Betsy Ryan has just been named to replace Gary Carter as president and
chief executive officer of the New Jersey Hospital Association; she
will assume her new position at the end of June. In the meantime, she
says, "I get to have one of best hospital executives in the nation
show me the ropes."
Ryan always had a healthy interest in the political process and public
policy, but she had her mind set on becoming a lawyer as early as her
freshman year at Rutgers University’s Cook College. After graduating
with a degree in political science in 1982, she went straight to Seton
Hall University School of Law, followed by a clerkship with a Mercer
County judge and two years in private practice with a small Mount
In the late 1980s when she stepped over into the policy realm. She
took a job with the New Jersey Election Law Enforcement Commission,
which regulates money issues around New Jersey candidates for public
office. She then worked as assistant counsel for Governor Jim Florio,
focusing on health-care policy and legislation.
In 2000 she was hired by the New Jersey Hospital Association as
general counsel. She was subsequently named chief operating officer,
and in the spring will become president.
She prepares to take on this job at a time when insufficient
reimbursement of hospitals, in particular by government payers but
also by some commercial ones, is destroying hospitals’ viability. "In
New Jersey one of the big payers for the disadvantaged is Medicaid,
and the reimbursement rate is woefully inadequate," says Ryan,
explaining that Medicaid covers only 69 percent of inpatient costs.
Medicare is a little better, but still does not cover costs. As a
result, New Jersey has had five hospital bankruptcies and two hospital
closures in the past several months.
The hospitals’ hands are tied. Under New Jersey law, all are required
to treat everybody. "If anyone presents, we must provide soup to nuts
care, including surgery and treatment in outpatient clinics," says
Ryan. "It is laudable, but we are woefully underpaid to provide care."
The state’s hospitals provided roughly $1.6 billion in charity care
services to needy New Jerseyans in 2006. But the state budget for 2008
allocates only $716 million to reimburse hospitals for this care.
Another critical area for healthcare is patient safety. To deal with
safety issues, the New Jersey Hospital Association has established
what it calls "collaboratives," which bring together experienced
personnel from different hospitals. One success was reducing the
incidence of bedsores, or pressure ulcers, by 70 percent in the
nursing homes and hospitals that participated. Once acquired, these
sores are difficult to get rid of, painful, and subject to infection.
The participants in this collaborative first agreed on best practices,
which were not always being followed. "It wasn’t routine to
immediately do an assessment of the skin of all patients of a certain
age in certain clinical categories and to always ensure that the
patient is moved a certain amount of times," says Ryan. The model
developed by the collaborative has gotten national attention; it has
been recognized by the Centers for Medicare and Medicaid Services, and
speakers from the New Jersey Hospital Association have been invited to
other states and even to Europe to discuss its efforts. Other
collaboratives are working to reduce the incidence of infections
related to catheters and central lines.
Another area of focus is MRSA infections. The association, for
example, strongly supported a bill recently signed into law that
requires reporting of infections in four disease categories, which
will make reporting more uniform across the state. Another bill,
passed by the New Jersey legislature in August, requires all patients
in intensive-care units to be tested for MRSA. Of course, the top way
to prevent MRSA infections is to have both professionals and patients
wash their hands. "We’re doing everything we can," says Ryan. "Don’t
forget that the incidence of MRSA has gone down in New Jersey despite
everything you are reading. We’re on top of it."
Both individual hospitals and the state government are now working to
bridge the gap between the high costs for patient care and the low
level of reimbursement.
"Hospitals are doing all they can to try to improve themselves," says
Ryan, "to market themselves to patients who can pay." As a result,
they are having to make capital expenditures to stay current with
available technology, in order to attract the paying patients who will
help keep their doors open.
To advise the state about the health-care system, Governor Corzine
created the Commission on Rationalizing Health Care Resources, headed
by Uwe Reinhardt, a health economist at Princeton University. Its
interim report, released at the end of June, analyzes the financial
condition of the state’s acute-care hospitals and outlines a method
for determining which hospitals are essential. Its final report
addresses access and equity for the medically underserved.
Although competition may be generally good for hospitals, Ryan is
concerned – with 18 hospital closures in the last 10 years – that it
is no longer a matter of the herd being thinned. "I’m worried that
we’re getting beyond the thinning stage," she says.
– Michele Alperin
From Survivor To Entrepreneur
Kevin Zepp, 28, is a cancer survivor, diagnosed at age 21 with
advanced testicular cancer. He went to Lance Armstrong’s doctor,
Indianapolis-based Lawrence Einhorn, who prescribed a similar but
stronger protocol than Armstrong had, and he took that chemotherapy at
the University of Pennsylvania. "Now I am free and clear," he says.
