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The Billion Dollar Molecule: One Company's Quest for the Perfect Drug

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Join journalist Barry Werth as he pulls back the curtain on Vertex, a start-up pharmaceutical company, and witness firsthand the intense drama being played out in the pioneering and hugely profitable field of drug research.

Founded by Joshua Boger, a dynamic Harvard- and Merck-trained scientific whiz kid, Vertex is dedicated to designing—atom by atom—both a new life-saving immunosuppressant drug, and a drug to combat the virus that causes AIDS.

You will be hooked from start to finish, as you go from the labs, where obsessive, fiercely competitive scientists struggle for a breakthrough, to Wall Street, where the wheeling and dealing takes on a life of its own, as Boger courts investors and finally decides to take Vertex public. Here is a fascinating no-holds-barred account of the business of science, which includes an updated epilogue about the most recent developments in the quest for a drug to cure AIDS.

464 pages, Paperback

Published March 1, 1995

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Barry Werth

20 books17 followers

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5 stars
333 (29%)
4 stars
445 (39%)
3 stars
269 (23%)
2 stars
63 (5%)
1 star
14 (1%)
Displaying 1 - 30 of 100 reviews
180 reviews2 followers
September 26, 2022
2/10. This book was interesting as it followed the creation of an idealistic pharmaceutical company. Even in the age of big pharma, this small company, founded at the perfect time, was able to raise money and publish papers critical to the understanding of immunosuppressants. However, there was way too much detail into the setting up, financing, and development of the company. I wish more time had been devoted to describing the research and science behind the development of FK506 and its structure. Not to mention, this book was a let down as they spent the whole time trying to build the billion dollar molecule and never actually built it. And this book is wildly out of date, especially when it comes to the biotechnology industry, which changes rapidly. But I suppose the idea to build molecules from their structure and not trying to find drugs by sifting through dirt was a pretty novel and cool idea.
2 reviews2 followers
February 6, 2013
A nose dive into the thrilling world of scientific research, this book takes one on an exciting journey of a biotech start-up named Vertex Pharmaceuticals, and also an amazing history of money and science.

Led by Joshua Boger, the center of the company's story, Vertex takes on the biggest drug firms in the world in a race to create the next big immunosuppressant. Vertex deals with fearsome problems and competitors and takes risks and decisions not for the faint of heart, and keeps you glued to the story.

The book also takes the reader into the history of all drug research, through the 20th Century and beyond.It takes you straight into fast-paced million dollar labs, through legendary Harvard department corridors, and into the historical successes and failures of the most famous chemists of all time, right from Paul Ehrlich to modern whiz-kids.

The best part of the book is Barry Werth's inimitable style and penchant for narration. It gives an insight into the gritty details of drug approval, the fierce competition for credit and patents, and a world where money drives science. Although, those new to this kind of literature might feel at some points that they are being bombarded with information which they can't process at the speed of the plot.

If you start reading this book, you will learn a lot about how industrial research works and why. If you're someone who wants to know about what R&D is like and what is expected of those who intend to work in it, this book would give you a solid idea. Also, for history fans, this book is a gem. It will tell you about things that miss the modern history textbooks, a history which ran parallel to the one we know, creating a deep mark on the latter all the way.
79 reviews37 followers
September 23, 2022
I may be doing this book a disservice by awarding it 4 stars, as my 5-star rating system is likely biased toward books that build on my own preexisting knowledge and against books on subjects about which I know very little.

Billion Dollar Molecule is fascinating even for a biotech know-little like me. In all honesty, I lost track of some of the many scientists/characters, not to mention some of the science, but I think that fault lies with me, not Werth’s telling. I most enjoyed the way Werth provided a real sense of the drama and stress inherent at the intersection of biotech and Wall Street.

While I wholeheartedly appreciated his *very* thorough explanation of the relevant drugs and chemistry, I admit that my eyes glazed over at some of the level of detail. I imagine a reader with more background knowledge of pharmaceuticals and/or biochemistry would appreciate that level of detail more.

Still and all, even for me, this was great - challenging, but ultimately terrific, and especially good on the as-if-you-were-there descriptions of the internecine rivalries amongst the scientists. Altogether a fascinating read.
Profile Image for Xinyu Tan.
198 reviews30 followers
May 23, 2017
Anyone who has done some biomedical research would be very familiar with the uncertainty and frustration the author described. This is definitely not an very exciting story as I would imagine for a successful young company; there were very little eureka moments in the process - most of them were repeated trials and excruciating failures.

