The Age of Cures: Barry Werth on How Big Pharma Once Saved Your Life

00:00:31 Andrew Keen: Hello, everybody. Earlier this week, we did a show with a very successful AI researcher, entrepreneur, and writer, Richard Socher. He's the CEO of Recursive, a $4 billion AI startup, and he's also the author of an intriguing new book, The Eureka Machine. It's out this week in which he suggests that we're on the verge of what he calls a new scientific renaissance, which will cure everything, especially, all our medical problems, all our woes, all the great diseases. We even talked about the idea of AI coming up with a cure for cancer. It's taken for granted, of course, that, maybe in historical terms, science didn't do such a great job curing everything. My guest today, however, might strongly disagree. Barry Werth is a very distinguished writer on science, a historian of technology, the author of eight books, including, his 1995 book, The Billion-Dollar Molecule [ed.: first published in hardcover in 1994], the 2014 follow-up, The Antidote: Inside the World of New Pharma, and his book, which is out this week, a new book, the third in the trilogy, The Age of Cures: How American Scientists Saved Your Life. Barry is joining us from Northampton, Massachusetts. Barry, congratulations on the new book. Why do we tend, in broad terms, to be a little cynical about technology and our health industry, Barry? Why do we need writers like you to remind us that once upon a time, pharma was a remarkable industry, maybe even a miraculous one.

00:02:33 Barry Werth: Thanks for having me on. The short answer is, we have very short memories. We take things for granted, and, we don't remember that as recently as eighty or ninety years ago, there were almost no drugs for any diseases. There were natural substances that had been discovered over the eons, but, and there so there were drugs and there were many, many people who had a variety of diseases, but there was no established way for finding new medicines. And that all began to change in the early part of the twentieth century. A German biochemist, Ehrlich, postulated that chemicals could be used to treat diseases. But then it was another twenty years before the sulfa drugs, which were really the first indication that that might be a prophecy that that might come true.

00:03:33 Andrew Keen: Lead me through the trilogy, as I said, in and all these books have been very well received. You wrote in 1995 The Billion-Dollar Molecule, then you followed up with The Antidote. And today, you've got The Age of Cures. How do these fit together? Why are they a trilogy? What story are you telling?

00:03:54 Barry Werth: In 1988, during the AIDS crisis when there were no medicines and people were if they were diagnosed with HIV, were bound to die. I started writing about the business of biomedical research. I followed a couple of people at Harvard who had moved into the pole position for, finding a cure. And, David Baltimore, the Nobel laureate and eventually head of Rockefeller Institute [ed.: Rockefeller University], proposed at that time a Manhattan Project for AIDS. That is the best scientist in the country pulled together and, in a sense of responding to a national need, share, cooperate in a federally funded, federally directed program, and try to, establish a crash program for curing AIDS. I was shocked to discover that no one was interested. And I didn't really understand why I became consumed with this question of how does this system work and why is it so resistant to an idea like that. So in 1989, I got inside a small startup drug company, Vertex Pharmaceuticals. They had just gotten their venture financing. There were five or six scientists. They could all fit in the founder's Volvo wagon. And I followed them for a couple of years, and I wrote The Billion-Dollar Molecule. And it was really just them trying to get this little engine off the ground. They did spectacularly. And during that time, they went public. They became, leaders in the number of scientific areas. And I thought I was done. I went on, wrote a couple of other books. And then in 2012, right before they were about to this is almost twenty years later, launched their first two blockbuster drugs, I got back inside the company. The founder warned me that they wouldn't probably wouldn't let me inside, but I navigated a way and I wrote The Antidote, which is about the launch of two drugs. One for hepatitis C, which was the fastest launch in history, and then the other much more historically important was their first cystic fibrosis drug. Vertex is now known as the company that cured cystic fibrosis. It has a very robust scientific, pipeline. They've cured a number of other diseases. There are other approvals pending. And during COVID, I again, I thought I was done. I really did. I had no idea of writing a third book. But during COVID, it seemed somewhat urgent to sort of figure out, you know, what is our system? How does it work, especially in, like, in times of emergency? So I've gone back now, and I've written a prequel. So it's the third book written, but it's the first book in the trilogy, The Age of Cures, which covers, the middle third of the twentieth century when, mostly American companies and the federal government in cooperation with one another, also with academic labs, assembled a system that created a cornucopia of what would call then miracle drugs. So that's the substance of this new book.

