The Antidote: Inside the World of New Pharma

by Barry Werth

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.

Genres: Science, Business, Nonfiction, Medicine, Health Care, Economics, Biography

448 pages, Hardcover

First published February 1, 2014

Reviews

[David Rubenstein · Rating 2 out of 5]

In a previous book (The Billion-Dollar Molecule: The Quest for the Perfect Drug), Barry Werth followed Vertex, an upstart drug development company for the first five years of its life. In The Antidote, Werth returns to Vertex after twenty years, and tells the story of how Vertex was built into a full-spectrum pharmaceutical company. The company is different from other drug companies, in that it was developed as a "twenty-first Century" corporation, with modern drug development methodologies, and a unique philosophy. The book describes the development of two important drugs, one for Hepatitis-C and one for cystic fibrosis. The book interleaves details about the science, the thirty-or-so most important players, and the business.

I thoroughly dislike this book, as it is so poorly written. I have no idea who the audience is. Is it for biochemists who work for pharmaceutical companies? Only biochemists would understand the science that is tersely described at intermittent intervals in the book, without any background explanations. Is it for Wall Street analysts? Only analysts would be interested in reading about every single up-and-down ride of the stock price of a single company, for hundreds of pages.

The reader is given no perspective on the "bigger picture". The reader gets thrown into a story about the development of a drug by an upstart company--that's great. But while it goes through the development process, details are thrown at the reader without any overall understanding of the total process. Then, the whole thing is repeated with respect to the FDA's approval process. I simply couldn't see the forest from the trees.

So many characters are involved (there is a helpful list of most of them, in the front of the book), that the book has little time to go into any character development. I certainly could not feel for any of the characters.

One way to improve the book would be to have chapters with titles; have each chapter describe a theme that frames the narration of the entire chapter. In that way, the book wouldn't feel like a stream-of-consciousness narrative. Also, what would really help the book is a pair of chapters with outlines (even flowcharts would help). One outline, early in the book, could describe the steps involved in developing a new drug. A second outline, later in the book, could describe the steps in getting FDA approval.

(Full disclosure: I received a pre-publication copy of the book from the publisher, Simon & Schuster.)

[YouMo Mi · Rating 3 out of 5]

Topic:

Insider account of internal decision-making, scientific breakthroughs, financial struggles, and commercial success of Vertex Pharmaceuticals, charting how the biotech company overcame various challenges in the late 1990s/early 2000s in bringing ground-breaking therapies for Hepatitis C and cystic fibrosis to market by 2012.

Style:

Author is a journalist who had previously written "The Billion Dollar Molecule," which introduced Vertex as one of the first biotech companies to use rational drug design for discovery and development of new therapeutics. This sequel picks up after Vertex had spent the better part of the 1990s pursuing various immunosuppressant and anti-viral candidates (largely driven by the search for an HIV "cure"). Subject matter is steeped in financial, research, and commercialization terminology from Vertex's executive team.

Organization:

Book is divided into three parts.

Part 1 introduces Vertex's team and picks up with the company struggling to find financing amidst competition in HIV from larger players like Gilead and Merck, pivoting focus to hepatitis C while keeping investors happy, acquiring other drug discovery programs to bolster cash flow and the pipeline, and negotiating licensing deals with other companies in exchange for cash upfront to keep afloat (a modest deal with non-profit Cystic Fibrosis Foundation to develop a new cystic fibrosis treatment will play an important part of Vertex’s story).

Part 2 sees reshuffling of the executive team amidst difficulties in finding a viable lead compound for Hep C. Partners such as Novartis and Eli Lilly pass on candidates as too difficult to formulate or shift focus to different mechanisms of action. One bright spot is Vertex’s discovery of a potentially ground-breaking treatment for cystic fibrosis.

Part 3 recounts the race to FDA approval and commercialization of an interferon-free hepatitis C treatment in the face of more established competitors Merck, Gilead, Pharmasset, and BMS, how Vertex’s blockbuster Incivek (telaprevir) isn’t enough to satisfy Wall Street despite ~$1 billion sales and market dominance in its first year, and how the launch of Kalydeco (ivacaftor) to treat a far smaller cystic fibrosis patient population ends up the surprise savior of the company.

Takeaway:

This was a tough book to get into but started picking up half-way through. For one, keeping track of so many characters introduced with unnecessary details of their appearance and CVs was distracting. Part 1 is also quite dense with cursory overviews of complex immunology concepts to explain the Hep C competitive landscape and a disjointed narrative of how financing was secured for development of Vertex’s many prospective pre-clinical drug candidates. The second half of the book was more focused as Vertex's ups and downs eventually converged on lead candidates for Hep C and cystic fibrosis, respectively.

