The Antidote: Inside the World of New Pharma (65 page)

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Authors: Barry Werth

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DDI—
drug-drug interaction

delta-F508—
CFTR gene mutation, folding

DNA—
deoxyribonucleic acid

EASL

European Association for the Study of the Liver

EPO—
erythropoietin

ET—
executive team

EU—
European Union

E&Y—
Ernst and Young

FDA—
Food and Drug Administration

FEV1—
forced expiratory volume in one second

FTE—
full-time employee

G551d—
CFTR gene mutation, gating

GSK—
GlaxoSmithKline

HBE

human bronchial epithelial cell

HBS—
Harvard Business School

HCV—
hepatitis C virus

HIV—
human immunodeficiency virus

HMR—
Hoechst Marion Roussel

H&Q—
Humbert and Quist health care conference (now Morgan Healthcare)

ICE—
interleukin-1 beta converting enzyme

IMPDH—
inosine-5'-monophosphate dehydrogenase

IMS—
IMS Health; leading provider of medical market data

IPO—
initial public offering

JAK

Janus kinase

JB-II—
Joshua Boger Innovation Center II

J&J—
Johnson & Johnson

KOL—
key opinion leader

M&A—
mergers and acquisitions

NDA—
new drug application

NIH—
National Institutes of Health

p38 MAP kinase—
mitogen activated protein

peg-riba—
pegylated interferon and ribavirin

PhRMA

Pharmaceutical Research and Manufacturers of America

PI—
product insert, prescription information: FDA-approved label

PK—
pharmacokinetics

POC—
proof of concept

PZA—
pyrazinamide

RA—
rheumatoid arthritis

R&D—
research and development

Reg FD—
Regulation Fair Disclosure

RGT—
response-guided therapy

RNA—
ribonucleic acid

ROV—
real options valuation

SEC
—Securities and Exchange Commission

SJS—
Stevens-Johnson syndrome

SVR—
sustained viral response; cure

VIP—
Vision into Practice

VRTX—
Vertex NASDAQ symbol

ACKNOWLEDGMENTS

Embedded reporting earned itself a black eye during the wars in Iraq and Afghanistan, but often it’s the only route a journalist can take to find a story. Having embedded with Vertex once before, I’ve now finished my second deployment, so to speak, and what I’ve found again—happily—is an amped-up, open culture where people are deeply passionate and proud about the work they do and eager to have others understand it. Whatever the hundreds of people inside the company with whom I spoke did not, or could not, tell me pales, I think, next to their willingness, patience, and good humor in having me along through an intensely productive and stressful period in their lives. I am especially grateful to Josh Boger, Ken Boger, and Matt Emmens for thinking it might be valuable for Vertex, and readers, to have me around.

It was not a condition of employment at Vertex, past or present, that you had to talk with me, but perhaps because people were as curious about me as I was about them I felt greeted warmly wherever I went, the San Diego site in particular. For their time and assistance, many kindnesses, and tolerance for my bumbling questions as I tried to find my way I also want to thank Bambang Adiwijawa, John Alam, Richard Aldrich, Valerie Andrews, Mike Badia, Zach Barber, Virginia Carnahan, Paul Caron, Karolyn Cheng, Heather Clark, John Condon, Pat Connelly, Peter Connolly, Bo Cumbo, Paul Daruwala, Dave Deininger, Maria DeLucia, Diane Ferrucci, Matt Fitzgibbon, Ted Fox, Bink Garrison, Shelley George, Carol Gonsalves, Steve Goodstein, Cami Graham, Jim Griffith, Peter Grootenhuis, Sabine Hadida, Matt Harding, Beth Hoffman, Tom Hoock, Ty Howland, Trish Hurter, Marc Jacobs, Dawn Kalmar, Bob Kauffman, Lisa Kelly-Crosswell, Tara Kieffer, Liz Kula, Ann
Kwong, Jeff Leiden, Chris Lepre, Judy Lippke, David Livingston, Jon Moore, Peter Mueller, Mark Murcko, Dallan Murray, Mark Namchuk, Victoria Narausky, Paul Negulescu, Tim Neuberger, Eric Olson, Megan Pace, Michael Partridge, Debra Peattie, David Rodman, Amit Sachdev, Vicki Sato, Priya Singhal, Ian Smith, Russ Smith, Craig Sorensen, Cynthia Spencer, Christiana Stamoulis, Megan Steel, Pam Stephenson, Ernst ter Haar, John Thomson, Roger Tung, Fred Van Goor, Alissa Van Zee, Jack Weet, Chris Wright, and Nancy Wysenski.

