The Antidote: Inside the World of New Pharma

by Barry Werth

  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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  ALSO BY BARRY WERTH

  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.

  (pp. 49–53) Interviews with Josh Boger, Rich Aldrich, and Michael Partridge. Gabi Horn, “Vertex Vortex,” POZ, September 1998; Alana Kumbier, PopPolitics.com, “Despite Ad Images, HIV Still Not Carefree,” AlterNet, posted June 12, 2001; Tom Abate, “Passing the ‘BioBucks’—Small Investors Aren’t In on the Joke/Inflated Deal Values Sometimes Only Way Firms Can Raise Funds,” SFGate.com, June 14, 1999.

  (pp. 53–60) Interviews with Mark Murcko, Josh Boger, Ken Boger, Rich Aldrich, and Vicki Sato. Andrew Pollack, “Finding Gold in Scientific Pay Dirt,” New York Times, June 28, 2000; Philip Ball, “Bursting the Genomic Bubble,” Nature, published online March 31, 2010; Siddhartha Mukherjee, The Emperor of All Maladies, Scribner, 2010; Daniel Vasella, Magic Cancer Bullet, HarperCollins, 2003.

  CHAPTER 4: January 22, 2001

  (pp. 61–64) Interviews with Josh Boger, Ann Kwong, Roger Tung, Dave Deinin
ger, Vicki Sato, and John Thomson.

  (pp. 64–67) Interviews with Josh Boger, Vicki Sato, and Mark Murcko. Amy Tsao, “The Vertex Vortex: Drug Development at Hyperspeed?” BusinessWeek, March 15, 2001; Andrew Pollack, “Vertex Buys Biotechnology Rival for $592 Million,” New York Times, May 1, 2001; Kevin Fogarty, “Speed Is the Vertex Creed,” BioIT World, April 7, 2002.

  (pp. 67–70) Interviews with Josh Boger, Vicki Sato, Bob Beall, and Rich Aldrich. Vertex’s decision to partner with the nonprofit Cystic Fibrosis Foundation is the subject of an excellent academic case study, which I relied on heavily in reporting this section: Robert F. Higgins, Sophie Lamontagne, and Brent Kazan, “Vertex Pharmaceuticals and the Cystic Fibrosis Foundation: Venture Philanthropy Funding for Biotech,” Harvard Business School, October 2007; revised July 2010.

  (pp. 70–73) Interviews with John Alam, Josh Boger, and Vicki Sato.

  (pp. 73–76) Interviews with Josh Boger, Ken Boger, Vicki Sato, and Mark Murcko. United States District Court, District of Massachusetts, In Re VERTEX PHARMACEUTICALS, INC. SECURITIES LITIGATION, Master File No. O3 11852 PBS.

  (pp. 76–78) Interviews with Josh Boger and Vicki Sato. Andrew Pollack, “Announcement on a Hepatitis C Drug Is Expected Today,” New York Times, January 7, 2002; Tom Abate, “H&Q Conference Has Matured Along with the Biotech Industry,” SFGate.com, January 7, 2002.

  (pp. 78–81) Interviews with John Thomson, Paul Negulescu, Mark Murcko, Roger Tung, and Eric Olson.

  (pp. 81–83) Interviews with Vicki Sato, Ann Kwong, Josh Boger, Roger Tung, and John Thomson. Ryan McBride, “How Eli Lilly Let a Billion-Dollar Molecule Slip Away, and Make a Fortune for Vertex,” Xconomy, August 4, 2010.

  CHAPTER 5: January 6, 2003

  (pp. 84–88) Interviews with Josh Boger, Ian Smith, Ken Boger, and Vicki Sato.

  (pp. 88–90) Interviews with Ian Smith, John Thomson, Jon Moore, Vicki Sato, and Chris Lepre. Andrew Pollack, “Despite Billions for Discoveries, Pipeline of Drugs Is Far from Full,” New York Times, April 19 2002; Andrew Pollack, “Awaiting the Genome Payoff,” New York Times, June 14, 2010; Allison Connolly, “Bio-Layoffs Cool Once Booming Job Market,” Boston Business Journal, June 30, 2003.