If I had read the book five years ago, I would probably have reconsidered my decision of doing a PhD in experimental biology.

This book is amazing at revealing all aspects of scientists and doing science and business. It reads very true and sincere. It is a book that anyone curious of biomedical or pharmaceutical industry should read.
Profile Image for Dipanshu Gupta.
71 reviews
September 9, 2023
What a ride, this book. An unparalleled insight into how early stage startups work, the humans involved in building them, the optimism required to build something new, and the dark clouds that follow every victory.
Human biology is one of the most complex sciences and it remains an evergreen beacon of the magic possible with the building blocks that nature has provided us. It dares us to build the impossible, because by tumbling through the maze of evolution, even we were possible.
Profile Image for Andy Oram.
625 reviews30 followers
December 1, 2010
Full of evocative writing and nearly incredible anecdotes, this book
illuminates one of the most important fields of research and
development while providing lots of human stories and ethical
questions to chomp on. The characters are so inspiring as to be
intimidating. I mean, here are whole generations of researchers who
spent a decade in higher learning and then devoted twenty-hour days
for months on end to alleviate some of the most devastating illnesses
affecting humanity. And what have you done with your life? The book
also contains some intriguing psychology, because the main actors
indicate that they're in the game for far more than money or glory.

Notwithstanding the heroism of all these protagonists, they also
engage in some morally questionable decisions in the pursuit of claims
to fame and funding for their companies. One has to end up
acknowledging that, in the strivings to advance human health and
knowledge it is hard to determine what is proper and what is
necessary.
Profile Image for Ben.
969 reviews119 followers
August 2, 2019
A very interesting story of a pharmaceutical startup. So much hype, with no solid basis, and yet they survive. Werth does a good job explaining the business, the science, and the experience of doing the science.

> Scientists, unlike, say, athletes, conjure their own competition. They seldom know precisely whom they’re competing with or where they are in the race. They hear things—rumors, reports—but the information comes at a distance and with a price: It may be exaggerated, deliberately misleading, or simply false. The atmosphere in a lab in the throes of a heated project is insular, secretive, xenophobic, superheated, and paranoid.

> "There's two situations where you want to be aggressive about publishing. One is when you're behind; the other is when you're ahead. When you're ahead, you demoralize the other guy. When you're behind, you have nothing to lose. It's when you don't know that you want to be most careful."
1,046 reviews
March 29, 2025
It’s a bit longer than it needed to be but this book does a great job of following the huge changes in the Pharma industry as it went from finding new molecules in a haystack hunt in nature to bioengineering them new molecules in labs to “fit” purposes. It follows the story on the startup of Vertex and the dynamics of competing for funding, prestige, and knowledge in the increasing competitive industry. It ends in the early 1990s so now I need to read the follow-up to understand how much the industry has evolved since then
250 reviews4 followers
January 22, 2024
The book follows the creation of an idealistic pharma company Vortex and the ferocious competition in the research of FK506 (immunosuppressive drug lowering the risk of organ rejection) and AIDS medication. I didn’t like that we don’t quite get proper closure on the competition (besides that Stu Schreiber beat them at the discovery). Boger (the scientist creator of Vortex) pioneered an approach to structure-based rational drug design that changed the way that drug development occurred (as opposed to techniques based on combinatorial chemistry).