00:07:26 Andrew Keen: Was that the narrative that was commonly accepted at the time, Barry?

00:07:32 Barry Werth: I'm not sure I know what you mean.

00:07:34 Andrew Keen: Well, this idea of companies like and I know you write extensively about Merck in the book and companies like that. Was it perceived at the time in the twenties, the thirties, the forties, and fifties that companies like Merck were, participating in what you call this age of cures. Were they viewed as, maybe, I don't know, the Anthropics or the OpenAIs or the Googles of their age?

00:08:03 Barry Werth: It depends on what incarnation of those companies you're talking about. But, yes, they were, I'll take an example. Penicillin discovered in Britain quite by accident. Mold spores drifted into Alexander Fleming's laboratory in 1929 [ed.: 1928]. And as late as 1941, when during the Blitz, when the United States was not yet in the war, there was enough penicillin synthesized to give to one patient, a, very sick, London policeman. He they he started to recover. They ran out of drug. They harvested whatever they could from his urine. They reinjected it, and eventually he died. And the sponsoring scientist came to the United States more or less hat in hand, said we've got no research infrastructure. We've visited every American pharmaceutical company. No one wants to participate. They went to, Alfred Newton Richards who was the head of that time, the Committee on Medical Research, which was part of the larger umbrella organization, the Office of Scientific Research and Development, which is much better known for, fathering the Manhattan Project. And, Richards made this the number one priority, which was to get enough penicillin for D-Day. Even then, they could anticipate that at some point, the United States was gonna be all in, in the war and would have to help in the retaking of Europe. And within a couple of years, establishing these protocols, recruiting the best companies in the country, using federal laboratories, every research at hand, really the corollary of the Manhattan Project, they accomplished this mission. They delivered, enough penicillin for D-Day, and it was an essential part of, the America's, assistance in winning the war.

00:10:12 Andrew Keen: It's a remarkable story. One of the characters who I know figures quite centrally in your book, who I have to admit I was quite surprised to see, was Vannevar Bush. Of course, he's best known now as the father, in some ways, the inventor of the Internet. Does he represent the kind of epitome of, I don't know how you would describe him, part of this scientific industrial establishment in pre and post war America that were not only important in inventing the Internet and, of course, much military technology, but also these remarkable breakthroughs in pharma?

00:10:56 Barry Werth: Absolutely. Though he was not a chemist or a biologist, he was an electrical engineer, built one of the first analog room-sized analog computers. Vannevar Bush and a number of other scientific administrators began meeting in 1940 and surveyed the American scientific infrastructure and found that it was not well organized. It was not competitive certainly with the Germans who had the best science in the world, certainly the best chemistry in the world. And Bush and these other administrators, decided to approach Franklin Roosevelt. Bush went to Roosevelt on his own, so this is how I think we ought to do it. I think it ought to be publicly funded, but I don't think we need to draft the scientists into the military as we did in World War I. I think with having, committees of leading scientists making the decisions, we can farm a lot of this work out and distribute it widely and have, people who are normally rivals work together towards a common cause, and they established he Bush did the Office of Scientific Research and Development. As you point out, after the war, they this was so successful that after the war, Bush wrote a very famous book, which is still cited today called Science, the Endless Frontier [ed.: a 1945 report to President Truman]. And he said we can extend this partnership, this public-private partnership into peacetime, and it will have tremendous benefits. And, the proof is there. You know? This was when America got great at science. How did it get great? It got great through collaboration, through sustained federal funding, through, transparency, by sticking close to the science, by, encouraging cooperation. And, so he you know, these are all the people I write about are pioneers, but Bush was the real visionary, I think.