In fairness, this is probably how it feels to run an early-stage life sciences start-up: wooing investment on an unproven idea with little certainty on efficacy or toxicology; trying to stay afloat while keeping investors satisfied without turning a profit for a decade or more; figuring out when to march on or pivot business strategy in the face of obstacles; attracting and retaining talent even while they clash behind the scenes; and waiting to catch a break even while planning for the following decade to sustain a yet-unseen profitability. Vertex’s momentum in Part 2 and view of the finish-line in Part 3 required persevering through doubts that more often than not kill a company.

This insider’s account of the uncertainty and challenges facing the pharma/biotech C-suite (especially start-ups) is the book’s strength. For example, Vertex’s Hep C drug Incivek (telaprevir) made close to $1billion in its launch year, dominated Merck’s rival boceprevir with a 75% market share and was hailed for being made affordable for low-income patients. Yet Vertex’s stock price fell significantly during this time in the face of promising clinical results from Pharmasset’s next-gen "nuke" (nucleotide analogue) Hep C treatment (which later became Gilead’s uber-blockbuster Solvaldi/sofosbuvir, hailed as a practical “cure” for Hep C and so expensive experts predicted the drug could potentially bankrupt the US, UK, and French healthcare systems). Vertex had an indisputable winner but, in Wall Street’s eyes, had failed to make the right acquisitions early on to strengthen its pipeline in the face of next-gen competition (Incivek was discontinued two years after launch due to falling demand).

This tension, between a hunt for a scientific breakthrough by very smart (and altruistic) people and the need for a business strategy in crafting a narrative for Wall Street’s expectations, is a theme that pops up throughout the book. Early in the book, Vertex is faced with difficult choices in deciding which research teams to lay off to deal with the reality of burning too much cash and the need to bring a product to market in a certain timeframe. At another early point, Vertex’s share price rises when it decides to reward investors with a dividend while rival Merck’s share price drops when new CEO Ken Frazier reinvests net profit back in the company’s R&D efforts to better prepare for the future. I hadn’t appreciated how confusing this balancing act between innovation and (often fickle) investors could be.

Overall, I’d recommend this book for someone working in life sciences/biotech or healthcare generally (e.g., pharma/biotech companies, pharma reps, physicians/nurses, health insurance) or with a vested interest in understanding drug discovery and commercialization (e.g., specialized academics, consultants, institutional investors, journalists). For such audiences, it has great insights that I haven’t seen covered in such intimate detail in other books or articles though may require re-reading a chapter or two early on. It would be a stretch to say this is an accessible read for the average citizen to understand the challenges in making a new drug product and its impact. Perhaps in the hands of a better writer it could have been (as was done with cystic fibrosis in Part 3, the author could have expanded upon storylines of real-life patients and how the new drugs affected their lives). If you want to know whether this book is for you, I would recommend reading the first chapter of Parts 1, 2, and 3 to see if it sparks an interest.

[William · Rating 3 out of 5]

'The Antidote' is a follow up to 'The Billion Dollar Molecule' (1993), and if you've enjoyed that excellent book, it may seem 'werth'while to find out what happens when Vertex Pharmaceuticals Corporation finally launches its two drugs that were more than 20 years in the making.

However, the first two thirds of the book were a disappointment. Although it does provide a bridge from 1993 to the company's long awaited success in the marketplace, Mr. Werth's account of the undoubtedly hard work leading up to launch of Incivek as the first effective Hepatitis C treatment in 2011, and that of Kalydeco to improve the lives of a subset of Cystic Fibrosis suffers in 2012, is a dry record of corporate comings and goings leavened with very little in the way of insight, drama or analysis. The writing is competent, but not up to the standard of his earlier book.

Takeaways:

* 90% of the value in reading this comes in the last third, beginning with the Incivek launch--skip to that part if you value your time.
* Mostly, this is a long, boring Wikipedia entry about Vertex Pharmaceuticals Corporation.
* Dumb title. Grandiose, and it's never clear which of Vertex's two drugs is referred to. Neither one, strictly speaking can be called an antidote, since one kills viruses, and the other administers therapy for a genetic flaw.
* The small contributions of money and enthusiasm made by the Cystic Fibrosis Foundation beginning in the 1990s did in fact pay big dividends both for disease sufferers and for Vertex and its stockholders.
* Werth spends a lot if ink saying that Vertex is 'special,' but never seems to come to grips with whether it is or not, or show why it should be considered as such.
* Jeff Boger's two-page 'vision' for the future quoted at the end comes across as a preposterous fantasy: ipso facto, preposterous fantasies can help build important companies.
* Science is hard work (cf. Edison: Invention = 99% perspiration + 1% inspiration.), as was conveyed well in the first book; not so much in this one.