Many people who have observed Vertex at close quarters helped inform my perspective. Bob Beall, Bob Brown, Doug Deiterich, Clint Gartin, Adam Koppel, John McHutchison, Geoff Porges, Charles Rice, Mark Robinson, and David Stein were insightful and generous. Erica Jefferson helped at the FDA. John Hallinan, Mark Jones, Arnold Thackray, and Jamie Cohen-Cole brought timely attention to my work among their communities and colleagues. Keith Johnson volunteered to share his experience, opening an unexpected vista on the conundrum of personalized medicine.

I owe a special debt to all those who agreed to help me through the early drafts of this project and who, as it sprawled and slogged and lumbered finally toward coherence, probably wished they hadn’t: Hilda Werth, Kathy Goos, Alex Werth, Alan Sosne and Fred Eisenstein. Cathy Bouffides Walsh, Richard Levine, Jackie Austin, David Weintraub, Emily Filloy, Susan Eisenberg, and Susan Werth put me up during my travels. Jamie Moore helped with a fine transcription that unfortunately ended up on the cutting room floor. Steven Shapin, Sam Freedman, and Tony Giardina lent timely encouragement. Clear-eyed professional and trusted friend Chris Jerome again saved me from my worst tendencies as a writer.

At Simon & Schuster, Alice Mayhew, Jonathan Karp, and Jonathan Cox saw—and brought out—the best in the story and, I hope, in me. Elisa Rivlin, Phil Bashe, and Mara Lurie helped immeasurably with turning the manuscript into a book. I want to thank George Turianski, Kyoko Watanabe, and Jackie Seow for packaging it and pushing it out the door. I’m grateful to Julia Prosser, Stephen Bedford, and Kate Gales for marketing and publicity.

As an unaffiliated journalist-historian, I am grateful to the Smith College American Studies Department for providing me with an operating base, especially Rick Millington, Michael Thurston, and Dan Horowitz. As always, I am indebted to my unfailing agent, Amanda Urban, and her assistant, Margaret Southard. No words can do justice to the sustenance I get from my family—Kathy Goos, Emily Werth, and Alex Werth—who know that every book I write is like a long illness, and that eventually it ends.

ABOUT THE AUTHOR

RICHARD EVANS

Barry Werth is an award-winning journalist and the acclaimed author of six books. His landmark first book,
The Billion-Dollar Molecule,
recounts the founding and early struggles of Vertex. Werth’s articles have appeared in
The New Yorker, The New York Times Magazine,
and
GQ,
among others. He has taught journalism and nonfiction writing at Smith, Mount Holyoke, and Boston University.

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authors.simonandschuster.com/Barry-Werth

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ARRY
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ERTH

Banquet at Delmonico’s

31 Days

The Scarlet Professor

Damages

The Billion-Dollar Molecule

The Architecture and Design of Man and Woman
(coauthored with Alexander Tsiaras)

From Conception to Birth
(coauthored with Alexander Tsiaras)

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NOTES
CHAPTER 1: April 28, 1993

I was in attendance at both scenes described here. (For more on the origins of Vertex’s HIV program, see
The Billion-Dollar Molecule
.) Additional sources:

(
pp. 11
–16) Interviews with Josh Boger, Rich Aldrich, and Mark Murcko. Rupert Cornwell, “Clinton Lambasts Greedy Drug Firms,”
Independent
, February 13, 1993; Elizabeth Rosenthal, “Research, Promotion and Profits: Spotlight Is on the Drug Industry,”
New York Times
, February 21, 1993; Philip J. Hilts, “U.S. Study of Drug Makers Criticizes ‘Excess Profits,’ ”
New York Times
, February 26, 1993; Tom Petruno, “Penny Pinching Squeezes Growth Stocks,”
Los Angeles Times
, June 21, 1993; Thomas Stossel, “The Discovery of Statins,”
Cell
, September 19, 2008.