00:13:00 Andrew Keen: It's hard to talk these days, again, you don't need me to tell you this, Barry, about big pharma and science in general, especially medical science, and avoid the politics in our age of JFK Junior [as spoken: RFK Jr.] and Tony Fauci and Donald Trump. Is there a polemical element to this book, The Age of Cures? Are you reminding us and we've done many other shows, not specifically about this subject, but many other shows looking back with a degree of nostalgia at FDR's New Deal state. Are you making the argument that this is the best way to not only enable miracle cures, but also create profitable industries?

00:13:44 Barry Werth: We've led the world for eighty years. I think we're about to be challenged in a major way by China, but I don't think there's any question that this has been the most productive system for using medical science to produce cures that help people survive disease. It was, it vanquished the German scientific empire. It was superior to the Soviets. We've had, the our life expectancies have doubled—nearly doubled in three generations or so. It's given us our world in many respects. And as I you ask whether it's polemical, I laid this out because I think it shows the stakes. You know? If this is a system that is under siege now. I read today in the Times that Trump wants to take over NIH funding, making the decisions about who should get NIH funding. I besides his wanting to bring to heel the our great universities and our industrial laboratories, I can't see any reason why anybody would think this was a good idea for our country. So, it's polemical in the sense that it shows what's at stake and, but it doesn't make the argument except intrinsically that this is how we are gonna be most successful. But looking back, we've been wildly successful. Now I'm not defending pharma, big pharma. I'm not defending their pricing policies or the rampant fraud and greed that has, infected the industry. But I don't see where anybody can really argue that this way of going about achieving scientific goals, particularly in medical research, has been anything but a success.

00:15:42 Andrew Keen: Yeah. And when I asked the question on the polemical element, I don't necessarily mean that critically. Mhmm. Again, of course, I don't wanna turn this into just another boring conversation about Donald Trump. But many, of the shows we've done, Barry, over the last couple of years, especially since Trump came back to power, note that something was changing even before Trump. The subtitle of your book is How American Scientists Saved Your Life, not Save Your Life. Was there a shift maybe in the seventies or sixties and seventies with the birth of neoliberalism, the shift from FDR's New Deal, LBJ's Great Society, to a more of a Reagan style free market economy. How did pharma come out of that? Was it in a sense a casualty of this shift in the American economy?

00:16:37 Barry Werth: Well, yes and no. So this is drug discovery is extremely difficult, takes decades, billions of dollars, thousands of people working hundred-hour weeks to bring out a, you know, an entirely new medical approach, that can cure disease. And so these miracles, obviously, if you're selling miracles, there's gonna be a big market, and there's gonna be money to be made. I think the shift with Reagan is that Wall Street got much more heavily involved. It coincided with the rise of biotechnology. Before that, the standard way of drug the drug discovery was to, and this was established in the forties and fifties and is very much a part of the book, was to sift through large libraries of, chemical compounds that were found in dirt and sludge and soil and wastewater. And for active agents that could be turned into drugs. That's how it was done. And it was all the antibiotics came that way. Generations of drugs for other disease were discovered that way. And then in this neoliberal period as you describe it, two things happened. Wall Street thought, man, this is a you know, there's a fortune to be made in all this, and there's great stories to be told in these new biotech companies, which are promising the next generations of, miracle drugs. So it all kinda got skewed towards satisfying Wall Street's short-term lust for profit. That what that really didn't exist before. I just you know, in terms of saving your life, I'll give you two quick examples. I have two autoimmune diseases. One is, I have an overactive thyroid, and the other is I have pernicious anemia. Both of these were resolved very early on in this period. They discovered how to reproduce the active ingredient in the thyroid gland that regulates, thyroid production. So they nuked my thyroid, and I've been on a pill one a day for the rest of my life. Not a problem. People died from this invariably before. B12 was, discovered in the forties. Before that, people with pernicious anemia also invariably died horrible deaths. They didn't produce any blood red blood cells, and they just kind of, were vanquished by the disease. Now I take a B12 pill every morning, and that one's taken care of. You know, there are endless examples that all of us look in our medicine chest and see what we've got there and how it's altered the course of our lives. So, I guess to answer your question, yeah, I think, you know, Wall Street got much more heavily involved starting in the eighties. Drug stocks were great. People started to want them in their retirement portfolios. The whole country started to rely on the profits of these big pharma companies to survive on in their old age. So, and we can talk about whether these profits are excessive or obscene or but the combination of the two things really put, I think, an extra level of, intensity to the research all around.

