Fellow blogger, current colleague and friend Keith and I
spent an enjoyable evening two days ago at an event which I wouldn’t have
anticipated if you had asked me about it before: a sort of fund-raiser/pitch
for a movie based on Barry Werth’s book about the creation of Vertex Pharmaceuticals, “The Billion-Dollar Molecule”.
I have to confess being blown away by the book when I first
read it in graduate school. The breathless descriptions of the science and the
scientists, the glitter of structure based drug design and and the sheer effort
of drug discovery really left an impression of me. After working in the reality
of drug discovery for a decade or so, I perhaps don’t feel as breathless as I
did the first time around. Yes, drug design is exciting, but no, most of the
work that we do in the field is far more mundane and boring than what appears
in the book (and this is true for the rest of science). And the science of drug
design is also far more sobering and limited than what it seemed in the 80s. Nonetheless,
if there was a short list of books on biopharmaceutical research that would seem
likely to transition to the silver screen, Werth’s volume would probably be on
top of that list for me because of its sheer novelistic qualities.
The event itself featured a panel of three scientists and
one lawyer who were present at the creation and subsequent developments at Vertex
in the late 80s and early 90s: Manuel Navia, Mark Murcko, Roger Tung and Ken
Boger would all be familiar to anyone who has read the book. The event was
fittingly organized in the old Vertex building near 3rd street in
Cambridge, and not surprisingly it drew a lot of Vertex old timers which
inadvertently turned it into a Vertex reunion. An ancillary side session
featured a silent auction for photographs taken by Nobel Laureate (and Keith’s
graduate school co-advisor) Wally Gilbert who was also there.
Much of the discussion really focused on the scientists’
views of what they thought should really come across from the movie, and I
largely agreed with their suggestions. The overwhelming consensus was that the
movie needs to communicate the sheer and appalling rate of failure – probably
unprecedented relative to any other industry – that we in pharma and biotech
have to deal with. 99% of everything that we do, right from the most basic
research to the most applied clinical work, simply fails. Almost all of us go
through our entire careers without contributing to the discovery of a single
important drug. And it all fails because of one overriding factor which I and
others have discussed before – our ignorance of basic biology and human disease.
It seems that this is probably the preponderant feature of drug discovery that
simply fails to make its way across to the public: almost every argument that
the public makes against drugs, from their high cost to their side effects,
boils down to the simple fact that we simply don’t know how to do it any better. I
agree with the participants that if there’s one message that really needs to
shine forth from any movie about drug discovery it needs to be this one about
attrition, failure and ignorance. Not exactly an uplifting message, but
essential for an accurate perception of drug research.
One of the panelists also raised the very relevant issue of
how to accurately strike a balance between the sheer tedium of everyday
research and the occasional breakthroughs that permeate the entire practice of
science. If there’s one flaw in “The Billion Dollar Molecule” it’s that it
seems to downplay the former aspect and really emphasize the latter. Yes, drug discovery
is a high stakes enterprise and yes, the scientists who do drug discovery can
have titanic-sized egos and can have their emotions running high and wild and yes, the
science of drug design can sometimes seem as exciting as the ‘science’ in ‘Avatar’,
but for every one of these facts the opposite is also true: drug discovery
scientists are normal people with a spouse and kids and a mortgage, and 90% of
the science of drug discovery is like 90% of science in general – incremental,
unflashy and mundane; less Holmesian detective work and more 9 AM-5 PM office
job. What the book did was compress all of this into a heady, heroic 350-page narrative, and one wonders if the movie should try to do the same. Another way
to tackle the issue might be to make a documentary that’s more realistic,
although admittedly it would then be harder to get Kevin Spacey to play Josh
Boger (one of the more fanciful suggestions bandied about).
Curiously, the entire project that the book hinges on - the
quest to find a breakthrough immunosuppressant - actually failed because they
were looking at the wrong target (the curse of biological ignorance struck
again), so communicating the reality of the fantastic failures that emerge from
a fantastic effort should come naturally to the narrative in the movie. It's a testament to the vision and resilience of the company's BOD and management that they successfully pivoted away from this major failure. It also
seems that the movie should heavily capitalize on the sequel to “The Billion-Dollar Molecule” (“The Antidote”): while that’s far less sensational, it deals with the two breakthrough projects at Vertex (hepatitis C and
cystic fibrosis) that actually succeeded in a very big way.
Notwithstanding the challenges, I have to say I am game for any cinematic, literary or other endeavor that makes the science, art and business of drug discovery more comprehensible to the layman. There are few activities both more profoundly misunderstood and more fundamentally important to human society than the creation of new entities that save or improve the lives of millions, and any project whose express goal is to make the general public appreciate this reality – even at the expense of some glamorization – would be one I fully support. Good luck to the film-makers!
Notwithstanding the challenges, I have to say I am game for any cinematic, literary or other endeavor that makes the science, art and business of drug discovery more comprehensible to the layman. There are few activities both more profoundly misunderstood and more fundamentally important to human society than the creation of new entities that save or improve the lives of millions, and any project whose express goal is to make the general public appreciate this reality – even at the expense of some glamorization – would be one I fully support. Good luck to the film-makers!