Keep in mind that the book is written in 1995 so not so up to date. There were quite a lot of scientists’ names and sometimes the story breaks to tell their background story, so I felt lost sometimes. The book gives deeper understanding behind the technologies used but the way it was explained, it was hard to grasp for somebody not being knowledgeable in chemistry and biotechnology. But the book spent also fair amount on the business hurdles and raising money for a pharma startup (some things applicable in general for startups).
Profile Image for Stephen Russell.
Author 1 book5 followers
May 16, 2014
Good writing transcends genre, a fact that Barry Werth highlights in The Billion Dollar Molecule. What first began as a research assignment in preparing for my own manuscript, this book knocked down my expectations of a scientific tome written in and about the 1990s and replaced that notion with a powerfully written narrative about one man's goal to succeed. The pace is crisp, the writing precise, and the verbs muscular enough to push through 400+ pages of dense science. Werth shines most when he uses analogies to make abstract concepts understandable. Perhaps the best testament to this enjoyable book (albeit a bit too long for the story being told) is that I bought the sequel, The Antidote, on the day I finished The Billion Dollar Molecule.
Profile Image for Biafra.
32 reviews
August 27, 2015
This book is bloody brilliant. Follows Joshua Boger and crew as they take Vertex from an idea to a working pharmaceutical company. Along the way it outlines the history of several others outside the company and how their work influenced the projects chosen within the company. The writing is clear and one is left with a palpable sense of excitement for both the science and the biotech industry in general.
421 reviews2 followers
September 26, 2020
A very dramatic history that arguably leans heavier on the personalities involved than the science, though it doesn’t ignore the latter. Loses a star for me though in that too much of the “finale” is just basically briefly summarized in an epilogue. Know the author wrote a follow up but the net result was, despite the book’s length, I felt short changed by the material.
Profile Image for Christopher Benassi.
145 reviews
June 23, 2019
One of the best 5 healthcare/biotech books I've read. Extremely pertinent coverage with notable figures such as Schreiber and Starzl...and obviously the birth of a top biotech company
1 review
January 2, 2022
I read "The Billion-Dollar Molecule" because I've had a long-standing interest in drug discovery. It's an interest that I've pursued during my bachelor's degree in chemistry at Harvard, and now as an MD-PhD candidate at Northwestern. So I was pleasantly surprised to find that many elements in "Billion-Dollar Molecule" resonated strongly with my own life. For example, many of the Harvard faculty it mentions are people with whom I have only a few degrees of separation. I've looked up at R. B. Woodward's portrait, for instance, while doing problem sets in the chemistry library; and mentors keep telling me that I should get into contact with Stu Schreiber, who is still affiliated with the University. The same goes for Northwestern's involvement in the story: it prominently features the famous transplant surgeon Thomas Starzl, whose autobiography is sitting on my roommate's shelf. His own mentor, Loyal Davis, founded a surgical society that some of my classmates are involved in. And so it goes.

What keeps "The Billion-Dollar Molecule" from earning a fifth star, for me, is Barry Werth's writing style. His sentences interrupt themselves and he overuses appositive phrases. You never have to wonder what he's trying to say, because he will tell you three or four times, using synonyms, separated by commas. A related problem is his attempt to add color to the story by departing from his journalistic style. Werth is at his best when he's reporting dialogue, or even when he's explaining scientific concepts in layman's terms. When he's trying to describe the Boston winters, or the ambience at an investor conference in the Vista hotel, he struggles. Atmospheric paragraphs like that can add color to a novel, such as in former President Barack Obama's "Promised Land," or in Thomas Merton's "Seven-Story Mountain". Werth doesn't have their talent.

The book periodically drops names that will be of immense interest to readers with a science background and makes interesting connections between seemingly unrelated topics. In that regard it feels a little like glimpsing the web that holds modern scientific progress together. But those exciting interludes are offset by long stretches of boring material with bad prose, making "Billion-Dollar Molecule" a bit of a slog.
Profile Image for Todd Cheng.
554 reviews15 followers
July 9, 2024
“A Billion Dollar Molecule" is an epic heroic narrative that captures the relentless journey of scientific innovation and entrepreneurial spirit. The book portrays each heroic barrier and challenge, weaving them into a story that reads with a literary saunter, making complex themes accessible and engaging. I knew nothing of the science but liked learning about it through this book.

The author excels at delving into the intricate details of the scientific endeavors, the human stories behind the research, and the corporate battles faced by those in the biotechnology field. These elements are artfully intertwined, creating a harmonious fabric that keeps the reader charmed throughout a collection of chapters.

The use of metaphors and a diverse vocabulary enriches the narrative, offering a deeper understanding of both the science and the personal struggles involved. The author's adept storytelling illuminates the complexities of drug discovery and also highlights the passion and perseverance required to turn a groundbreaking idea into a billion-dollar success. A death march with epic egos and intense capitalism.

I am grateful for the nuanced exploration of these themes and the vivid portrayal of the characters' journeys. "A Billion Dollar Molecule" is a good-read for those interested in the intersection of science, business, and human ingenuity. A great read for a first exposure.
Profile Image for Chan No.
55 reviews
May 5, 2024
I'm not sure if I enjoyed this that much while I was reading it; I read the first ~50% in print form because it was sitting around the office, and the rest as an audiobook, with one three-hour section listened to on a flight a couple of times because I kept falling asleep. It's very dense with details and it wasn't clear where everything was going.