But Zepp’s close encounters with the medical profession instigated his
own career in healthcare. "I am basing my business on how I have seen
my parents be caregivers," he says. Last fall Zepp bought a
five-year-old firm, Liberty Healthcare Services, an accredited
homecare provider that is reimbursable by Medicaid, veterans’
benefits, HMOs, as well as private payments. His goal is to take a
personalized hands-on approach to every aspect of running a
traditional homecare agency.
The previous owner, Keith Shevlin, had expanded the business last
summer with a move from 1603 South Broad to 1,650 square feet at 2333
Whitehorse-Mercerville Road. Both buyer and seller worked with a
business broker, Chip Measells of Wyatt Matas in Washington, D.C.
With six current employees in the office, and about 100 in the field,
Zepp plans to open offices, or buy other agencies, in Toms River and
Burlington County within the next 18 months. "It can be more practical
to combine two agencies than to start one from the ground up," he
Zepp is a Medford native who now lives in Mount Laurel. His father
owns a construction equipment company, and his brother is a computer
science major at Rowan University. After majoring in accounting at the
University of Richmond, Zepp was an auditor for a national healthcare
lender, CIT, traveling to all kinds of healthcare facilities and
businesses to conduct due diligence for acquisition, merger,
restructuring and recapitalization financing. Then, after completing a
management training program with Universal Health Services, the third
largest hospital chain in the country, he went to west Texas, where he
was one of the youngest hospital CFOs in the nation.
After those experiences, he did not want to buy a franchise. "I don’t
believe in franchised health care. I wanted a business small enough to
get my hands around it. We pride ourselves that we are individually
Zepp’s clients pay an average of $18 an hour for a 15-hour week, or
$14,000 a year. Round the clock live-in care costs $62,000 a year.
This contrasts to the $50,000 and up that a nursing home costs, but
insurance sometimes pays for part of the nursing home fees.
His biggest competition is the underground networks that pay cash
under the table ."Most people don’t know that the healthcare workers
would not be covered under their homeowners policies," he says.
Zepp also is looking at advanced caregiving technologies, such as
bundling hands-on care with virtual visits and partnering with an
emergency response company to provide smart bracelets and the latest
in monitoring devices and in-home thermal and motion sensors. "Some
don’t want or need someone in their house every single day, but the
virtual visits would add to the comfort level of the family."
With the goal of being a one-stop agency, Zepp plans to have a small
stable of recommended attorneys and social workers. For right now,
though he is focusing on publicity. "I went to get our name out there
and build up the brand."
Zepp is active in the cancer advocacy community and is a legislative
ambassador for the American Cancer Society, traveling to share his
story of survivorship with congressional representatives. Says Zepp:
"I truly believe the cure will be found in my lifetime."
– Barbara Fox
Liberty Healthcare Services Inc., 2333 Whitehorse-Mercerville Road,
Suite B, Hamilton 08619; 609-890-0311; fax, 609-890-3499. Kevin Zepp,
Illness Launches a Search for a Cure
Christopher J. Schaber, president and chief executive officer of DOR
BioPharma, joined the company in August, 2006, for a very personal
reason – his father has multiple myeloma and will shortly undergo a
stem cell transplant. Because DOR’s lead product treats the
gastrointestinal graft-versus-host disease that may follow his
father’s transplant, he wants to move it to market as quickly as
"I took on more of a personal charge to get this drug out there," says
Schaber. "Having it hit so close to home, and knowing what this
process of cancer can do to my family, I figure it is similar or worse
DOR, which relocated from Miami to Princeton in October, was founded
in the late 1980s. After a series of transitions and mergers DOR now
focuses on products that treat life-threatening side effects of cancer
treatments and serious gastrointestinal diseases as well as vaccines
for certain bioterrorism agents. Schaber initiated the move to New
Jersey as soon as he had the opportunity, without disrupting
regulatory filings, because this area is closer to home for a number
of DOR’s employees.
DOR’s lead product, orBec, treats graft-versus-host disease (GvHD), a
serious side effect of bone marrow or stem cell transplants that do
not come from the patient’s own body (which is the optimal source).
For leukemias these autologous transplants are often times not
possible, and donors are sought either among siblings or, if
necessary, from a stranger.
