The Antidote: Inside the World of New Pharma
is liable to “blow at any seam,” as Tom Wolfe wrote about the endless ineffable peril of staking it all on a lofty high-risk mission.
    Mostly I wanted to see what it had taken to prevail against such harrowing obstacles: What had Boger’s vision become, and did it representa true way ahead in our boundlessly promising and still barely comprehended new biological epoch? After he’d resigned from Merck—alone, without first taking anyone with him, and without any assurance that anyone would follow—Boger went home and sketched his goals on a whiteboard: “Make better drugs, faster. Create the 21st century biopharmaceutical company. Become Merck, only better.” It was almost a haiku. He thought it would take him twenty years and $1 billion. Now, just two years late, at nearly four times the cost, Vertex verged on proving all that he had set out to do.
    “One of the most common questions I’ve gotten lately is, ‘Gee, did you ever imagine this would occur?’ ” he told Vertex’s sales troops that spring. It was a few days after Osama bin Laden was killed in Pakistan after a decade-long manhunt, and the company was counting down to launch, primed to go one-on-one against Merck for the richest commercial opportunity in pharma. “My completely unsatisfying answer is, ‘Yes, absolutely.’ Now, that comes across to some people as fairly arrogant, and to that I say arrogance is only a problem if it doesn’t turn out to be true. If it turns out to be true, it’s just persistence.”
    I’d discovered at Vertex that biomedical research emits a high emotional heat. It may be tempting to think that the competitive commitment in other disruptive tech industries is similar but the comparison is slender. In Silicon Valley, you’re trying to make a better product, not cure cystic fibrosis or Parkinson’s disease. Here the difference between success and failure can be the difference between life and death. Vertex was about to debut not only the first drugs discovered and developed by its own people and commercialized under its own label. It was about to debut itself, an organization of nearly two thousand people sculpted as much by the changing health care economy and the gyrations of its industry over the past two decades as by Boger and the others who joined him. They had had notable early success in the crucible of that new biomedical order—AIDS—but that victory had been pyrrhic because, while it had produced a drug, Vertex hadn’t fully emerged along with it. Now the company would correct that disparity.
    Boger was right about arrogance. We may not like it in our faces, but it’s a problem only when it doesn’t turn out to be true.

PART 1
----
    Feeding the Beast

CHAPTER 1
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    APRIL 28, 1993
    Boston’s World Trade Center, unlike New York’s, was not a beacon of wealth and power but a refitted waterfront mercantile mart. It squatted on a pier above the city’s famously ruined harbor, offering a postcard view of downtown. Boger, age forty-two, stepped onto the podium before 250 worried executives at the annual meeting of the Massachusetts Biotechnology Council, a statewide trade group. In four years, his “highly unlikely start-up” had grown to 110 people sprawling among a warren of reconverted lab buildings near MIT—a public company with $50 million in the bank—and its reputation as a leader in structure-based drug design was supported chiefly by a string of impressive publications. The company had competitive research projects in multiple disease areas. Even those who’d thought its long-term goals delusional had to concede its short-term progress.
    Across the drug industry, the mood was black. In February, a month after Bill Clinton took office, he announced that his wife, Hillary, would oversee national health care reform, and at an appearance together at a Virginia medical clinic the president denounced “shockingly” high drug prices. He cited figures showing the industry spent more on

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