(
pp. 16
–20) Interviews with John Thomson, Josh Boger, Vicki Sato, Mark Murcko, and Roger Tung. Lawrence K. Altman, “Conference Ends with Little Hope for AIDS Cure,”
New York Times
, June 15, 1993; Editorial, “The Unyielding AIDS Epidemic,”
New York Times
, June 17, 1993.

CHAPTER 2: August 22, 1993

Most material for this chapter was contemporaneously reported. Other sources:

(
pp. 21
–24) Interviews with Debra Peattie, Charles Rice, John Thomson, and Vicki Sato. Gina Kolata, “Mysterious Epidemic of Furtive Liver Disease,”
New York Times
, January 19, 1993.

(
pp. 24
–27) Interviews with Josh Boger, Vicki Sato, Richard Aldrich, Roger Tung, and David Deininger. David Gold, “Highlights from the First Conference on Human Retroviruses,”
Gay Men’s Health Crisis: Treatment Issues
, March 1994; ACT-UP Capsule History, 1989 (
www.actupny.org/documents/cron-89.html
); Huntley Collins and Shankar Vedantam, “8 Years and $700 Million Later, How a Better Drug Was Found,”
Philadelphia Inquirer
, March 17, 1996.

(
pp. 27
–30) Interviews with Rich Aldrich, Josh Boger, Vicki Sato, Mark Murcko, John Thomson, and Roger Tung.

(
pp. 30
–32) Interviews with Roger Tung, Josh Boger, Vicki Sato, and Carl Dieffenbach. Collins and Vedantam, “8 Years and $700 Million Later . . .”; John James, “Searle Abandons Its Protease Inhibitor,”
AIDS Treatment News
, November 4, 1994.

(
pp. 32
–35) Interviews with Mark Murcko, Paul Caron, John Thomson, Ted Fox, and Matt Fittzgibbon.

(
pp. 35
–36) Interviews with Rich Aldrich, Josh Boger, and Ken Boger. David Dunlap, “From AIDS Conference, Talk of Life, Not Death,”
New York Times
, July 15, 1996;
Time
’s Man of the Year: Cristine Gorman, Alice Park, and Dick Thompson, “Dr. David Ho: The Disease Detective,” December 30, 1996. (Remarkably, the story credits Ho for coming up with the idea of combination therapy, while giving one company, Abbott, a single mention in the thirty-fourth paragraph.)

(
pp. 36
–38) Interviews with Mark Murcko, Paul Caron, Ted Fox, John Thomson, and Josh Boger. Lisa Benavides, “Hepatitis C Discovery Could Be Boon for Vertex,”
Boston Business Journal
, October 18, 1996; Lawrence Fisher, “Schering-Plough and Lilly Sign Liver Drug Deals,”
New York Times
, June 13, 1997.

CHAPTER 3: April 11, 1997

(
pp. 39
–42) Interviews with Ann Kwong, Vicki Sato, John Thomson, and Roger Tung.

(
pp. 42
–44) Interviews with Rich Aldrich, Josh Boger, and Vicki Sato.

(
pp. 44
–49) Interviews with Josh Boger, Vicki Sato, and Ann Kwong. Walter Isaacson,
Steve Jobs
, Simon & Schuster, 2011. Veronica Hope Hailey and Julia Balogun, “Devising Context Sensitive Approaches to Change: The Example of GlaxoWellcome,”
Pergamon
, 2002; Janet Kelly, “GlaxoWellcome Cultural Change,”
Management Development Review
, 1996; GlaxoWellcome: Fighting Disease and Improving Health (http://folk.uio.no/ivai/ESST/GlaxoSmithKline_Case_Study.pdf); Wendy Orent, “Out of the Shadows (On the Long Road to Fighting Hepatitis C),”
Proto
, Summer 2007; Jon Cohen, “Chiron Stakes Out Its Territory,”
Science
, July 2, 1999; “Chiron’s Hepatitis C Patents,”
Hepatitis C Harm Reduction Project
, June 22, 2004.

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