  (pp. 90–94) Interviews with Josh Boger, Vicki Sato, and Peter Mueller. Again, deeply reported academic case studies were invaluable here for piecing together critical developments during a formative period: Gary Pisano, Lee Fleming, and Eli Peter Strick, “Vertex Pharmaceuticals: R&D Portfolio Management (A),” Harvard Business School, June 20, 2006; Francesca Gino and Gary Pisano, “Vertex Pharmaceuticals: R&D Portfolio Management (B)&(C),” HBS, April 25, 2006.

  (pp. 94–96) Interviews with Ann Kwong and Josh Boger.

  (pp. 96–99) Interviews with Geoffrey Porges and Josh Boger. HBS case studies; Time cover story, “Medicine: What the Doctor Ordered,” August 18, 1952; Jim Collins and Jerry Porras, Built to Last, HarperBusiness, 1994; “Vertex Slips 37% After Arthritis Test Halted,” Boston Business Journal, November 11, 2003; Geoffrey Porges, “Vertex Pharmaceuticals: Still Floundering,” Bernstein Research Call, October 17, 2003.

  (pp. 99–102) Interviews with John Alam, Josh Boger, and Geoff Porges. Charles Pierce, “Boston’s Biotech Moment,” Boston Globe Magazine, December 14, 2003; David Hamilton, “The FDA’s Approval of Drugs Doesn’t Ensure Biotech Riches,” Wall Street Journal, October 29, 2003; Geoff Porges and Marshall Gordon, “VRTX: Investor Day Yields More Positives Than Negatives; Uncertainty Remains, Upgrade to Marketperform,” Bernstein Research Call, December 4, 2003.

  CHAPTER 6: February 14, 2004

  (pp. 105–9) Interviews with Ian Smith, Josh Boger, Ken Boger, John Alam, and Ann Kwong. David Margolis, “11th Annual Retrovirus Conference,” Conference Reports for NATAP (National Aids Treatment Advocacy Project), February 8–11, 2004; Ann Kwong, Robert Kauffman, Patricia Hurter, and Peter Mueller, “Discovery and Development of Telaprevir,” Nature Biotechnology, November 2011.

  (pp. 109–11) Interviews with Peter Mueller, Mark Murcko, Josh Boger, John Alam, and Vicki Sato.

  (pp. 111–14) Interviews with Ian Smith, Vicki Sato, Trish Hurter, and Pat Connelly.

  (pp. 114–17) Interviews with Josh Boger, Bink Garrison, and Vicki Sato. Gardiner Harris, “Drug Makers Seek to Mend Their Fractured Image,” New York Times, July 8, 2004; Jim Collins and Jerry Porras, Built to Last, HarperBusiness, 1994.

  (pp. 117–21) Interviews with Vicki Sato, Roger Tung, Paul Negulescu, Eric Olson, Peter Grootenhuis, Fred Van Goor, and Sabine Hadida. Jerome Groopman, “Open Channels,” New Yorker, May 4, 2009 (Groopman was a member of Vertex’s original scientific advisory board); Penni Crabtree, “Poised to Be a Star: Cystic Fibrosis Project Has San Diego Unit of Vertex on Verge of Treatment,” San Diego Union Tribune, October 21, 2005; Matthew Herper, “A Drug of Your Own,” Forbes, July 20, 2011.

  (pp. 121–24) Interviews with Josh Boger, Bink Garrison, Matt Emmens, and Trish Hurter. Anna Wilde Matthews and Barbara Martinez, “E-Mails Suggest Merck Knew Vioxx’s Dangers at Early Stage,” Wall Street Journal, November 1, 2004; Alex Berenson, Gardiner Harris, Barry Meier, and Andrew Pollack, “Despite Warnings, Drug Giant Took Long Path to Vioxx Recall,” New York Times, November 14, 2004.

  (pp. 125–28) Interviews with Tim Neuberger, Paul Negulescu, and Vicki Sato.

