BLOCKBUSTER DRUGS This page intentionally left blank B L O C K B U S T E R D R U G S The Rise and Decline of the Pharmaceutical Industry JIE JACK LI 1 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Th ailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Oxford University Press 2014 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. [Library of Congress Cataloging-in-Publication Data Li, Jie Jack, author. Blockbuster drugs : the rise and decline of the pharmaceutical industry / Jie Jack Li. p. ; cm. Includes bibliographical references and index. Summary: “Th is book uses the cases of several landmark drugs to discuss the history of the pharmaceutical industry, and discusses what could be next”--Provided by publisher. ISBN 978–0–19–973768–0 (hardback : alk. paper) I. Title. [DNLM: 1. Drug Industry—history—United States. 2. Drug Industry— trends—United States. 3. Drug Th erapy—history—United States. 4. History, 20th Century—United States. 5. History, 21st Century—United States. 6. Pharmaceutical Preparations—history—United States. QV 11 AA1] RS100 338.4’76151—dc23 2013017116 9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper To Professor Rick L. Danheiser This page intentionally left blank Contents Preface | xi 1. Before the Age of Blockbuster Drugs | 1 2 . B eginning of an Era: Th e First Blockbuster Drug, Tagamet | 5 §2.1. James Black and the Discovery of Tagamet | 5 §2.2. From a Frog into a Prince | 26 §2.3. Zantac and More “Me-Toos” | 28 §2.4. Lessons | 36 3. More Blockbuster Drugs for Ulcers: Prilosec, Nexium, and Other Proton-Pump Inhibitors | 41 §3.1. Better Ulcer Drugs Still Needed | 4 1 §3.2. Prilosec | 44 §3.3. Nexium | 57 §3.4. “Me-Too” Proton-Pump Inhibitors | 61 §3.5. Th e Saga Continues—Ulcers Are Caused by Bacteria! | 63 vii viii | Contents 4. A ntihistamines as Allergy Drugs | 67 §4.1. What Causes Allergies? | 67 §4.2. Conventional Antihistamines | 70 §4.3. Second-Generation Antihistamines | 79 5. Blood Th inners: From Heparin to Plavix | 87 §5.1. Tales of Two Old Drugs: Heparin and Warfarin | 9 0 § 5.2. G ood Old Aspirin | 1 05 §5.3. From Ugly Duckling to Beautiful Swan—From Ticlid to Plavix | 110 §5.4. Blood Feud | 122 §5.5. Beyond Plavix | 129 6. Conquest of Pain: Analgesics: From Morphine to Lyrica | 136 §6.1. Aspirin and Other NSAIDs | 138 §6.2. Celebrex and COX-2 Inhibitors | 140 §6.3. Morphine and Opiates | 142 §6.4. Fentanyl and Opioids | 146 §6.5. Eff exor and Other Antidepressants | 152 §6.6. Parke-Davis and Dilantin | 153 §6.7. Parke-Davis and Neurontin | 156 §6.8. Silverman and His Th eory on GABA Compounds | 159 §6.9. Parke-Davis and Lyrica | 161 §6.10. Lyrica, the Blockbuster Windfall | 165 §6.11. How Does Lyrica Work, Exactly? | 166 7. Refl ections | 168 §7.1. What Makes a Blockbuster Drug? | 1 68 §7.2. How Do You Sustain Blockbuster Drugs? | 1 69 Contents | ix §7.3. Th e Rise and Decline of the Pharmaceutical Industry | 171 appendix: chemical structures of the drugs | 1 75 bibliography | 185 index | 1 99