adam Gross, director of affordable housing at Business and Professional People for the Public Interest, which helped craft the bill. "It's not a vibrant market, but there's some kind of market. If you have a property that sits vacant for 600 days, whatever neighborhood it is, it's going to be worth a lot less at the end of 600 days than at the beginning of that 600 days. This has the potential to be beneficial in every neighborhood."

In addition to the $50 filing fee charged to lenders in foreclosure actions, the legislation also would require lenders that filed at least 175 foreclosure complaints during the previous calendar year to pay an additional $500 per foreclosure complaint. Those that filed at least 50 to 174 foreclosure actions would pay an extra $250 and those that filed no more than 49 foreclosure actions will be assessed an extra $50 fee.

Seventy percent of the collected fees would be used to help municipalities offset their costs to secure and maintain neglected buildings. Most of the remaining funds would be used to make grants to assist foreclosure prevention programs and housing counseling programs throughout the state.

The bill's proponents estimate that the additional housing counseling funds could benefit 18,000 homeowners annually, while the ability to speed the foreclosure process for abandoned homes by as much as 17 months could save lenders $43,000 to $89,000 per property. Using a conservative estimate of 5,000 foreclosure cases fast-tracked annually, that would generate savings to the financial industry of almost $214 million a year.

Under the bill, Chicago aldermen also would receive notices of foreclosure on properties in their wards.

The bill would take effect June 1.

mepodmolik@tribune.com | Twitter @mepodmolik

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