The first step in a transplant is treatment with radiation and
chemotherapy to kill cancer cells. These harsh measures, however, also
kill good cells and compromise the immune system. As a result, the
healthy donor cells administered during the transplant will often
attack the patient’s body, particularly the skin, liver, and
gastrointestinal tract. They will strip away the thin tissue lining of
the GI tract’s interior, leaving open inflammation through which
bacteria from the stomach or the intestines may enter the blood system
and cause infections.
Gastrointestinal graft-versus-host disease, because of its similarity
to ulcerative colitis and Crohn’s Disease, is currently treated with a
high dose of Prednisone, a systemic steroid with a host of detrimental
side effects when given for extended periods of time. Prednisone
quickly enters the bloodstream where high dosages taken for too long
can damage or weaken the body, increasing the likelihood of infection,
bone demineralization, muscle atrophy, hypertension, and even
psychiatric effects like depression.
Patients with graft-versus-host disease typically must stay on
Prednisone for four to six weeks, then taper off slowly. The whole
weaning process can take up to eight to ten weeks. But the cure can be
as bad as the disease, and indeed extended use of Prednisone can
result in a patient’s death. "Typically these patients succumb to the
systemic steroids they are taking, not to their graft-versus-host
disease," says Schaber. "The mortality rate is 25 percent in these
very sick patients."
Graft-versus-host disease is an orphan disease, or a disease that
affects a relatively small number of people. Of the approximately
12,000 transplants from strangers each year in the United States,
about half of the patients will develop gastrointestinal
graft-versus-host disease, about 5,000 cases per year. That is the
group for whom DOR’s treatment is designed.
"Like many biotech companies, we are going after something the big
pharmas wouldn’t bother with," says Schaber. He estimates the
worldwide market to be over $100 million, but as more patients are
getting transplants from other people, the patient population will
DOR BioPharma’s orBec is a new formulation of a topically active
steroid that has been used for 20 years as an aerosol to treat asthma
patients. DOR has developed a two-pill oral delivery system to treat
gastrointestinal graft-verus-host disease. One pill is an immediate
release tablet that dissolves quickly and treats the upper
gastrointestinal tract and stomach, and the other is a time release
that passes from the stomach to the small intestine and treats the
lower gastrointestinal tract.
The drug’s uniqueness lies in its being a topical rather than a
systemic steroid. It treats at the point of inflammation and less of
it is drawn into the bloodstream – 30 to 40 percent as opposed to
nearly 100 percent with Prednisone.
In 2004 DOR completed its first phase 3 trial of orBec in 129
patients. Although the trial’s primary end point did not achieve
statistical significance, orBec did demonstrate some success in
controlling graft-versus-host disease. For example, there was a 66
percent reduction in mortality at 200 days post-transplant among
patients taking orBec, with only 5 deaths as compared to 16 among
patients taking a placebo. Other key secondary end points were also
DOR filed a new drug application with the FDA, but after a long
review, including a meeting with the advisory committee of the FDA,
the company received a not-approvable letter on October 18. Schaber
attributes the lack of approval to missing the primary endpoint even
though he believes the data was compelling.
People at the Food and Drug Administration have been working closely
with DOR to put together a confirmatory phase 3 clinical trial. The
FDA appears to be interested in getting the drug out to this small
patient population his company is targeting, says Schaber, who
suggests there may be ways to expand access to the drug to patients
outside of the protocol under what is called compassionate care
DOR’s pipeline contains a number of other products, a number of them
in the preclinical phase. A phase 2 trial is now enrolling to use
orBec for prevention of graft-versus-host disease, and DOR is
exploring the use of orBec’s active ingredient to treat
gastrointestinal radiation injury. Other efforts involve Oraprine,
which uses a different immunosuppressant drug to treat oral lesions of
the mouth associated with graft-versus-host disease, and an oral drug
delivery system to encapsulate Leuprolide, a drug for the treatment of
prostate cancer and endometriosis that today is injectable only.
DOR BioPharma’s biodefense division has responded to post-9/11
concerns by developing vaccines to treat ricin toxin and botulinum
toxin. "We believe we are ahead of everyone else on in the deveopment
of a ricin vaccine," says Schaber. DOR has treated humans with the
vaccine, showing it can generate antibodies without bad side effects.
The vaccine has also been able to protect animals from high doses of
toxins that otherwise would have killed them.
This biodefense work is funded entirely by government grants of
approximately $5 million between the two toxin programs. Most of DOR’s
work so far has been with ricin toxin, and the company was recently
awarded a million dollar drug grant to do additional work in humans.
For the botulinum toxin, DOR is doing formulation and early animal
DOR was originally incorporated in Delaware under the name Biological
Therapeutics in 1987 and two months later merged and changed its name
to Immunotherapeutics. Then in 1996 it became Endorex. The name DOR is
an acronym for (D)elivery of (Or)al biopharmaceuticals.
