FOR BLOOD AND MONEY

The story of two small biotech firms who vied to dominate the market for a cancer drug and reaped billions of dollars in compensation.

During the “great biotechnology decade of the 2010s,” Pharmacyclics and Acerta, both based in California, worked feverishly to develop a new drug that used BTK inhibitors to treat chronic lymphocytic leukemia with minimal side effects. Vardi, managing editor at MarketWatch and former senior editor at Forbes, tells a fascinating story of the science behind this approach and the financial arrangements, medical controversies, regulatory processes, and business rivalries without which the two competing drugs—Imbruvica and Calquence—would not have become publicly available. Driving the quest was the possibility of huge sales; in 2020, Imbruvica had $6.6 billion in revenues. Such sales would enable the companies to be sold to bigger biotech companies, with massive payouts to investors and management. The major investor in Pharmacyclics, for example, made $3.5 billion on his $50 million investment. Vardi brings readers on to significant phone calls, places them at management meetings, and reveals in detail the deliberations that occurred among investors, medical officers, hospital doctors, and federal regulators. We learn the backstories of the key participants and the science and politics behind experimental drug trials, the competition among venture capitalists and hedge fund managers, and the strategic calculations of big pharma (Johnson & Johnson, AstraZeneca) as it engaged the “small biotech companies with experimental therapies” then dominating research and development. Tens of thousands of patients eventually benefitted, although the financial burden—a blood cancer drug can cost $10,000 per month and has to be taken for the duration of the patient’s life—is staggering. The book will appeal to readers of Brendan Borrell’s The First Shot and Gregory Zuckerman’s A Shot To Save the World.

An interesting tale of how personal ambition, scientific curiosity, and the pursuit of wealth led to life-extending drugs.