  (pp. 128–32) Interviews with Robert Kauffman, John Alam, Josh Boger, and Ian Smith. Scott Gottlieb, “Magic Bullet for Hepatitis C,” Forbes, January 24, 2005; Geoff Porges and Neil Agran, “VRTX: VX-950—‘Billion Dollar Molecule’ in New SCB Market Model,” Bernstein Research Call, June 8, 2005.

  (pp. 132–35) Interviews with Trish Hurter, Bink Garrison, and Josh Boger.

  (p. 135) Interview with Bink Garrison.

  CHAPTER 7: January 9, 2006

  (pp. 136–40) Interviews with Josh Boger, John Alam, John McHutchison, and Ian Smith. Andrew Pollack, “Hoping a Small Sample May Signal a Cure,” New York Times, February 7, 2006; Scott Kirsner, “Why Biotech CEOs Need to Think Like Steve Jobs,” Boston Globe, August 26, 2007.

  (pp. 140–43) Interviews with Eric Olson, Bob Beall, and Ken Boger.

  (pp. 143–46) Interviews with Josh Boger, John Thomson, Mark Murcko, and Roger Tung. Manuel A. Tipgos and Thomas J. Keefe, “A Comprehensive Structure of Corporate Governance in Post-Enron Corporate America,” CPA Journal, 2004; Bruce Morton, “Two NC Democrats Vie for a Shot at Helms,” All Politics/CNN TIME, May 6, 1996.

  (pp. 146–50) Interviews with Josh Boger, Ann Kwong, Tara Kieffer, and Ian Smith. Andrew Pollack, “New Medicine for AIDS Is One Pill, Once a Day,” New York Times, July 9, 2006; “Vertex: A Promising Hep-C Play,” BusinessWeek, October 9, 2006; Peter Kang, “Vertex’s J&J Deal Key to Future Success: Analyst,” Forbes.com, June 30, 2006; Brian Lawler, “Vertex’s Billion-Dollar Drug,” The Motley Fool, April 18, 2007; Andrew Pollack, “2 Winning Drug Tests, One Expected and One a Surprise,” New York Times, November 2, 2007.

  (pp. 150–51) Interview with Bob Kauffman.

  (pp. 151–57) Interview with Josh Boger. Boger Blog, with permission from the author; “Case Study: The Brain Power,” Boston magazine ranking of the city’s most powerful people, May 2008; “Hawking Takes Zero Gravity Flight,” BBC News, April 27, 2007; Luke Timmerman, “Gov. Patrick Travels West to Plug Massachusetts’ Life Sciences Initiative at BIO,” Xconomy, June 16, 2008.

  (pp. 157–62) Interviews with Josh Boger, Bink Garrison, and Trish Hurter.

  (p. 162) Interviews with Josh Boger, Amit Sachdev, and Lisa Kelly-Crosswell.

  (pp. 162–65) Interviews with Josh Boger, Amit Sachdev, and John Alam. Jacalyn Duffin, Lovers and Livers: Disease Concepts in History, University of Toronto Press, 2005; Gardiner Harris, “Medical Marketing—Treatment by Incentive: As Doctor Writes Prescription, Drug Company Writes a Check,” New York Times, June 27, 2004; Douglas T. Dieterich, MD, “IDEAL Study COMMENTARY: A Healthy Dose of Curiosity: Clinical Trial Results Require Careful Interpretation,” Liver Health Today, January–March 2008); Andrew Pollack, “2 Winnin
g Drug Tests, One Expected and One a Surprise,” New York Times, November 2, 2007; Robert Langreth, “Viral Vertigo,” Forbes.com, November 26, 2007.

  (pp. 165–67) Interviews with John Condon, John Thomson, John Alam, and Josh Boger.

  (pp. 167–74) Interview with Josh Boger. Boger Blog©, with permission.

  CHAPTER 8: February 11, 2008

  (pp. 175–78) Interview with Michael Partridge. Vertex’s Q4 2007 earning call transcript, available online: http://seekingalpha.com/article/64143-vertex-pharmaceuticals-inc-q4-2007-earnings-call-transcript; Vikas Bajaj and Louise Story, “Mortgage Crisis Spreads Past Subprime Loans,” New York Times, February 12, 2008.