For Blood and Money: Billionaires, Biotech, and the Quest for a Blockbuster Drug

"Even in cancer drug development most of the financial gains often went to capital and not to labor."

I read this because my daughter is a research scientist for a startup biotech company, and I was surprised to learn that the book is about the development of the drug ibrutinib, which is a kinase inhibitor, and the targeted cancer drug that worked very well for my husband for nearly 5 years. It is indeed a "blockbuster" drug.

The book takes us from the almost accidental discovery of the drug, its acquisition by the company that brought it through further development to clinical trials, and ultimately to market. The science is interesting, but what made the book especially interesting is how the whole shebang is financed--the investors and show more venture capitalists who, sometimes despite having little formal science training/education, are often self-educated or just following their gut in deciding which drugs they think have to potential to make it big, and are therefore worthy of pursuing, and which to let fall by the wayside.

What I found particularly interesting is that when a drug makes it big, the bulk of the reward goes to these investors/venture captalists (vultures), and not to the scientists who did all the work to develop the drugs. I also found it interesting that nowadays the big drug companies, the company names you'd recognize, no longer seem as focused on developing new drugs as they do on investigating startups to find one with a promising drug nearly ready for FDA approval. They then acquire the startup, or the rights to the drug, and avoid the risks and uncertainty inherent in drug development.

Here's the money quote:

"The structure of the payout could not have more clearly highlighted the divide between the operators and the financial investors. It was Hamdy's blood, sweat and tears, it was Izumi's garage, vision and drafting, it was the constant devotion and work of so many unsung heroes that helped create {the drug}. Hamdy recognized the role of Rothbaum and his group of financial investors. They clearly were essential, but the reward seemed misallocated. While the financial investors spent their time manufacturing equity instruments that allowed them to be paid first and most, those in the trenches spent their time manufacturing medicines and had no idea about potential payouts or how to protect themselves."

Recommended if you have an interest in the subject.

3 1/2 stars show less

Compelling book and I found the people involved to be interesting (albeit not always for good reasons). I found it particularly cool that the book is about meds used for blood cancers, as the author talks about ASH (American Society of Hematology) meetings. I haven't been to them but I've travelled a few times to the places they've been held with my dad as he's gone to the meetings.

At any rate, I was chatting with my dad about this book and he mentioned off the cuff that, apparently, when they did clinical trials for acalabrutinib, they did not include patients at risk of atrial fibrillation in the study so they could claim it doesn't cause atrial fibrillation as a side effect. But apparently it does. (I haven't read the study, but I show more trust my dad on this.) So I guess I wish the author had interviewed one or two hematologists or hem-oncs who weren't involved directly in the clinical trial process to get their unbiased opinions on the two different meds. I mean, they both appear to be game-changers as far as CLL treatment goes. But something struck me the wrong way about the author's pretty much universally positive take on acalabritinib after hearing about the study design from my dad. (The author is more critical about the first med, ibritinib. I think it would be more fair to be equally critical about both meds unless there was a really good reason not to be.) show less