As a person working at an early stage biotech company, there was a lot that resonated. The description of the open plan office. People in one time zone work on something throughout one work day then send it off to the other side of the world just in time for them to start their day. People get attached to their projects and have fights about where to direct resources. There's a point where someone says something like, "I always like experiments that don't work the first time, because if they do, they never work again," and I think about that line every time I run one of my assays. Clearly, everything that happens has happened before.

It's not heavy on either scientific or business explanations, focusing more on personalities and drama. To describe it unseriously, I guess it's a niche slice-of-life about unusual people pursuing a nearly-impossible goal. I like that; everyone should think more about the human element of scientific work.
72 reviews1 follower
April 19, 2025
Highly entertaining story, with impressive level of detail. I would have given this book more stars if it wasnt for:

i) The book was almost too detailed. Even though it added to the sense that you were almost taking part in the science and company building yourself, the personal background and stories and motivations of every main player in the company (as well as outside) made the book too long

ii) The book ended way too early in the history of Vertex. It is telling that Vertex has revolutionized the treatment landscape of Cystic Fibrosis, but CF is not mentioned once in the book. Obviously this points to the quick pivots sometimes required in biotech and business, and also the number of hurdles required to get a drug to market. I think however now with hindsight, that the book likely ended in the most interesting time of the companys history.

I primarily liked the book because of:
i) The well-researched story (even though it was slightly too long)
ii) The fascinating behind the scenes of building in biotech
iii) The tension seen among monst biotechs between science and commercialization, and even the tensions within the different disciplines of science that needs to collaborate to bring a new drug to market.
Profile Image for Ezekiel Bajomo.
4 reviews
January 21, 2026
Great book for anyone interested in biotechnology, especially drug discovery and target selection. Werth really dives into the weeds of the founding of Vertex Pharmaceuticals and every detail of their excruciating work, from crystallizing the structure of FKBP12, the scientific rivalry with Stuart Schrirber's Lab at Harvard, working with investors and partners like Chugai, and Joshua Boger's (founder of Vertex) philosophy and approach to managing a company as well as its people.

The book does a great job of setting the stage with the state of drug discovery at the time (literally going through dirt), the key companies (Merck especially), and important organic chemists (such as Robert Burns Woodward and Max Tishler). You will learn a lot about immunophilins through the course of the book (FK506 and cyclosporin) and essentially the birth of chemical biology.

The book is fairly long and dragged in several portions, but it is still a great book overall, and I would recommend it to those who are truly interested in the field and subject matter. If you don't really care about the nitty-gritty details of pharma, drug discovery, drug design, chemical biology, or adjacent topics, then this would be an extremely boring read.
Profile Image for Chloe Kirk.
160 reviews140 followers
October 4, 2023
If you cut out all the unnecessary backgrounds of the infinite character list or tangent stories about the many many drug pipelines that never made it through, it would’ve been a much better read. The author spends too long on the stocks and business conversations while haphazardly throwing tiny snippets of science. I read these books for the science, not a 10 page breakdown of the politics at a drug conference.

I give it a 3⭐️/5 because Vertex is still a really cool story. Vertex beat its competition to make a name for itself in Pharma. But the story is poorly written, alike to someone scribbling notes while different events are happening without linking them together in a cohesive narrative.

(I read this book along with the second book - The Antidote - because I was lost when reading the second book and thought it was because I hadn't read the first book. It didn't change my opinion in the end.)
31 reviews1 follower
April 1, 2021
Werth received amazing access to the key players in the story of Vertex - imagine if John Carreyou had been at Theranos from Day 1 (without the fraud) - and does an excellent job recounting the ups and downs of the initial years. His translation of scientific, technical, and medical concepts is exceptional and allows the reader to understand and follow the challenges and breakthroughs that drive the business narrative. The book, written in the mid-90s, is also an interesting historical artifact of the era when venture-backed medical companies were bursting onto the scene and pursuing big opportunities with massive execution and scientific risk. In a year when biomedicine has delivered enormous benefits on the basis of decades of research, experimentation and risk taking, this book is a good reminder of how difficult that process is and why we should encourage more of it.
10 reviews
November 13, 2021
This book is an excellent peak inside how a small company develops a drug. You learn about the early days of Vertex Pharmaceuticals, which is now a very successful drug company. There are lots of takeaways but the biggest one for me was the 'fake it to you make it'.

