Barry Werth - The Billion Dollar Molecule: One Company’s Quest for the Perfect Drug

PRAISE FOR THE BILLION-DOLLAR MOLECULE

A truly masterful combination of science writing, business sophistication, and simple page-turning narrative skill. This book will help any reader better understand the fundamental scientific changes shaping the world, as well as the financial climate in with which Barry Werth has carried this project off. This is a gripping and important book.

James Fallows, author of Looking at the Sun and Washington Editor of The Atlantic Monthly

A complex book... Werth knits it all together with clarity and polish.

Chicago Tribune

Entertaining... a lively narrative of clashing egos, grand gambles and frantic scrambling after renown riches... Werth bags a host of telling anecdotes in his trek behind the scenes.

David Stipp, The Wall Street Journal

Fast-paced inside account... enough high drama for a television miniseries... colorful... an absorbing story about a brave new world.

San Francisco Chronicle

Revealing... a wealth of information.... Youll find the book a good investment.

Scott Lafee, The San Diego Union Tribune

A fascinating and complicated story... a well-researched narrative... interesting, revealing. The story will nurture many an entreuprenerial-scientist dream.

Sandra Panem, Science

The liveliest and most revealing story written so far about the biotech industry.

Clive Cooksen, Financial Times

An authoritative book about science and the business of science. It is also a fascinating, gripping tale about real people working under extreme pressure in pursuit of what seems like an impossible goal.

Tracy Kidder, author of Soul of a New Machine

Timely, fascinating, fast moving story... brilliantly written.

Ezra M. Greenspan, M. D.

Clinical Professor of Medicine (Oncology)

The Mount Sinai School of Medicine

Medical Director, Chemotherapy Foundation

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FOR KATHY

Courtesy of Vertex Pharmaceuticals

Joshua Boger

W e live in an age of sequels. Many film lovers think the best sequel ever is The Godfather: Part II, and I support them. But the true impact of the second movie was to ensure from then on that no novelist, filmmaker, TV executive, documentarian, or record producer would ever again consider a major undertaking without weighing the opportunity to follow up, round out, and extend the original material into a multipart bonanza. But what of the original story, the creation, rooted in its time, foreshadowingmaybeall that comes after it? Not just fun but instructive, a return to roots deepens our understanding, providing glimpses of the mature creature in embryo, so to speak.

In my latest book, The Antidote, I dramatize a twenty-year period, starting from when Vertex emerged as a promising but cash-starved start-up with distant ambitions to compete with the major pharmaceutical companies. The story climaxes with the company beating Big Pharma simultaneously in major disease areas, in a period of sweeping change throughout health care and society that even its far-seeing, charismatic founder Joshua Boger hadnt envisioned. How it survived that period (burning through nearly $4 billion) to mount a challenge to the old biomedical order just as that order was crumbling drives an account of ambition and hope, hubris and Wall Street, ferocious competition and extraordinary collaboration, extreme highs and desperate lows.

Whats amazing (to me at least) is how much of that storyits DNA, to use the obvious tropeis stuffed into this first book, coiled and ready to unfold. Here, for instance, is Boger, age thirty-nine, a year after defecting from Merck, commenting on his treatment by the worlds biggest drug company, Glaxo, where executives listened to his proposal to collaborate on a program, heard his exorbitant demands, and promptly showed him the door: Arrogance doesnt disturb or impress us. We understand arrogance. Or else here, in a meeting with Vertexs scientific advisors, an august group of a half dozen senior Harvard scientists, as he explained his plan to upend the drug industry by designing better drugs atom by atom. Whats to stop Glaxo from saying, Oh, oh, we see. Maybe we can do what youre telling us ourselves? someone asked.

But they cant do it, Boger said.

But Merck can.

No, Merck cant either.

Bogers blunt assurance that he could do what Merck, the most admired corporation in America, could not, was creating on the fly a uniquely confident and ambitious research group. Throughout the time that I was there Vertex was more of a free-lance lab and privatized university-style consortium than a commercial drug business. Nearly everybody, including me, was younger than Boger, and it showed. The company was creating itself to conceive of and design and build small molecules better than the worlds most skilled, profitable, and heavily endowed research organizations and what it took from the scientists was utter commitment, extreme passion, thrilling insight, and fearlessness. A volatile mix at any age, this is an especially strong brew for thirtysomethings, pent-up and wild to do the things that will distinguish them in life and launch their careers.

So remember the place was a research boutique, not a drug company. The differences are huge, as I immediately discovered when I realized in late 2010 that I wanted to go back inside. I approached Boger, and he discouraged me. Drug companies had become a favored target of federal prosecutors, and the companies were paying billions in penalties for defrauding government payers, bribing doctors and hospitals, marketing drugs for unapproved diseases, foisting antidepressants on nursing home patients, and otherwise trying to wring profits out of expiring product lines. Retired by then from Vertex, Boger told me he thought it would never let me back inside. It was Ken, his older brother and the companys general counsel, who convinced CEO Matt Emmens that it could manage the risk of having a reporter hanging around, and that I could be trusted.

I couldnt know in the fall of 1989 when I first wandered into Vertexs work in progress what I would see, much less that twenty-five years later I would return to publish a sequel. But I quickly found out that everyone there understood that it would take twenty-five years and possibly much longer to know whether they were really succeeding. Merck wasnt built in a day. The company became a research powerhouse in the forties and fifties, and only decades later became the paragon of the late twentieth century after its labs delivered a string of first in class and best in class pharmaceuticals. At its zenith, its stock spiked 500 percent in five years while it distributed free an unlimited supply of the drug Avermectin to cure African river blindness and began leading the way in developing treatments for AIDS. By that time, Merck was an organization, culture, and brand a half century in the making.

Ive thought hard about how to situate this original story and its sequel among other well-known stories about American industrialists and the companies they built. Andrew Carnegie was thirty-five when he traveled to England in 1872, witnessed the Bessemer process for making steel, and got the flash, as he liked to say: came to understand that steel would replace iron for building railroads and bridges, which ignited him to press inordinately to build his own steel company from the ground up. Three years later he opened his first steel plant. In 1901, twenty-six years later, he sold Carnegie Steel to J.P. Morgan, allowing Morgan to create U.S. Steel and making Carnegie the worlds richest man.