[Alex Radtke · Rating 3 out of 5]

The Antidote is a pseudo-first-person account of the harrowing field of pharmaceutical development told through the perspective of Vertex's management as an amorphous bloc. While there is a distinct cast of characters, they aren't particularly fleshed out; an exception is Josh Boger, though a lengthy section that includes bits from his blog I found more grating than illuminating.

It also takes a highly financially minded perspective, with much of the text dealing with coaxing money from Wall Street and managing investor expectations while keeping an eye on the competition. Near the beginning, when the science and biology are more at the forefront, the mixture of discovery and breakthrough with the nitty-gritty of finance did effectively convey the chaotic jumble that drug development can be. However, by the 3rd section, the only real narrative thrust seemed to be the movement of the stock price and Vertex's market capitalization. Honestly, I tired of being given an update of the trading every 3 pages. Perhaps this is because the narrative has no clear ending, and the only way the author saw fit to conclude the book was on the ceaseless movements of market echoing the unpredictable fits of drug development that nonetheless will continue lumbering into the future.

This is a context-less book that doesn't do a great job setting up any of the narrative threads that it tries to tell through a particularly complex interwoven story. Basic science, biological research, regulatory navigation, finance capitalism, management philosophy, there's a whole witch's brew here. Even with my background in science, following the developments of each of the multiple drug programs could be difficult at times. The financial aspects were often confounding, and from my perspective it seems astonishing that anyone would invest money in these companies. And that's before broaching the argument of whether or not this is a rational system for developing treatments for patients. I think the book takes an overly deferential tone towards questions like drug pricing and drug patents, not offering any real critical perspective.

Overall, I can't help but feel that the largest takeaway is how Vertex largely fell short of its founder's claims. Boger comes across as having outsized ambitions and an overly optimistic view of his company's abilities. It's notable that their major successes are in cystic fibrosis, stemming from a collaboration with the Cystic Fibrosis Foundation, while their efforts in hepatitis C are eventually matched by competitors (and ultimately Vertex is beaten out). While they certainly can be commended for achieving as much as they did as a comparatively small company, their revolution is more incremental than their rhetoric suggests.

[Yang Zheng · Rating 4 out of 5]

*My caveat to this review is that I am in biotech, which is why the 4-star review*

Otherwise a 3-star book, The Antidote, sequel to The Billion Dollar Molecule, goes through the years after Vertex establishes itself as an up-and-coming biotech/pharmaceutical company. It isn’t as well organized as the prequel and often goes into painstaking details that breaks the flow of the book. However this fully captures the amazing journey of Vertex and gives readers a realistic look into the world of biotech.

A must-read for anyone in biotech or have a strong interest in the space. Not really your typical read if you’re just searching for another book.

[K · Rating 1 out of 5]

This book took me more than four months to read, which is something that has not occurred to me since high school. There was something interesting in there, somewhere, but the prose was too bloated with extraneous detail to ever bring it out. Instead, The Antidote drones on for about 400 pages before coming to an sudden stop (with the Marathon Bombings shoehorned in as an abrupt endpoint).

[Andrew · Rating 4 out of 5]

I am writing this review in 2020. The #1 topic around the world this year is a pandemic. This can be broken into sub-topics, such as “who has / had it?”, “what is the infection / survival rate?”, “What is my/other government doing about it?”, and “when will there be an effective treatment / cure / vaccine?” Those that are interested in a high level look at just what it takes from a scientific and business side at addressing the last question are encouraged to go back a few years and read “The Antidote” by Barry Werth.

In “The Antidote”, Mr. Werth follows the history and fortunes, ups and downs, of Massachusetts based pharmaceutical company Vertex. The potential rewards of an effective treatment for a disease can be incredibly lucrative. However, the up-front costs are enormous. Scientists must prove to their management that they have a promising lead on a new medical development. Those same scientists and their associates – or those replacing them – must perform a significant amount of research, and test upon test upon test, in order to prove that the treatment is effective AND to prove that the potential side effects have been identified without them being worse than the disease that they are attempting to cure. Then, there’s the government … documentation of every step of the way must be prepared in accordance to strict standards. Finally, they MAY approve it. That all takes time.