00:20:13 Andrew Keen: Barry, George Merck, one of the most distinguished figures in the industry you write about, famously talked or promised in terms of his scientific breakthroughs, medicine for the people. Were guys like Merck genuine in that? And, these days, Silicon Valley founders of companies like Anthropic and OpenAI are talking about AI for the people, although it seems to many people as if it's really just AI for them to get richer and richer. Was there a genuine idealism with figures like Merck, and did it change, as the this founding generation was replaced by maybe more corporate leaders?

00:20:55 Barry Werth: Mhmm. Yeah. Merck was for real. Merck's family was in pharmaceutical business since the sixteen hundreds in Germany. There used to be German Merck and American Merck. Merck's father was sent over by German Merck—Merck, excuse me—to establish a US arm. And he went to Harvard, and he was a planned to become a chemist, but, there was such anti-German feeling during World War I that his father urged him as he said to come into the shop. George Merck could see the future. George Merck could see that with the right kind of research and the right kind of alliances with the right universities and the right researchers and sustained support that this would this was all possible. So he was utterly for real, but I think what's interesting about that quote is medicine is for people, drugs are for people, not for profit. It was actually on Merck was on the cover of Time magazine the week I was born in 1952 with that quote underneath it. But that was an abridgment of the actual quote. The actual quote was, I'm paraphrasing now. Medicine is for people, not for profits. The if we remember that, the profits will follow. The better we remember that, the bigger they will be. So he was not simply altruistic in the sense that he wanted to bring life changing drugs into the world. He wanted to make a profit. He wanted to make a big profit. But he saw that the way to do that was to remain focused on the patient. And that is what the industry has lost sight of. When with Wall Street's, heavy intervention, the profits became the main goal for many companies. Now it's not for all companies. I actually believe that Vertex, the company that I wrote about, in the previous two books, which is wildly successful and immensely profitable, has retained some of this vision.

00:23:02 Andrew Keen: Would it be fair to say that in the book, you suggest that not all scientific breakthroughs were good for these companies' bottom line. Merck might be an example. In other words, you'd sort of take it for granted, or one would take it for granted that the more scientific innovation, the more profitable these companies were. But was that or has that actually been the case?

00:23:28 Barry Werth: Overall, I'd say yeah. You know, the economically speaking, pharmaceuticals are a one-off. I'm not sure that there's another industry like it. That is that the consumer is not the customer. With the prescription drug, you're the consumer, your doctor is the customer. And so at the same time that all this was happening, the explosion in antibiotics and new medicines for a whole host of diseases, the company recognized that the way to great profitability was to, enlist doctors and sell to doctors. And in fact, that's, you know, when we think of the really the big change, it was selling through the pages of the journal—the Journal of the American Medical Association or the New England Journal of Medicine selling products to doctors. Busy doctors didn't have a whole lot of time to decide which broad spectrum antibiotic was better. So they, you know, they were susceptible to advertising, and then shortly after that, to favors, to meals, to, golf outings, to you know, I when we I understand all the reasons why pharmaceuticals are vilified. But at the same time, the purveyors of all these miracle drugs are doctors. And, you know, that's another way of looking at the economic equation.

