“Why Triaxcion?” Gordon asked.
“The pharmaceutical company that developed and markets Triaxcion is pretty slick. Their television ads target men with hair loss, and as the boomers age, it’s becoming a huge market, almost bottomless. The money Veritas is making off this drug is sinful.”
“Veritas? What’s Veritas?”
“Veritas Pharmaceutical, the manufacturer. They’re a medium-size pharmaceutical company out of Richmond, Virginia, and Triaxcion is an enormous cash cow for them.”
“Does it work?” Gordon asked, fingering the bottle and reading his brother’s name again, as he had done twenty or thirty times since finding the pills.
Hastings shrugged. “The FDA approved it, and for them to approve any drug it has to have passed Phase III clinical trials.”
“What’s a Phase III clinical trial?” Gordon asked.
“It’s the third tier of a system that starts with Phase I. Phase I trials are small, maybe twenty to fifty people who are closely monitored to see what kind of side effects there are and how much can be taken before the drug becomes toxic to the system.”
“Sounds dangerous-like they should be using rats, not people.”
“Oh, by the time the drug enters a Phase I trial, they’ve got a pretty good idea that it’s reasonably safe. It’s already undergone a lot of testing in the labs. The rats have already had their doses.”
“Then what?”
“Phase II trials are conducted on people with the disease. Half the test group, usually a few hundred, is given the drug, the other half a placebo. They’re testing the effectiveness of the drug more than anything in this phase.” He took a sip of water and continued. “Phase III trials are the real test. They concentrate on long-term effectiveness and side effects. Once the drug passes Phase III trials, the company can apply for a New Drug Application, or NDA as they call it.”
“Then the drug’s on the market?”
“If the FDA approves, yes.” Hastings returned to Gordon’s original question. “So does Triaxcion work? I can’t say exactly how effective it is, but I suspect there’s some benefit.”
Gordon nodded. “Is there any downside to it?”
“Every drug has side effects, Gordon. Veritas acknowledges the user may suffer upset stomach, and because Triaxcion targets conversion of testosterone to dihydrotestosterone, there could be changes in sexual performance. They don’t say for better or worse, just that desire and performance may change.”
Gordon looked skeptical. “I’m sure if it enhanced sexual prowess, they’d mention it. Viagra doesn’t have any problem advertising that.”
Hastings nodded. He glanced at his watch. “I have patients, Gordon. I should get back to them.”
Gordon stood and offered his hand. “Thanks, Alex. I appreciate your time.”
“Not a problem. Call me if you need any more information.”
Gordon stopped in the doorway to the office. “Anything in Billy’s file that would indicate he was a hemophiliac?”
“Nothing,” Hastings replied immediately. “I checked through his file thoroughly when I was informed of his death.”
Gordon took the stairs to the main floor and sat in the driver’s seat of the BMW, going back over the meeting in his mind. Billy had no history of being a bleeder, and this certainly wasn’t the first time he had cut himself and needed stitches.
But this time had been different. Very different. Billy had died. And that didn’t make sense. The only variable that had changed in his life was that he was taking medication daily to prevent his hair loss. If the FDA had approved the drug, how could it be dangerous?
But try as he might, Gordon couldn’t shake the feeling that something wasn’t right.
4
BioTech Five is one of seven research buildings in the Virginia BioTechnology Park in Richmond, Virginia. One block north of the Coliseum, it’s tucked between a group of horseshoe-shaped buildings to the east and south, and BioTech Three to the west. The entire third floor, almost twelve thousand square feet, is dedicated to the corporate offices of Veritas Pharmaceutical. The office of Bruce Andrews, CEO of the company, occupies the southeast corner, with a partial view of the Coliseum and City Hall. But the view was the last thing on Andrews’s mind this particular Wednesday morning. He sat with his back to the window, peering at his computer screen.
An imposing man, over six feet four, Bruce Andrews had the body of a pro linebacker-for a good reason. For two years he was one, playing for the Pittsburgh Steelers, crushing opponents into the natural turf and enjoying every minute of it. He was selected to the Pro Bowl in his sophomore year, but one of his own teammates was flattened by a running back and fell back, landing on Andrews’s knee and tearing the anterior cruciate ligament. A professional sporting career was erased in a few seconds of agonizing pain. The upside was that Andrews had a 3.8 GPA in the sciences even as he was playing college ball at Stanford. He took his degree and entered the pharmaceutical business as a researcher.
Andrews was a good catch. He was bright, well-connected, and extroverted. His face was well proportioned, with a prominent chin and inquiring eyes. He had an easy smile, which disarmed most people within a few seconds of meeting him. And in the research industry, where most of the staff are graduates of college chess and glee clubs, a physically attractive employee with good social skills was worth his weight in platinum, not gold.
Looking at the career offers on the table, Marcon was his first choice, and when they offered him a position in R amp;D working at the new one-hundred-million-dollar research facility bordering Harvard Medical School, he had to control his shaking hand as he signed the contract. Four years later, he reluctantly closed the door behind him as he left for Frezin, one of Marcon’s top rivals and another of the Big Pharma companies. Frezin’s offer was too generous to turn down: his own research group, an excellent salary, bonuses for meeting or exceeding expectations in Phase I and Phase II trials, and totally flexible office hours.
He excelled at Frezin, clearing the way for two new cholesterol drugs, one of which found a spot on the crowded shelves of America’s pharmacies and generated almost six hundred million in sales before the patent expired and the generics jumped in. His success in the research labs led to a high-level management position, at which he immediately excelled. He reworked the Frezin mindset on R amp;D, modeling it after what he had seen at Marcon.
It worked. It worked very well. Frezin passed Marcon on the Standard amp; Poor’s 500 Index and the bellwether Domini 400 Social Index, putting Frezin in the enviable position of being the new benchmark in pharmaceutical research and development. His salary went through the roof, and his bonuses eclipsed his wages. He had found his niche and was enjoying huge personal success, despite the public’s dislike and distrust of the pharmaceutical giants. Bruce Andrews often looked back on the day that 260-pound lineman crushed his knee as a great day in his life.
But even with all the perks and the money, he was, in his own mind, still a lowly vice president. He coveted the top position, but after a few years he realized that he was not moving in that direction. The upper echelons of Frezin were powerful and connected, and he was not one of the chosen. He realized that if he were to ever achieve the position of CEO, it would entail moving to a competitor. He found a heavyweight headhunter and the search to find a company that needed a CEO was under way.
Veritas Pharmaceutical was not a major player in the industry, but neither was it a lightweight. Four drugs with household names were under patent, and three more were in the pipeline. Wall Street was behind Veritas and investor confidence was high. What they lacked was vision. And when the board of directors interviewed Bruce Andrews, they knew they had found their visionary.
Andrews’s agent drafted a ten-year contract, collected a huge finder’s fee, and disappeared back where he came from. Andrews planted himself in the corner office and took stock of his new empire. The company had annual sales of six hundred million, which Andrews considered low, considering the company had four drugs still under patent on the market. Their R amp;D budget was $162 million, marketing $73 million, and administration $12 million. Legal fees and payments on class-action suits ran to almost $200 million, courtesy of an FDA recall on Haldion, a drug that was designed to reduce blood pressure but actually caused heart palpitations. Not heart attacks or death, at least not that had been proven-simply palpitations. Veritas had pulled the drug from the market, but the damage was done. The ambulance chasers were all over it, and tort suits kept appearing, even seven years after the negative reports had chased Haldion from the shelves.