The founder of Vertex, Josh Boger, is obviously a brilliant scientist. He filled the company with other first grade scientists. And yet still, Boger had to tell a rosy story to investors that did not line up with the chaos that was going on in the firm.

The book conveys how complex scientific drug discovery is. And how even if you try to approach it systematically, with a plan, there is still a whole lot of luck involved.

Profile Image for Patrick Hackett.
372 reviews30 followers
April 24, 2024
I'm relatively new to the biotech space and while I did work at the Cystic Fibrosis Foundation for 7.5 years (which is relevant because the CF community saw a number of Vertex's breakthrough therapies approved during that time frame), in the past year I've learned soooo much more about the biotech/pharma industry and the science behind treatments and therapies. I still have an impossible amount more to learn, but I loved this book about the history of Vertex Pharmaceuticals side-by-side with a chronicle of the industry throughout the 1980's and 1990's. A lot has changed but...a lot has not changed. Couldn't put this one down.
25 reviews
October 4, 2020
When I began this book I knew very little about biotech companies. However, Werth kept me engaged throughout. This book is a biography of the early years of Vertex Pharmaceuticals in the late 1980's and 1990's before it became the $70b company it is today. By the end of this book it is still well short of that too. This book explains the financial and scientific difficulties experienced, the sheer amount of time it takes to create a marketable drug and the many false starts along the way. This book is well researched and Werth had great access to all the key people in the book.
3 reviews
October 14, 2024
This book had the potential for 5 stars, but Barry Werth needs a lesson in writing. His excessive use of clauses between subject and verb made many sentences difficult to follow. I often found myself having to reread paragraphs to grasp the meaning.

The story of Boger and Aldrich starting Vertex kept me on the edge of my seat. I felt like I was in their meeting rooms, selling the idea of structure based design to investors and pharma execs. Werth managed to capture the adventure, its highs and lows, of entrepreneurial science. Definitely recommend this book to those working in science.
12 reviews
December 31, 2025
Great book on the early history of Vertex as well as some background on the biopharma industry as a whole. It’s incredible how hard these people work to produce new scientific breakthroughs, let alone translating those breakthroughs into meaningful treatments.

I’ve been reading as much on the space as I can recently for work and found this story to be interesting and scientifically challenging yet also digestible. For better or worse, I felt like I needed a dictionary given the author’s broad vocabulary. Highly recommend if you’re interested in the biopharma space.
216 reviews2 followers
September 15, 2020
This was a well-written book about a biotech start-up trying to intelligently design new drugs. Werth did a great job explaining the science of drug discovery in accessible ways. The main issue I had with the book was that it was too long, and sometimes had too much unnecessary detail. I got the sense Werth was waiting around for Vertex to actually successfully design a drug, and finally gave up and published the book without them having done so (though they eventually did).
11 reviews
December 25, 2020
This is a captivating re-telling of a well-funded pharmaceutical company at the dawn of the biotechnology era. A history of scientific development of pharmaceuticals is peppered through the novel, with fascinating stories about George Merck, Max Tishler, Robert Woodward Burns, among others. One issue I had was that the writing is a bit too effusive at times in the description of these scientists.
5 reviews
September 1, 2024
I read it following a friend's recommendation. While the story is gripping and told in a very passionate manner, I do not really enjoy the name-calling or the money-driven nature of the story. Plus, there are too many details on the business and money side, beyond me. I could imagine that it would be a good read for someone interested in opening his/her own biotech company or working on a licensing a new drug.
23 reviews
December 3, 2017
Great book if what you wanna have a inside perspective of the pharmaceutical industry. This book will wreck some people belief about the wickeness of the industry as well as realize how difficult to develop a drug is and the huge amount of people striving to their limits in their personal and professional life for a simple molecule.
28 reviews
July 4, 2022
Good but depressing

A good look at why drug companies expect large profits. Many people work around the clock to try to determine the bodies cells, chemicals, and reactions. These reactions are never guaranteed but if you want to become a chemist or biotechnologist this book is for you.
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