00:25:03 Andrew Keen: There's one thing that's changed, Barry, that I mean, you mentioned the number of drugs that save people's lives, penicillin, a couple of drugs that probably saved your life. But it seems as if some of the miracle drugs, at least of our contemporary age, are more associated with lifestyle. The drugs associated with weight loss comes to mind. Has there been a shift in pharma from saving people's lives to simply selling them lifestyle products?

00:25:34 Barry Werth: Absolutely. That, you know, that was already happening before the eighties, before the neoliberal period. But it really took off then. You know, suddenly, you had companies developing drugs for hair loss and for erectile dysfunction and, you know, the list goes on and on and on. Why? No. Not to save people's lives, to make money. So that, you know, that current was always there. As I point out in the book, the American pharmaceutical industry, like the Nile River, comes from two diverse streams. One was what were previously called ethical drugs, which were powders made by manufacturers sold prescribed by doctors and sold over the counter in pharmacies. The other was the patent medicine trade, where desperate people eager to try anything that might work would buy anything, you know, doctor, you know, doctor duties [unclear], pain pills, whatever. Because people, you know, people want drugs, need drugs. So, you know, the commercialism has always been overlaid with the scientific, goal of finding better medicines. And so yeah. You know, you can question what the drug industry does now, but the model as the companies grew, the model became, don't try to search endlessly for new breakthroughs. Bring out a drug that's mildly better than the competition that you can outsell with marketing. And it was a conservative consensus. It was a way for them to make sure that they delivered what Wall Street wanted, which was a, you know, which was a successful bottom line every quarter. So, yeah, I think we've lost sight in many cases of what's important. As far as the GLP-1 drugs go, you know, I think a lot of people are having their health restored. We, you know, we've created this problem ourselves with our diets. I understand all that. But those drugs are lifesavers, you know, not the boner pills, but the GLP-1 drugs were lifesavers.

00:27:56 Andrew Keen: Barry, you're talking to me from Northampton, Massachusetts, not too far from Boston where I think biotech is mostly centered. How important is biotech and the industry you write about in your book in the broader American economy?

00:28:14 Barry Werth: You know, it's vital. You know? And I think if we lose it—

00:28:20 Andrew Keen: But percentage, do you have any numbers? I mean, has it shifted? Was it a larger piece of the economy in the sixties and fifties?

00:28:31 Barry Werth: I can't answer that question. I can tell you that I think drugs are only about 13% or so of the health care economy. So when people believe correctly that health care is too expensive, you can lay a certain amount of it, maybe one seventh on the drug industry, and, you know, that's something they have to address. But it's not the reason why our health care is so expensive. It really does, in the long run, create a lot of savings.

00:28:59 Andrew Keen: So how does it fit into our profoundly dysfunctional health care system? I mean, the argument, especially amongst, there's even a Wikipedia page on big pharma conspiracy theories, is that big pharma is somehow central to American America's increasingly dysfunctional health care system. How do you see the role or lack of role of big pharma in this endless crisis of American health care? Or maybe in your view, it's not quite the kind of crisis that some people presented as?

00:29:32 Barry Werth: You know, I think you see what you're looking for. As I said, there's widespread fraud and greed and secrecy within the pharmaceutical industry. There's every reason to believe not to trust these companies. You know, if you look to see the best selling books about drugs, you've got, Empire of Pain, which is about the fentanyl, excuse me. I'm sorry. The OxyContin—

00:29:57 Andrew Keen: Yeah. And Patrick Radden Keefe was on the show recently with talking about his new book. But he was more critical of the family than of the industry, wasn't he?

