The Antidote: Inside the World of New Pharma
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In this timely and much praised book, Barry Werth draws upon inside reporting that spans more than two decades. He provides a groundbreaking close-up of the upstart pharmaceutical company Vertex and the ferocious but indispensable world of Big Pharma that it inhabits.
In 1989, the charismatic Joshua Boger left Merck, then America’s most admired business, to found a drug company that would challenge industry giants and transform health care. Werth described the company’s tumultuous early days during the AIDS crisis in The Billion-Dollar Molecule, a celebrated classic of science and business journalism. Now he returns to tell a riveting story of Vertex’s bold endurance and eventual success.
The $325 billion-a-year pharmaceutical business is America’s toughest and one of its most profitable. It’s riskier and more rigorous at just about every stage than any other business, from the towering biological uncertainties inherent in its mission to treat disease; to the 30-to-1 failure rate in bringing out a successful medicine even after a molecule clears all the hurdles to get to human testing; to the multibillion-dollar cost of ramping up a successful product; to operating in the world’s most regulated industry, matched only by nuclear power.
Werth captures the full scope of Vertex’s twenty-five-year drive to deliver breakthrough medicines. At a time when America struggles to maintain its innovative edge, The Antidote is a powerful inside look at one of the most intriguing and important business stories of recent decades.
asked Smith to help him extrapolate. “So we’re talking about maybe six weeks, and you sold seventy-five million dollars,” Werber started. He did a few back-of-the-envelope calculations. “You said half was retail demand, and then you said that retail stocking on the order of around thirty-seven, thirty-eight million is already out of the channel. So that’s within three weeks. And then there would have been inventory on top of that. It almost seems like I can back into a doubling of the rate of
Vertex’s position, but he was attuned to any disruption in the game plan. He, too, like the analysts, had to project ahead. The next step for the company was to think about connectivity, growth, and scalability worldwide. All three required costly investment. Yet no CEO can ignore for long Wall Street’s betting culture and relentless insistence on mounting returns. Now that Vertex was on a steep path to profitability, Emmens wanted to satisfy investors and analysts, but the Street always had
My model, I need to plug in numbers.” Our model here is, “Let’s just find people who are really sick, see if we can mimic the disease in the laboratory, and see if we can make an effect on that disease.” People ask what’s our strategy. You know what I say to them? “Find sick people and make drugs for them.” You get too fancy on the strategy you’re gonna screw yourself up. It takes away from the opportunism. The strategy is simple: Are you in the health care business to treat patients with serious
growing up. Alam recognized the problem but seemed powerless to act any more than passingly, reluctantly collegial toward Fleischer. “I absolutely was the wrong person; the smart-guy physician,” he says. “His attitude was, ‘Fuck you, I’m not going to do what you want me to do.’ Both my scientific ability to connect the dots and leap ahead and my personal impatience and urgency absolutely did not fit with how the FDA wanted to move.” In pharmaceuticals, time is money in an expanded sense: every
Be yourself. They’ll love it.” CHAPTER 8 * * * FEBRUARY 11, 2008 It was an hour after dark by the time Boger, Smith, Graves, and Alam took their places in the windowless conference room for the year-end earnings call with Wall Street analysts. They sat at a large round table, a speakerphone positioned between them. Vertex’s new senior director for strategic communications, Michael Partridge, directed the call. On a whiteboard he printed the names of the dozen analysts listening in,