Nathan Vardi: Why America’s Billionaires Need to Lead the Fight to Cure Cancer

Robert Duggan is not a scientist. He’s a college dropout. But Duggan got very rich, launching and selling multiple companies, starting with Jiffy Stitchery kits in the ’80s. In fact, he became a billionaire.

A number of years ago, Duggan got involved with a tiny California biotechnology company called Pharmacyclics that was developing an experimental cancer medicine. He became the company’s biggest shareholder and, later, its CEO. Duggan had no experience with biotechnology or drug development.

Like so many people, Duggan had been personally impacted by cancer. His son died of brain cancer at age 26. He wanted to make a difference. But nobody thought he would. At one point, Pharmacyclics’ stock traded for as little as 57 cents as the company ran out of cash and couldn’t find anyone willing to finance it. Pharmacyclics seemed headed for bankruptcy. Duggan refused to let that happen. He extended $6.4 million of personal loans to keep Pharmacyclics going and during those days authorized the start of the first in-human trial for a drug code-named PCI-32765. 

Today that drug is known as Imbruvica. It is an incredible medicine that has made a big difference for patients with chronic lymphocytic leukemia, a blood cancer that is the most common form of adult leukemia.

I tell the incredible story about how two rival drugs revolutionized treatment of this cancer in my new book, “For Blood and Money: Biotech, Billionaires, and the Quest for a Blockbuster Drug.” Billionaires played an important role. 

Cancer drug development is very hard. It is also expensive. The cost to get a single drug approved by the Food & Drug Administration and bring it to market can exceed $1 billion. There are so many scientific and regulatory hurdles, as there should be, including preclinical tests in the lab and in animals, and a range of clinical studies that test the drug in human beings. But the vast majority of cancer drugs tested in patients fail. While the rewards can be great, the risks are very high. 

In the last decade or so, a big shift has taken place in the life sciences. Much of the innovation in cancer drug research has been coming out of small and nimble biotechnology companies, as opposed to big pharmaceutical companies, which prefer the less risky approach of buying small companies that demonstrate success. 

Unlike an Apple or Google, you can’t start a small biotech company out of your garage because of the huge costs and regulatory burdens involved. These smaller companies are often controlled by their founders, some of whom are entrepreneurs, while others are often successful hedge fund managers or venture capitalists. These tend to be people with serious means. In other words, the super-wealthy.

When the financial situation at Pharmacyclics was most precarious, for example, Duggan tried to sell a piece of Imbruvica for cheap to any big pharmaceutical company that was interested. There were no takers. It’s hard to see how Pharmacyclics would have survived without Duggan’s loans and support of the company. 

What about the government? For all of President Biden’s talk about cancer moonshots, and the impressive amount of money the federal government spends on important and crucial research, a lot of the burden of developing cancer therapies rests on small biotechnology companies. We need entrepreneurial risk-takers, billionaires, to drive them. Imbruvica, for example, was already on its way to being tested in patients by Duggan’s company before the National Cancer Institute even started tinkering in a lab with the cellular signaling pathways the drug targets. 

While Imbruvica is an amazing medicine, it’s not perfect. Today, more than 55% of patients who start this kind of medicine to treat chronic lymphocytic leukemia choose a second-generation drug called Calquence. Calquence would have never been developed if it weren’t for Wayne Rothbaum, a billionaire stock trader who operated under the radar in New York. 

The drug had previously been owned by pharmaceutical giant Merck, which shut down its development. Rothbaum funded the development of Calquence, risking a big chunk of his net worth, and got some of his billionaire buddies to shoulder the rest of the investment required. 

No one person can create a cancer drug alone. It takes scientists, researchers, doctors, administrators, and of course, courageous patients willing to test unproven experimental medicines. But we desperately need the billionaires, too.  

Nathan Vardi is the author of “For Blood and Money: Biotech, Billionaires, and the Quest for a Blockbuster Drug” (W.W. Norton & Co), out Jan. 10, 2023.

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