00:30:08 Barry Werth: Yeah. I know. But the, you know, they're emblematic, the family. And that what the interplay there between the pharmaceutical companies and the doctors is very interesting. They persuaded doctors that OxyContin was safe. Doctors bought in and wrote endless prescriptions, and we ended up with an illegal drug crisis largely as a result of that. Or you can look at the there's No More Tears, which is about Johnson & Johnson and the dishonesty there. You know, there's lots of bad behavior, and I go back to the fact that these are things that we will pay whatever we have for if they're available to us. So, again, I can't get to your question of what part of the economy this is, but I would say on balance that these medicines are a savings and not an expense. As far as costs go, I think, you know, if you're really interested in looking at drug costs and they are too high, there's no question. You need to also examine availability. That is accessibility. It's like college education here. The sticker price is very high, but, because the schools know that they have scholarship programs and work study programs and ways to help people who can't afford the sticker price get some access to it. And I think access is what we need to be looking at, not necessarily the blockbuster prices that we see.

00:31:45 Andrew Keen: Although someone who just paid for two kids to go to college, the sticker price—yeah. I mean, it's always annoying to think that someone probably paid less than you did when you think it's already overpriced. You mentioned GLP, which, please correct me if I'm wrong, my understanding is it was invented in Denmark, by a very innovative Danish company. How does the American pharma industry compare and contrast with European pharma, particularly in Switzerland and Denmark, which I know have very powerful, pharma companies?

00:32:21 Barry Werth: Somebody wrote to me today that the last drug major drug discovered in Switzerland by a Swiss company with Swiss scientists was probably LSD in the fifties [ed.: LSD was first synthesized at Sandoz in 1938]. They—nobody has out-innovated us. People will make the case. So—I got it. Yes. The Dutch, you know, with the GLP-1 drugs [ed.: Novo Nordisk, maker of the leading GLP-1 drugs, is Danish]. And I don't really know. I know there was a race with Lilly. Lilly also is a big, promoter of these drugs. There's no other country in the world that has the same track record as the United States. Now that being said, China is close on our heels. There are many, many more new experimental drugs being tested in China now, which to me adds to the absurdity of not wanting to protect this domain. You know, if what it relies on so heavily is I've two things I think. It's just sustained support, government support, and, transparent that it's, you know, that it's it adheres to the science. It's not motivated by other economic or political agendas. So, you know, here we have this thing that, we do better than anybody else and have for eighty years. And, if things keep going the way they're going, we will soon be surpassed by another country.

00:33:59 Andrew Keen: And so RFK Jr., for example, who's the current US Secretary of Health and Human Services, very controversial figure, one of the news stories recently is that his movement now has corporate sponsors. Are they, in your view, at least attacking the very foundations of the industry that you claim created the age of cures?

00:34:22 Barry Werth: They're, you know, they're I don't understand why when you're in the let's look at the things that the United States has led the world with consistently over the last seventy five years. Culture and entertainment, higher education, medical research. Okay? If you have any others, I'd be interested to hear what they are.

00:34:48 Andrew Keen: Well—

00:34:48 Barry Werth: You know, we used to—

00:34:49 Andrew Keen: Probably technology. Certainly, digital technology.

00:34:52 Barry Werth: Digital technology. Okay. So but, you know, but there's a fight on there too now. So, it's been a very fertile, diffuse, but cooperative system that was recognized as being, fair and transparent and it produced oh, let's take the most obvious example, Operation Warp Speed. What other country in the world had the when every country in the world got hit with COVID at the same time, what other country in the world had the resources and the integrated scientific approach to develop in record time, safe and effective vaccines? Why anybody would wanna dismantle that? I really don't understand it to tell you the truth. But except for political reasons, which is there are people who have been burned by this system, don't believe in the system, think that there are conspiracies afoot to make their lives worse, not better, and that as a political agenda, it could be useful to a politician. But I don't see what's there. And, again, the companies make too damn much money, and they don't uphold their responsibility to society in the way that I think we would all wish. But, yeah, I think Kennedy and Trump are taking a wrecking ball to the probably the most important thing that we have done consistently better than the rest of the world over the last eighty years, and I don't get it.

