Nathan Vardi, author of the new book For Blood and Money spent some time talking to IPM’s editor in chief Damian Doherty about this thrilling and dramatic true story of a small California biotech company and its quest to discover a blockbuster drug for chronic lymphocytic leukemia (CLL). When investors, scientists, corporates, and a biotech company all compete for market domination, much is revealed about vested interests, missed opportunities, and the serendipitous nature of discovering an elusive “miracle” molecule.
Q: Congratulations Nathan on a truly gripping story on the trials and tribulations of being a drug hunter and the quest for hitting the multimillion molecular jackpot! Is this the first book you’ve written?
A: Thanks, Damian. My professional roots are in magazine journalism, but For Blood and Money is my first book.
Q: Did you find the transition easy from reporting to writing a book?
A: I have written many long articles during my career, but I found writing long to be absolutely liberating. The idea of developing characters, foreshadowing events and themes, and telling the whole narrative arc of a story was a tremendous amount of fun. Making sure the structure of the book worked was a new challenge for me that I definitely had to take on. It’s very different from the structure of a magazine article.
Q: What was the genesis of the book?
A: For many years, I was responsible for the coverage of big money investors at Forbes, including private equity and hedge funds. That meant I was reporting on different industries all the time, which was super fun. One day I could be reporting on oil, the next day healthcare, next streaming services. During the period 2010 to 2020, the industry I found most dynamic was biotechnology. This was a golden age of biotechnology investing, and the impact it had on human lives was profound. The role that big money played in innovation was large and often misunderstood, even by industry participants themselves. Then, I stumbled across this one story that I thought was fascinating and extreme, and epitomized the biotech boom itself. At first, I was interested only in reporting on Wayne Rothbaum, a mysterious biotech–investing billionaire. When he initially refused to talk to me, I started to talk to other people in his orbit. I eventually decided the story of the development of BTK inhibitors would make a good book.
Q: Did you personally know any of the protagonists in the story before you decided to write the book?
A: Not really. I didn’t know any of the main protagonists before I started to report on this story.
Q: How important was it to illuminate the work of physician scientists like John Byrd in the book?
A: It was very important to me to highlight the role that physician-scientists play in the drug development process. In fact, it was very important to me to show how many different people make crucial contributions to a novel cancer drug. Nobody can do this alone, and doctors like John Byrd play an important role. One of the reasons Dr. Byrd was able to play such a big role in the development of BTK inhibitors is that he had a huge institution behind him, the cancer center at Ohio State University. His dedication to patients is extraordinary. In this book, I tried very hard to be honest and open about the incentives money creates in drug development. But the physician-scientists really don’t participate in the financial windfalls. That was another point I wanted to make clear.
Q: Would you say there is an overarching lesson this book espouses for investors or start up biotech founders looking to start their journey to bring a successful candidate to market?
A: You bet. This is all very hard. You need to get both the science and financing sides of the equations right. Luck helps.
Q: How long did it take to research and consequently write the book?
A: The whole process took me three years. Remember, I also had a day job for most of that time.
Q: Do you think this narrative is a unique outlier, or do you sense there may be other intriguing tales waiting to be told?
A: I do think there are some unique aspects to this story. When I went to the publishing houses with my book proposals, some wondered why I was writing about BTK inhibitor drugs and not, say, Humira. There are ads for Humira. My answer was that the Humira story is not nearly as interesting or emblematic as the Imbruvica/Calquence story. Nevertheless, I know there are other amazing drug developments waiting to be told. Some are still developing as we speak.
Q: What would you say was the most challenging aspect of pulling such a huge project together?
A: There are so many challenges. Here’s one. When I told some people in the industry I was writing this book, they said, “good luck.” They said every time they try to tell people about what they do for a living, their eyes glaze over the moment they say, “Phase 1 trial.” Understanding the regulatory trip these drugs took, and writing about it in a reasonably compelling way, is a specific challenge to writing about drug development.
Q: The level of detail and descriptive skill you blend in creating a seamless, fast-paced narrative is a true testament to your journalistic talent and clearly your ability to engender trust with individuals. How important are those qualities in a writer, amongst others, in producing a successful book, do you think?
A: Thanks! I enjoy reporting out and writing about small details, but as a writer you need to make decisions. What do you keep and what needs to go? I try as much as possible to remember I am writing for the reader and keep them firmly in mind. When I have failed as a writer, it’s often because I was writing for myself, for sources, to show off, whatever, but the reader needs to be front and center.
Q: Were there many twist and turns as the chapters evolved, or were you always sure of the shaped direction of the narrative from the outset?
A: I had a firm idea about where I wanted to go, but as I wrote the book, I adapted when necessary. For example, when I first wrote this book, I wrote it in two parts. The first focused on Pharmacyclics and the second on Acerta, the two biotech companies featured in the book. One of the challenges when writing about drug development is the sheer number of people involved. So you are asking a lot of the reader. But when I finished, I realized the structure didn’t work. It was like reading two books. No fun. So I changed the structure to three parts. Everything flowed so much better after that.
Q: Are you mulling over the next potential fascinating biotech drama, or are you taking a well-earned break from what must have been an epic endeavour?
A: I am thinking about it. But not in book form. I will stick to feature articles for a while.
Q: Lastly, if you had the chance to have lunch with a biotech/pharma/science leader, past or present, who would that be?
A: Uğur Şahin
Nathan Vardi is managing editor for enterprise at MarketWatch. He was previously a senior editor at Forbes.
