Book review: THE ANTIDOTE, by Barry Werth



“Today’s medicines can cost hundreds of thousands of dollars a year. The story of how two companies set prices for their costly new drugs suggests that the way we determine the value of such treatments will help decide the future of our health-care system,” writes Barry Werth in the MIT Technology Review.


In “A Tale of Two Drugs,”, he writes that the advent of these more targeted, more effective drugs will introduce the prospect of ever-rising prices, highly effective and ultra-­expensive so-called orphan drugs like Kalydeco may impose a stricter rubric for determining the price of all new medicines. Being able to more precisely identify the effects of new treatments and the patients who will benefit from them should finally allow companies to price these drugs on the basis of their true value. Whether the resulting prices are “worth it” will then be up to society to decide.

Barry Werth’s book The Billion-Dollar Molecule (1994) described the early days of the startup Vertex. A sequel, looking at Vertex 20 years later, is called THE ANTIDOTE (2014).

In THE ANTIDOTE, Barry Werth draws upon unprecedented inside reporting spanning more than two decades to provide a groundbreaking closeup of the upstart pharmaceutical company Vertex and the ferocious but indispensable world of Big Pharma that it inhabits.

In 1989, the charismatic Joshua Boger left Merck, then America’s most admired business, to found a drug company that would challenge industry giants and transform health care. Werth described the company’s tumultuous early days during the AIDS crisis in The Billion-Dollar Molecule, a celebrated classic of science and business journalism.

Now he returns to tell a riveting story of Vertex’s bold endurance and eventual success.

The $325 billion-a-year pharmaceutical business is America’s toughest and one of its most profitable.

  • It’s riskier and more rigorous at just about every stage than any other business, towering biological uncertainties inherent in its mission to treat disease
  • a 30-to-1 failure rate in bringing out a successful medicine even after a molecule clears all the hurdles to get to human testing
  • the multibillion-dollar cost of ramping up a successful product
  • operating in the world’s most regulated industry, matched only by nuclear power.

Werth captures the full scope of Vertex’s 25-year drive to deliver breakthrough medicines. At a time when America struggles to maintain its innovative edge, The Antidote is a powerful inside look at one of the most intriguing and important business stories of recent decades.

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