00:36:35 Andrew Keen: Yeah. And it's particularly ironic given that Trump once championed Operation Warp Speed.

00:36:41 Barry Werth: To his credit, you know, I mean, it's hard for me to credit him with much, but, yeah, he didn't get in the way. And, you know, with within nine months, we had effective [unclear: vaccines]. I think I'm I might need to be corrected on this, but I think the previous record was four years for the mumps. So, if people would like to look back and think, well, what would it have been like if we didn't have vaccines in 2021, 2022, 2023, 2024? It would have been a disaster.

00:37:19 Andrew Keen: Is the threat also we know about RFK Jr. and Trump. I mean, most of our shows are critiques of one of them or the MAGA movement. Is there also a threat to big pharma from the left? I mean, what's Bernie Sanders or AOC, or Mamdani? Are they finding all the sins of America and big pharma too?

00:37:45 Barry Werth: You know, I think mostly what they'll say is prices are too damn high. The companies are making too damn much money. They're not responsive to the public. They come out with these drugs that are you know, they bombard us with advertising. You know, you can't turn on a news show and not see a dozen or 15 drug ads, that it's corrupt, that it's that it has way too powerful a lobby in Washington. But the issues there and are it had it plays into the very complicated economics of all this. So for instance, you have drugs that are priced at hundreds of thousands of dollars in this country. I'll give you the best example is Vertex's first, cystic fibrosis drugs priced at $300,000. Vertex arranged it through, patient assistance programs and other kinds of programs, to make sure that everybody who is eligible got the drug. The insurance companies didn't because it was a small number, 70,000 as opposed to millions who might be taking a GLP-1 drug, were willing to pay. So that price went over in this country. Now you get to Britain where they have national health service, and they had to make a very difficult decision. Can we afford to pay this for the few patients in Britain, you know, relatively few patients in Britain? It was very controversial, and people probably died because they didn't get the drug because the health service was not willing initially to negotiate an adequate price, but they worked it out. So when people talk about bringing down the price of drugs or importing drugs, what they need to acknowledge is, that we have a system that is very friendly or has been to big pharma for decades, and that the high price of drugs here subsidized the price controls that exist around the world. This could I think all this could probably be addressed. I don't you know, with the low level of courage among our politicians at this point, I don't expect it to happen. But, you know, I think that Bernie and AOC, I think their complaint is mostly the price issue. And it should you know, accessibility should be the rule. Drugs are for people, not for profits. But if you deliver effective drugs to people, you will make profits. And the better you remember that, the bigger those profits will be. And the last thing is all those people who have drug stocks in their 401(k)s, including me. I try to stay away from them because I end up talking about this subject. But in between the twenty years in between, I, you know, I saw what everybody else saw, which was the drug stocks were good bets. And, I should say here, I'm probably one of the only people, if not the only person, who actually has lost money investing in Vertex. I—when I—

00:40:52 Andrew Keen: Well, they made your career in a different way, so maybe you need money [unclear].

00:40:55 Barry Werth: I know. But when I finished the first book, I thought, okay. I'm out of this. Looks like a good thing to me. I don't know. I don't really understand a lot of companies, but I understand the way this one works. I think it's a good bet. And so I it bumped along, and I went and did my other work. When I came back to it, I realized, well, I it would be an obvious conflict of interest for me, so I sold what I had at a loss. But the, you know, people should look in their stock portfolios if they've got a real complaint about that.

00:41:21 Andrew Keen: Yeah. I mean, maybe the difference between the left and the right is, as you know, Bernie and AOC are critical of drug prices, whereas RFK Jr., Trump, and the other MAGA populist writers [unclear] seem to be against the very idea perhaps of a scientific establishment, which is why they go after guys like Tony Fauci. Sorry.