Schaber grew up in Philadelphia and moved to Pine Hill in South Jersey
as a teen. He comes from a blue-collar family where his father was a
machinist and his mother tended home and children. A student athlete
whose specialty was football, Schaber graduated from Western Maryland
College in 1989 with three majors – in business, economics, and
Schaber started his career in manufacturing and product development at
Elkins-Sinn in Cherry Hill, which was later bought by American Home
Products and Wyeth Ayerst, and while working he earned a master of
science in pharmaceutics at the Temple School of Pharmacy. He also
holds a doctorate in pharmaceutical biosciences from Union Graduate
He then worked for several pharmaceutical companies, including
Liposome, where he worked on a number of products, gaining experience
in regulatory affairs, quality assurance, and operations, Acute
Therapeutics, where he was a cofounder and served as vice president of
regulatory compliance and drug development, and Discovery Laboratories
in Doylestown, where he was a cofounder and served as executive vice
president and chief operating officer from 1998 to 2006 and helped
develop Surfaxin, a product for premature infants with respiratory
Schaber lives with his wife and four children in North Hanover. DOR
Biopharma has six full-time employees and works with a number of
medical and regulatory consultants.
Schaber is looking to expand and grow the company in 2008 to support
ongoing and future clinical trials. Although DOR has enough money to
sustain itself for almost a year, it will need to raise significant
money to conduct long trials. Schaber will be looking either for
partners in pharma or biotechs, or will have to raise his own money
through financing. He expects in 2008 to have the potential to add 10
to 15 additional employees.
– Michele Alperin
DOR Biopharma Inc. (DORB), 850 Bear Tavern Road, Suite 201, Ewing
08628; 609-538-8200; fax, 609-538-8205. Christopher J. Schaber,
president and CEO. Home page: www.dorbiopharma.com.
Computer Associates, 200 Princeton South Corporate Center, Ewing
08628; 800-225-5224. Mark Thompson, managing director. www.ca.com.
Computer Associates has closed its offices at Route 206 and Orchard
Road. The company sold the building in 2005 to JER Partners, a real
estate investment company based in McLean, Virginia, and the move had
been in the works for quite some time. Employees from the 23 Orchard
road building have moved to Ewing, where they were joined by CA
employees from Mount Laurel and from Plymouth Meeting, Pennsylvania.
Michelle Healy, a CA spokesperson, says that there are 400 employees
in the international software giant’s new offices, which are headed by
Healy says that the move came about as a result of the company’s
ongoing "evaluation of cost structure." Greater collaboration was also
a goal, she says. Most of the employees in the Ewing office are in
development, sales, and marketing.
At the time of its move, CA occupied some 100,000 square feet in the
238,000-square-foot building. Consulting firm Blessing White was a
tenant in the building, says a spokesperson, and is continuing on
under the new owner. The other new tenant is Oscient, which is
occupying 10,000 square feet.
JER Partners has put $3 million into a renovation of the property,
which is being marketed by Colliers Houston & Co. Charlie Parmelli,
who has been marketing the building for Colliers for about six months,
says that about 200,000 square feet are still available. He says that
the building’s multi-story atrium, running its entire length, and its
extensive common areas, including a cafeteria run by Chamber’s Walk
and a fitness center, are features that sets it apart from many office
towers. At under $22 a square foot, its space is also less expensive
than that in most Class A buildings on Route 1.
InterCap Holdings, 100 Overlook Center, Second Floor, Princeton 08540;
609-375-2802; fax, 609-375-2640. Steve Goldin, Chairman and CEO.
Looney Ricks Kiss Architects Inc., 182 Nassau Street, Suite 201,
Princeton 08542; 609-683-3600; fax, 609-683-0054. James Constantine,
InterCap Holdings, a development company, with a specialty in
mixed-use projects centering on train stations and Looney Ricks Kiss,
an architectural firm with a focus on planning and development, are
setting up and moderating a series of public meetings designed to find
the best use of an industrial property near the Edison train station.
Both companies have a bent toward New Urbanism, a trend that is
transforming formerly lifeless areas – like acres-large train station
parking lots – into lively communities that put apartments over
stores, incorporate something to do at night, and cut short commutes.
Like Hamilton, West Windsor, Trenton, North Brunswick, and many other
New Jersey towns, Edison is looking for ways to maximize the use of
land that, until now, has been used mainly for hosting commuters’ cars
while they go off to work in Manhattan.
