Medical Research : Health is Wealth. A front row seat for the race to develop a blockbuster drug.

' For Blood and Money. ' By Nathan Vardi : Few scientific endeavours are more lucrative than developing a blockbuster drug - or a blockbuster vaccine. Liptor, Pfizer's cholesterol-lowering medication, is reputed to have made the company more than $160 billion.

Advair, an asthma drug, has earned tens of billions of dollars for GSK [formerly GlaxoSmithKline]. And BioNTech, a firm few people had heard of before the Covid-19 pandemic, has made billions from its MRNA vaccine.

Naturally pharmaceutical companies - and, these days, venture capitalists and hedge funds - are always searching for the next wonder drug. Nathan Vardi's new book is a fascinating look at the quest to develop a new drug for blood cancer that targets only cancerous cells and not the healthy kind.

''For Blood and Money'' follows two small biotech firms in California, Pharmacyclics and Acerta Pharma, as they try to capture the market for a drug to treat chronic lymphocytic leukaemia, a cancer of the blood and bone marrow.

The technique involves inhibiting the activity of Bruton tyrosine kinase [BTK],an enzyme that regulates chemical signals inside some white blood cells. Mr. Vardi explains the science behind BTK inhibitors and shows how they became an attractive tool for cancer treatment.

The corporate drama begins with Pharmacyclics. The author introduces Bob Dugan, a successful entrepreneur who invests in the company, quickly wrests control from its founder and becomes CEO.

Mr. Duggan sacks a couple of key employees, who wind up at another biotech startup, Acerta. There they try to develop a rival drug that is based on a BTK inhibitor.The race is on.

The technicolour cast of characters includes medical researchers, doctors, scientologists and New York financiers. Readers become acquainted with their personal ambitions, egos and quirks, and the intrigue and politics of the their rivalries.

Mr. Vardi also lays out the slow, complicated process for the approval of drugs in America, overseen by the Food and Drug Administration, and the cold calculations of big pharmaceutical firms as they assess whether to invest in a new product. In the middle of it all are the patients, often elderly and desperate for a cure.

A financial journalist, Mr.Vardi knows the world of venture capital intimately, and is at his strongest when writing about the financial aspects of deals. He delves into his characters' backgrounds and recreates meetings and events in detail; the contest between Pharmacyclics and Acerta comes alive.

His efforts to present the story as a real-life thriller generate pace, even if the approach sometimes feels formulaic.

The story has a happy ending. The race ends up producing not one but two cancer drugs. Imbruvica from Pharmacyclics and Calquence from Acerta. Both are effective and become blockbusters. The prices are dauntingly steep, but tens of thousands of patients benefit.

As royally, as the backers of the two drugs, Mr.Duggan's own total investment of $50 million in Pharmacyclics yields $3.5 billion , Mr.Vardi reports. {The firm was bought by AbbVie in 2015.} Imbruvica, which became available first - marketed jointly withJohnson & Johnson - generated over $5 billion in revenues in 2021 alone.

AstraZeneca took a majority stake in Acerta in 2016; their drug Calquence brought in more than a billion dollars in 2021 too.

This high-risk method for finding a new cancer treatment certainly works. Yet the reader is left with a nagging question. Is this testosterone-fuelled, profit-driven process really the best way to develop life-saving drugs.

The World Students Society thanks ' The Economist. '


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