00:41:43 Barry Werth: I was just gonna say, you know, I think they just and they wanna stick it to the universities. I think, you know, Trump wants to control the NIH grants. It's horrific to even consider. Sorry.

00:41:59 Andrew Keen: Yeah. Your book covers some of the heroic figures in the pharma industry, really smart people who graduated from places like Harvard. George Merck was at Harvard, another of the characters in your book. Max Tishler was at Harvard. Selman Waksman, I'm not sure where he went to college [ed.: Rutgers], but he was a very smart kid. I began talking today about Richard Socher's book, The Eureka Machine, an important figure in AI. Socher came to the US from, Dresden in Germany to Silicon Valley. I wonder these days whether, Barry, the smartest kids in the class are going into pharma. Is that one of the problems is they're all going into AI and tech and maybe business because that's where all the money is to be made? So this generation's Max Tishler or Selman Waksman or George Merck just not ending up in pharma?

00:42:58 Barry Werth: You know, I don't know that for a fact. I think, you know, if what you're looking to is make a lot of money, billions, if that's what you're after. Yeah. You know, you can design something in your dorm room that's gonna make you billions. You know, if you wanna make billions in pharmaceutical, it's gonna take you a generation. So, take your pick. So, the smartest people, not necessarily. You know, the ones with the, you know, the greatest desire to make the most money as fast as they can, yeah, probably those people are not going into pharma.

00:43:31 Andrew Keen: Maybe people who wanna find a cure for cancer, which, as you say, is a long-term thing. Finally, let's go back to AI. There's an interesting piece this week in the New York Times by, Zeynep Tufekci, another scientific technology writer, and talks about what she sees as the problematic impact of AI on mathematics. I'm sure there's a huge debate, Barry, within the pharma industry about how important AI can be and whether it can help revitalize the industry. Massive amounts of money are being invested, not just in AI, but I'm sure in the AI associated with pharma. What is your history as we struggle to figure out our AI future? We have people on the doom side and others on the, cornucopian side, utopians and dystopians. What can your book, The Age of Cures: How American Scientists Saved Your Life? How can it help us make sense of our AI future and getting our AI future right?

00:44:40 Barry Werth: I think it's gonna be a useful tool, maybe generations. I'm talking about AI generations from now. Bots will or armies of bots will be able to practice biological research. That's not what they can do now. What they can do is add more data to the mountains of data that you've already got. I saw today that, you know, somebody, you know, with an AI program asked it to design some drugs and came up with, hits. But hits are just the beginning of a very, very, very, very long process of turning a biologically active molecule into a drug. Will they help with gain of function? You know, can they make a drug better? Probably. Are they gonna cure cancer? You would have to ask people who are in cancer research. I think they would pretty much unanimously say, no. We'll you know, if anybody's gonna cure cancer, it's way down the road because it's a very complex mechanism that we still barely understand. So, you know, I think you can it's like everything else. I think it can be used as a tool, perhaps used wisely, but it's not gonna I don't think it's gonna transform drug research. There are other people who will argue that, but the people that I know who do drug design seem to think that it's not gonna change everything. But, again, we don't know where AI is going. It may be really, really, really advanced in a short period of time, and we'd have to reconsider this question. But at the moment with what we've got, I don't think so.

00:46:22 Andrew Keen: We need patience, which is certainly in short supply in the United States. You note, I think, Barry, that the best pharmacists are patient, and that's what defines the industry. You're patient too. This is a trilogy that's taken you thirty years. It's required a great deal of discipline and learning. You know, the first book was The Billion-Dollar Molecule that came out in 1995 about Vertex, then, The Antidote: Inside the World of New Pharma, and finally, as you say, the prequel to all this, The Age of Cures: How American Scientists Saved Your Life, a really important book about a subject which, as you note, is much misunderstood and, saved many of our lives. So thank you so much for such an interesting conversation, and such an important book.

00:47:11 Barry Werth: Thank you so much for having me on.