Finding the best use for the land around train stations can be a
contentious business, which is where Looney Ricks Kiss’ expertise in
defining options and forming a consensus is expected to come in handy.
The workshops will consist of round-table meetings with community
leaders, members of the public, and representatives of various levels
of government to come up with ideas for the property.
The Edison Exchange, the township group overseeing the train station
project, will then propose a plan that balances the desires of
residents with the economic possibilities of the site. It will all end
with a preliminary concept plan.
Looney Ricks Kiss has a number of locations in addition to its office
on Nassau Street. Two are in the ground-up planned communities of
Celebration, Florida, and Rosemary Beach, Florida. Others are in the
revitalized cities of Nashville, Tennessee, and Memphis, Tennessee.
Intercap Holdings, headed by Steve Goldin, owns the property slated to
become 350 commuter parking spaces on Truman Drive near the train
station. Goldin is developing an expertise in transit villages. He has
been involved in plans for mixed use development, combining housing
with offices and stores, at the Hamilton train station, and has been
active in promoting a transit village at the Princeton Junction train
Goldin speaks on transit villages on Friday, January 18, at 7 p.m. at
the Village Grande development in West Windsor. Call 609-918-9517 for
New in Town
Lutronic USA, 51 Everett Drive, Suite A-50, West Windsor 08550;
609-275-1565; fax, 609-275-3800. Jhung/Won Hwang, director of
Lutronic USA has opened an office on Everett Drive. The 10-person
company sells equipment used by surgeons doing cosmetic and
reconstructive surgery. The equipment is made by the company’s parent,
which is based in South Korea.
Lutronic’s main product, the MOSAIC fractional laser system, was
approved for use in the United States by the FDA in July. Its selling
point is that it targets damaged skin without harming the skin around
it, thereby promoting faster healing.
The company also makes a surgical tool whose popular uses include the
removal of tattoos.
LDMG LLC: Leatherman Builders, 100 Youngs Road, Suite 9, Mercerville
08619; 609-584-9751; fax, 609-584-8608. Todd Leatherman.
Todd Leatherman has moved his residential and commercial building
company to Ocean County.
It was a quality of life move. "It’s a better location," says
Leatherman. "I’m right at a marina, and just across from Jack Baker’s
Lobster Shanty. And I’m 10 minutes from home."
Leatherman does renovation and improvement projects throughout New
Jersey, and says it doesn’t much matter to his clients where his
office is located, so he chose a location that he enjoys.
Media Mastr Computer Products Inc., 7A Marlen Drive, South Gold
Industrial Park, Robbinsville. 609-586-7576. Bob Klar, president.
Media Mastr has moved from the South Gold Industrial Park to
Burlington. The company sells computer supplies, data cartridges, and
storage media. It also has a specialty in CD-ROM manufacturing and
The company’s new address is 340 East Broad Street, Unit 1A,
RBC Capital Markets, 196 Princeton-Hightstown Road, Building 1A, Suite
9, West Windsor 08550; 609-514-0075; fax, 609-514-1087. Upendra Shah,
Carlin Financial Group, a financial services group, has been acquired
by New York City-based RBC Capital Markets, the corporate and
investment banking arm of RBC that is involved in debt origination,
sales and trading, foreign exchange, infrastructure finance, metals
and mining, and energy.
Pharmasset Inc., 303-A College Road, Princeton 08540; 609-613-4100;
fax, 609-613-4150. P. Schaefer Price, CEO. www.pharmasset.com.
Shares of Pharmasset, a biotech founded in 1998, reached a new
all-time high on January 7 after the company said that 85 percent of
patients dosed with its experimental drug, R7128, in combination with
two other drugs achieved undetectable levels of Hepatitis C virus
after four weeks.
The early-stage study of two dosing levels evaluated 50 patients who
had not previously been treated. Pharmasset said both dose levels were
safe and well-tolerated compared with placebo.
No serious adverse events were reported during the four-week treatment
Hepatitis C is a blood-borne infectious disease of the liver and is a
leading cause of chronic liver disease and liver transplants. Nearly
180 million people worldwide are infected. The CDC has reported that
almost four million people in the United States have been infected
with HCV, of whom 2.7 million are chronically infected.
Shares in the company rose over $6, to $20, on news of the positive
Joseph H. Petrozzini, 88, on January 7. The Kingston resident was an
entrepreneur whose businesses included a direct mail company
specializing in lithographs.
Gerard J. Hogan, 55, on January 1. A Skillman resident, he was the
founder and president of Gerard Sheet Metal in East Brunswick.