Other parties do not WANT things being done slowly and meticulously. Financiers, whether stockholders, bondholders, investment firms, or banks, want as large a return on their investment as quickly as possible. Those afflicted with whatever disease is being investigated certainly do not want to wait for a cure, either – in many cases, they don’t have the TIME to wait!!

“The Antidote” takes an in-depth look at all aspects of the forces at work to bring a drug to market. For those who are not as into one of the aspects and pressures of this kind of research, the corresponding sections of the book may seem drawn out – perhaps even boring. However, those with an interest or those with an open mind will find this incredibly interesting and educational.

This book is a suggested read for most. The rest will find a magazine article sufficient to satisfy their needs.

RATING: 4 stars

[Josh · Rating 3 out of 5]

Werth's first book on Vertex, The Billion Dollar Molecule, follows Boger through the founding and early stages of Vertex. It describes this virile, urgent start-up trying to revolutionize the pharmaceutical industry. The Antidote picked up where the The Billion Dollar Molecule left off, as Vertex transitioned into a more stable company with a more robust and diverse research pipeline. The book covers the infamous period of "Vertex 2.0" where they are out-innovated in Hepatitis C, eventually ceding the market to other competitors. This lesson inspired the current "Vertex 3.0" strategy to be "first-in-class" and "best-in-class."

To begin my review, this book is probably longer than necessary. In particular, substantial stretches felt like a documentation of Wall Street's temperature and opinions on Vertex. While potentially valuable, the real interest in Vertex is its research pipeline and process of innovation. I would have preferred this book to focus more on the scientific side of Vertex than the financial and corporate aspects.

Other reviews question who this book is for. My answer would be Vertex employees, especially those in corporate, research, or clinical divisions. Otherwise, this book has a pretty narrow audience, further narrowing as it gets older and less relevant to modern pharma.

[Vlad · Rating 3 out of 5]

Biopharma is a fascinating subject and the book follows Vertex, one of the success stories in the industry. The author has inside access, and it's his second book about Vertex, the first received universal praise (though I haven't read it).

This book follows two new drugs of Vertex from inception to launch, and the biggest drawback for me is that the science/discovery part is brushed aside for the more mundane business part of the process. If you want to learn more about the medical science achievements of the last 20 years - look elsewhere.

Also, the book seems rushed, often reading like a loose set of notes than a coherent piece of work. That guy did this, this guy remember that, this guy left, and that was fired. And here is a copy-paste from the founder's blog. Yeah, not the best-in-class narration. You sort of feel relieved finding out that almost 50% of the book is taken up by appendices and indices.

Still, the subject matter is irresistible and the book does make you hunger for more, so I'll try to read the book on Genentech next.

[Chloe Kirk · Rating 3 out of 5]

If you cut out all the unnecessary backgrounds of the infinite character list or tangent stories about the many many drug pipelines that never made it through, it would’ve been a much better read. The author spends too long on the stocks and business conversations while haphazardly throwing tiny snippets of science. I read these books for the science, not a 10 page breakdown of the politics at a drug conference.

I give it a 3⭐️/5 because Vertex is still a really cool story. Vertex beat its competition to make a name for itself in Pharma. But the story is poorly written, alike to someone scribbling notes while different events are happening without linking them together in a cohesive narrative.

(I read this book along with the first book - A billion dollar molecule - because I was lost when reading this book and thought it was because I hadn't read the first book. It didn't change my opinion in the end.)

[Andrew York · Rating 3 out of 5]

(Audiobook)- Reads like Kidder’s soul of a new machine, but reads a little bit more like propaganda/advertising for Vertex. There are some interesting parts, so worth the read if you are interested in pharma or drug discovery.

[Christopher Benassi · Rating 5 out of 5]

As someone embedded in the healthcare-business ecosystem, this book is a must-read. Great view inside the development and maturation of a biopharma company - and what it takes to bring a drug to market

[Frank David · Rating 5 out of 5]

This sequel to "Billion-Dollar Molecule" is another great read about how new drugs get from "bench to bedside". The two together are must-reads for anyone who works in biopharma or is considering entering the industry.

[Pablo Mora · Rating 5 out of 5]

The continuation of "The billion dollar molecule".

[Chris Volzer · Rating 2 out of 5]

Put it down 3 chapters in. Dragged on for too long and felt redundant.

[Yubo Gong · Rating 3 out of 5]

A bit repetitive if you know the industry well but very very helpful history and background

[Michael · Rating 3 out of 5]

Some of this is interesting but its mostly dry "here's how it happened" journalism with little synthesis or analysis.

