In 2011, clinical researcher Ahmed Hamdi was sitting in a parking lot in Sunnyvale, California. On his mind: A brand new anti-cancer drug, to be true to Silicon Valley parlance, seemed ready to change the world. Kewal Hamdi had been fired earlier that day as chief medical officer from a startup called Pharmacyclics.
The scene of a sad doctor, head in his proverbial hands, opens Nathan Verdi’s “For Blood and Money: Billionaires, Biotech, and the Quest for a Blockbuster Drug” and is the first sign that Verdi won’t just spin the story whole. Exceptionally successful business to remake the industry as a thrilling victory.
Nor is it a morality tale typical of a cynically overhyped business. Instead, Hamdi comes across as an honest diplomat whose blowout highlights the grim realities of the biotech revolution and how secretive investors can create and destroy life-saving drugs.
Hamdy eventually became the co-founder of another company, Acarta Pharma, and the narrative is at its most inspiring as the two biotech startups race to develop two rival drugs now known as Imbruvica and Calquence. Both drugs block the activity of an enzyme called Bruton’s tyrosine kinase, and these so-called BTK inhibitors arguably revolutionized the treatment of mantle cell lymphoma and chronic lymphocytic leukemia.
The origin story of these blood cancer drugs will be unfamiliar to most readers, but, as Verdi puts it, they are part of the “hot new field of tyrosine kinase inhibitors.” So hot, in fact, that AbbVie eventually bought PharmaCycle for $21 billion and AstraZeneca bought a majority stake in Aserta Pharma in another multibillion-dollar sale. These two deals, argues Verdi, represent the pinnacle of the biotech boom and produced some of the “biggest Wall Street trades in any industry.”
Initially, however, the compound that would later become Imbruvica was little more than waste crude developed by a chemist at another company. It was then sold at a “rock-bottom price” as part of a larger deal. In 2004, Robert Duggan, a former cookie salesman, Scientologist and serial entrepreneur, began investing in pharmacyclics, inspired by his son’s death from brain cancer. He eventually threatens to oust the company’s board, leading to the resignation of the pharmaceuticals’ cofounder, a renowned Stanford scientist – all prelude to Hamdi’s departure and all kinds of drama. The conflict reached unexpected places, such as an oncology society dinner reception in Chicago, which, in Verdi’s telling, devolved into literal arm-twisting and at least one F-bomb in a dispute over the drug’s therapeutic window.
Vardy takes us inside — to the poster sessions, to the meeting rooms — and eventually he ups the ante as Wayne Rothbaum, a New York stock trader turned pharmacologic investor, funds a rival upstart, Acerta Pharma, where Hamdy And another major pharmaceutical employee works in California. It’s literally the quintessential Silicon Valley startup out of a garage.
Along the way, Vardy explains what was so unusual: for the first time, stock traders were funding a private biotech directly, opening up “a grain of money.” Vardy writes that Rothbaum, like Duggan, had no scientific background, yet the financier was well versed in science and forcefully inserted himself into the daily operations – strictly enforcing his stealth mode, keeping a close eye on patient data , and even used to garner a coveted byline on one study. Published in The New England Journal of Medicine.
Behind the story is a broader conflict between business and science: the desire to make money while making a serious effort to improve people’s lives. Verdi layers on several interpersonal conflicts, opening Rothbaum up to a reporter for the first time; Duggan didn’t cooperate other than denying some juicy details.
Verdi does his best to guide readers through this insular world, with all its excruciating technical details, translating BTK inhibitors and “participating preferred shares” and spelling out the regulatory steps required for new drug approval. That said, Vardi, a former Forbes reporter and editor, does a better job of explaining the science than expounding on the financial specifics (such as Series A financing and annualized net returns). It’s a short, pointed statement that it defines the Food and Drug Administration, but not the Securities and Exchange Commission.
Perhaps in a painstaking attempt to adapt the complex financial, legal and scientific twists to the vernacular, Verdi packs his narrative with metaphors. Many involve baseball; Many are familiar to the point of cliché. For example, Pharmacyclics initially failed to get one of its drugs approved three times, and then essentially “refused to go off the plate.” Later, when a clinical trial pits the two drugs directly against each other for the first time, and Acerta Pharma’s BTK inhibitor appears to be superior, Verdi writes that AstraZeneca (which by then had acquired Acerta) “Home Run, If Not A Hit”. Grand Slam.”
“For Blood and Money” superficially resembles those formulaic airport biz-books where some heroic outsider wins big with previously unknown drama. Duggan is, after all, a father grieving the death of his son, who prevails through persistence and persistence. “In the process, people were torn apart, dreams shattered, strategies co-opted, and companies overtaken,” writes Vardi. “But it was undeniable that Duggan did the unthinkable and created something that was saving lives.”
Lymph nodes shrink. Cancer patients get their life back. And finally, two drugs that may never become household names end up making a lot of money for investors. But Vardi goes a step further, including a roster of “forgotten scientists” (including the chemist who became the first successful BTK inhibitor) and “those who revolutionized the treatment of chronic lymphocytic leukemia with BTK inhibitors.” “.”
Behind the story is a broader conflict between business and science: the desire to make money while making a serious effort to improve people’s lives.
The high-resolution visualization of so many details involved in such a specific subclass of drugs can make a comprehensive analysis too nuanced. If nothing else, Verdi’s account injects some bite into an old adage about developing drugs: “The first disaster is if you kill people,” biotech analyst Alex Hittle told a reporter nearly 20 years ago.
“The other is disaster if you fix them.” The cure, after all, eliminates customers, a problem especially in a niche market already constrained by the relative rarity of a disease, and with older drugs that can cost more than $10,000 a month and patient Can be taken for the duration of the life of (Verdi quotes Duggan as saying, “What it doesn’t have in terms of volume of patients, it makes up for in terms of years of therapy.”) Rather than portray it as a vast conspiracy, however, The uniform is simply showing, up close and personal, how the game is played. This is how capitalism works.
In the years that followed, the financial appetite for biotech stocks cooled, suggesting that these two extraordinary companies were at the peak of a bull market. But, Vardi clearly raised other questions: Are they also representative of the role small-scale startups play in the global pharmaceutical industry? And are such startups really helping medical progress?
In one of his strongest takeaways, Verdi describes how the physician-scientists who worked in the trenches, completing paperwork, recruiting patients, and administering these once-experimental drugs eventually made corporate megadeals. felt small by.
For the team at Acerta Pharma, “they felt cheated, that they deserved more and had done more and taking home the fat cats was a big part of the victory created by what they had done, ” they write. “These sentiments were illusory but linked to the harsh reality of the biotechnology revolution. Even in cancer drug development, most of the financial gains often go to capital and not labor.”
Source – undark