It was a risky plan, because formal announcements about the success of a drug are almost never made in the middle of trials. But given the early success, Moy’s strategy was to create a market for Memorine before the first pill hit the shelves.
“Until then, we’re playing mum.”
Gavin Moy was paranoid and for good reason. He had sunk millions of his own and hundreds of millions of investors’ dollars into Memorine against a history of adventures that had turned out to be duds, including development of a cure for a rare neurological disorder; it proved disastrous in the Phase III clinical trials, costing GEM eighty million dollars and nearly tanking the company. Another agent targeting Parkinson’s disease was beaten to market when a competing lab offered a disgruntled GEM science director an offer he couldn’t refuse—the results: a look-alike that became a blockbuster while GEM fumbled around in Phase III trials only to scrap the project and end up with huge go-nowhere litigation fees. Those fiascoes were why Gavin Moy had guarded Memorine as if it were the Manhattan Project.
It was also why Nick had played coy with René. Only when she called to ask if the jellyfish connection was true did he confess a minor role in its development, breaking ethical protocol. Since learning about Memorine René had been flagellating herself with guilt for having consented to let her father die instead of holding out for some breakthrough cure. So he reiterated the fact that the compound had not been targeted for clinical trials of dementia patients until two years after her father’s death. Even then Gavin Moy had sworn Nick and others to secrecy in face of the Darwinian competition for a cure and the fact that when the patent would run out in a few years generic knockoffs would fly. But before that eventuality, GEM hoped to establish a global franchise on Memorine.
“We’ve tried to keep a low profile, but we’re getting calls from physicians and AD organizations wanting to know if it’s true we’re working on a cure, can they volunteer patients. Christ, this is going to be the biggest thing since the Salk vaccine, maybe penicillin.”
“We can only hope.”
As Moy scanned Walden Woods out his window, Nick thought that he was like one of those reptiles with independent turretlike eyes constantly alert to opportunities and dangers. That was how he had been decades ago, and, perhaps, that was the secret of his successes and failures. On his desk was a brass plaque with the inscription: “It’s not over until you win.” Quintessential Gavin E. Moy.
Although Nick had seen Moy over the years at conferences and colloquia, they went back to a time before GEM Neurobiological Technologies existed. They were residents together at Mass General back in the late 1960s, when Gavin had started the forerunner of GEM Tech in the cramped basement behind MIT and where Nick helped in the research before finishing his residency. For years, some antecedent of Memorine had been in Moy’s pipeline, going through molecular reconfigurations and testing until the final form was developed. Today it was the flagship product for GEM Tech—and virtually their only product.
The promise began when it was discovered that the toxin from the Solakandji demonstrated an extraordinary neuronal property: it enhanced long-term memory. Fetal rodents injected with the compound learned to whip through complex mazes as if radar-directed while their untreated siblings stumbled along. Even more remarkable, mature rats demonstrated enhanced long-term recall, mastering maze problems that they hadn’t been exposed to since they were juveniles. The immediate thought, of course, was what it could do for people suffering memory loss—a speculation that raised hope against the scourge of Alzheimer’s disease.
The first breakthrough came when it was discovered that Memorine treatments had all but eliminated deposits of beta-amyloid peptides in mice genetically engineered to have an Alzheimer’s-like disease. Even more remarkable, new brain cell growth explained why treated mice had higher learning curves and functionality than untreated mice. In short, Memorine had converted memory-degenerating rodents into recall wizards. Last year it was tested on human subjects and medical history began to be rewritten.
“Nick, you’ve read the reports—the results are fabulous and you could share in its success. So don’t tell me ‘no’ again, because I’m asking you to come aboard.” Moy’s eyes were shooting fire.
“Gavin, I’m very flattered, really.”
“On the contrary, we’d be flattered. And all bullshit aside, we’d like to have a man with your prestige and reputation.” Moy handed Nick a few sheets of paper. “Some of the people you’d be working with. I think you’ll recognize a few.”
It was a long and impressive list of physicians already taking part in the trials—names of medical researchers and practitioners associated with the best of institutions: the Scripps Institute, Yale, Washington University Medical School, the National Institutes of Health, et cetera.
“Plus some acquaintances of yours—Peter Habib, Jordan Carr, and others. We’re expecting the FDA to fast-track the application so we can get it to market in eighteen months.” Moy spoke with serene conviction. “Word is the president might support clinical development as a pledge to older voters in his reelection campaign. The long and short is this is a revolution, and we want you to be part of it.”
“And you’re working out possible ADRs—adverse drug reactions.”
Moy’s face froze. “What adverse drug reactions?”
“That woman who killed the CVS manager. I’ve also heard rumors of patients experiencing some deep-past delusional spells.”
“Where the hell did you hear that?”
It was actually Pete Habib who had come up with the “flashback” label. “Where I heard it isn’t important. The story of the murder was in all the newspapers. But questions have been raised about whether there’s a connection to the drug.”
The skin of Moy’s head flamed. “There is no connection, and there are no adverse drug reactions. These people were delusional psychotics suffering dementia. Christ, you see them all the time.”
“I’m just raising the possibility.”
Moy considered his words for a moment. His face suddenly lit up. “Then this is just the kind of thing we’d want you to monitor—making sure investigators look for contingencies, side effects, whatever. We need someone like you with uncompromising integrity. But, believe me, there’s no connection between the woman who stabbed the store guy and Memorine, and you can take that to the bank.”
“Okay, but why do you want me when you have all these top people?”
“Because I’d like you to direct the phase three clinical study, to be chief principal investigator—to coordinate all trial data for our FDA application. I want you at the top.”
Nick did not see that coming. “Why not Pete Habib? He’s chief neurologist at South Shore and one of the best around. Or Jordan Carr?”
“I said no bullshit: You’re senior neurologist at MGH and chief administrator of the imaging lab, and Peter Habib, Jordan Carr, and the rest aren’t. Having you in the lead would draw a lot of attention, not to mention investors.”
“That’s quite an honor, but to do this right will require a large commitment.”
“Of course, and you’ll be compensated handsomely.”
“I’m talking time, not money. I’ll have to think about it and talk it over with Thalia.”
“Of course.” Moy glanced at his watch. “How’s tomorrow by noon?” Nothing in Moy’s face said he was being humorous.
“Next week.”
“All right, next week.” Moy leaned into a huddle. “Okay, the ugly stuff: For your own patients, we’re offering you twice the standard trial rate—three thousand dollars per patient visit. We expect twelve to fifteen visits. You have a lot of AD patients and you can do the math. In addition, for all your expertise blah blah blah and the privilege of having you as clinical director blah blah blah … we’re offering you equity in the company in the form of stocks—the numbers to be worked out.