[Matthew Gaines · Rating 5 out of 5]

Fantastic book. Finished the arc from the billion-dollar molecule of how VRTX became a mature company. Makes me more bullish on the company's prospects.

[Oliver · Rating 2 out of 5]

A shoddy sequel to what was already a shaky first book.

[Silvano Paternoster · Rating 2 out of 5]

Boring and dry read

quit after 10%, quite a pain to read

interesting content every now and then, but I'd rather read a scientific review article than this

[Patrick Hackett · Rating 4 out of 5]

While I wasn't quite as enthralled with this 2014 book by Barry Werth highlighting Vertex's path as the 1995 "Billion Dollar Molecule," still a great and insightful read.

[Rj · Rating 5 out of 5]

Great follow up to a great story

[Katie Miller · Rating 5 out of 5]

I will read anything this man writes. I “read” as an audiobook and loved it!

[Jay French · Rating 4 out of 5]

I recently read and greatly enjoyed "The Philadelphia Chromosome", a book about the finding of a first-of-its-kind drug to treat a specific leukemia. I very much enjoyed the way that book portrayed the people involved in defining the disease, researching and testing the cure, and bringing it to market. You got to see a long lifecycle of research to application in drug development. "The Antidote" covers the same kind of ground, describing the next big drug developed like Gleevec from "The Philadelphia Chromosome". In fact, Gleevec makes an appearance in "The Antidote". Incivek ends up being the primary drug followed in "The Antidote", a cure for a variant of Hepatitis.

While this has a bit of the feel of "The Philadelphia Chromosome", this is much more a business story. The focus here is not on one disease, but on Vertex, a pharma that is working on a stable of drugs to impact a wide variety of disease targets. The author follows the stories of a variety of high level managers and executives through nine years as the company moves from research through focusing on specific drugs to testing and approval and the realization of sales. The book is positive on Vertex throughout, at least until the very end, when it leaves the story with questions of whether the company has lost its mojo as early employees leave.

I found the book somewhat difficult to read. The science is described in more detail than I could follow. The sheer number of people described were also difficult to follow, and they kept on reappearing at later points in the story. Focusing a bit here would have been better. There were few insights into the majority of the people that are described. This is a lot of description of "what happened at work".

On the flip side, the story behind the business of Vertex was very interesting. As a document of the issues faced and the decisions made at a critical point in the life of the company, as it changed its focus from purely research to commercialization, I thought this captured the intensity of the environment well. And there was inherent intrigue throughout, you never knew when a key player would quit or be fired, if the all-important tests would go well, if the company gets bought out, what the FDA does, or if the company sells out its founder's vision. The author kept the suspense up throughout. I have a higher appreciation for Vertex and for the drug commercialization process. I think a business-focused reader would take away examples of what worked at Vertex, including how they changed strategy over time, how they organized, and how the founders kept their vision alive after leaving the company.

I won a copy of this book in Goodreads First Reads program.

[Shalom · Rating 3 out of 5]

This book was really tough to get through. The author jumped between topics and paragraphs so quickly making it hard to follow. The way he jumped decades was reminiscent of an author with ADD, or an author with a bad editor. The book was very scientifically in depth and I’m not sure how many people are/were able to follow through and understand all the nitty gritty details. The author also introduces so many characters it made my head spin, but thankfully he provided a cheat sheet in the front of the book lessening the pain of the tortuous memorization.

This new, “modern” world of biopharmaceuticals is being funded solely through Wall Street with its promise of future revenues. This phenomenon is not only the operating mantra of Vertex Pharmaceuticals but also of Pharmasset, Isis and others as well. These small, nimble, and “innovative” biotechs raise hundreds of millions of dollars on seeming bravado while losing billions of dollars on operating costs. They only having the vague promises of hopefully developing successful and very expensive drug in the future. Somehow Vertex made deals with larger, more mainstream Pharmaceutical companies that allowed them to fund the R&D for their drugs. In the confusing sequence of events and acronyms, executive level managers are cycled through numerously and rapidly as the story rises to an anticlimactic conclusion.

I did enjoy this difficult to read book as it provided tremendous insight into the new world of biotech and pharmaceutical companies, especially the way they are managed and funded. This is exactly the modus operandi of the tech world and I wonder if this is the future of the pharmaceutical industry as well.

[Anoop Dixith · Rating 4 out of 5]

I have always closely followed pharmaceutical and biopharma stocks, and fascinated by their extreme volatility (except for few very big ones like J&J), which was the result of a trial going wrong, or a failed drug test, an FDA approval of their drug etc. The Antidote book opened my eyes to why that was the case, and in a very thriller-novel like way.

The book is about the Vertex Pharmaceuticals, its founding, losses, failures, and eventual success. Its founder Joshua Boger's undying persistence to make it big is a story as inspiring as any! He mentions his goal was to make Vertex a company with a billion dollar revenue and stand up against biggies like Merck, and it took him little over 22 years to accomplish the same.

But the book is not just about successes. The book is about all the failures of Vertex prior to reaching great heights, failure in HIV related drugs, and their eventual fortune with Hepatitis C drug. The book also elaborately describes all the politics, bureaucracy, and non-technical struggle in getting a drug successfully into market. The book, though not very technical, also goes through the basics of enzymes and other biopharma related terms and processes wherever needed.

This is my first book on the extremely operose and volatile business of biopharma and pharmaceuticals, and I thoroughly enjoyed the work.

[Eric Wurm · Rating 3 out of 5]

A follow-up to his related work "The Billion-Dollar Molecule", Werth's Antidote continues the story of the pharmaceutical startup Vertex. With a firm scientific basis in research as a business strategy, Vertex takes on the much larger firms in seeking to find treatments for cystic fibrosis and Hepatitis C.

A book about the rise of a publicly traded pharmaceutical company succeeding against larger rivals may not sound to the average reader to be an interesting subject. Admittedly, this book may appeal more to pharmaceutical insiders and medical professionals more than anyone else. However, if the potential reader has an interest in how new drugs are conceived and brought to market, or an in interest in applied science, then they might enjoy this work more than what the subject matter may imply.

"The Antidote" is a well written and detailed account of the rise of a small drug company and its highly successful product. If the described subjects are of interest to you, I believe you will find it a worthwhile read.

Disclaimer: This book was provided free of charge by the fine publisher Simon & Schuster for the purpose of review.

Further Disclaimer: Any publisher that sends me a quality book free of charge will be referred to as a "fine publisher".

[Steve · Rating 3 out of 5]

This is the author's second book about Vertex, an early 90's start-up pharmaceutical company founded to combat the virus that causes AIDS, that has now turned it's attention to other diseases. There are a lot of names that come and go quickly through this book and that made the first half of the book hard to follow at times. The underlying story is about how Vertex tried to keep it's start-up drive to be different than big pharma going while it got bigger and bigger itself. I liked how this book showed the counter influences of discovery and research against the need to please shareholders to fund the company while it worked to cure disease and finally turn a profit. The science was interesting as well as the business aspects of the company over it's 20 year (to date) journey to fight, AIDS, Hepatitis-C, Cystic Fibrosis and Wall Street. The personal stories of scientists, patients, executives, regulators and financial analysts were woven together to tell the story of Vertex and the world behind the creation and marketing of new drugs. I received a free ARC of this book through Goodreads First Reads giveaways.

[Brad McKenna · Rating 2 out of 5]

The chemistry was beyond me and I really dislike Wall Street. So the fact that the so much of the book focuses on how they procured money from stocks and venture capitalists and the like really made it tough for me to read. It was fascinating to read about how an industry with a 30-1 success rate on their products (read: drugs) remains viable. It was also interesting to see the battle between altruism (the want to cure diseases) and capitalism (it IS a business after all). One last thing I like was how I learned that the difference between a brand name and a generic is the medium by which the drug is absorbed through the body. One of the tricks getting the drug in the blood stream is to find a way for it to survive the GI tract. The brand name people don't have to give all their formula on this to generics and so the generics' drug may survive the GI tract is lesser quantities and thus be less effective.

So there is plenty to like about this book, but I just couldn't get passed the money making aspects of it.

[Stu West · Rating 3 out of 5]

A sequel to 1994's The Billion Dollar Molecule, a terrific story of the strategic scramble and grindingly exhausting lab work necessary to get Vertex Pharmaceuticals, a biopharma start-up, off the ground. By the time this second volume picks up, there's a creeping feeling of corporate middle age at Vertex as founder Josh Boger dedicates himself to formulating the perfect company mission statement and brings in a consultant to identify Vertex's corporate values. The book is less about the science and more about the boardroom politics and dealmaking involved in developing and launching a new drug, and while reading about patent disputes and stock market fluctuations proved to be surprisingly engaging, by the end my interest had waned and I was left with a hollow feeling about the whole endeavour.