Prescription for Profits: How the Pharmaceutical Industry Bankrolled the Unholy Marriage Between Science and Business

Prescription for Profits is an insider’s guide to the rise of biotechnology, the commercialization of this new field as seen in the birth and early years of Genentech, and the alleged abuses that have been at the heart of Robert Gallo’s laboratory at the National Institutes of Health. After a brief chapter on what Linda Marsa claims was the innocence and the financially disinterested character of biomedical research before the 1960s, she devotes two chapters to the following topics (in this order): the race to find the structure of DNA and the immediate impact of this discovery, Gallo’s rise at NIH, the launching of Genentech, the discovery of the AIDS virus, the selling-out of academic biotechnology to industry, Genentech’s development of tissue plasminogen activator (t-PA, a genetically engineered “clot-busting” product), the funding of AIDS research, Genentech’s marketing and defense of t-PA in the face of competition from streptokinase, investigations into Gallo’s laboratory and the discovery of the AIDS virus, and a conclusion. This arrangement suggests one of the problems with Prescription for Profits: it is not very well organized, as the flow is constantly interrupted by different topics. Marsa’s storytelling ability nonetheless manages to hold the reader’s attention, though the book could do without the occasional use of annoying (if not embarrassing) metaphors and hyperbole (for example, pp. 55, 84, 87, 129, 146, 154, and 224). On this count the copyeditor did not serve the author very well.

Based on the numerous appearances of undocumented quotations, this book apparently relies heavily on oral histories, but one can only guess: only 9 pages of notes document the 266 pages of text. This is all the more unfortunate considering the nature of Marsa’s “warts and all” study of the wheeling and dealing that launched the biotechnology industry, its cultivation of academic ties, and the internal and external investigations of Gallo’s NIH laboratory. Given that Prescription for Profits has more than a few erroneous allusions to fairly well known, easily documented events and trends, one wonders about the accuracy of this insider’s approach.

For example, the idea that the “story [of medical research] really begins more than half a century ago, when doctors were driven by an unselfish devotion to easing human suffering” (p. 9) is naive, as a reading of Richard Shryock’s American Medical Research (itself published more than fifty years ago) would have shown. It is possible that the author believes this because one of her “great heroes” (p. 16) is chemist Max Tishler, a close relative who arrived at Merck in 1937 and certainly played a significant role in the growth and reputation of this firm. But to say that Merck “hadn’t yet formulated a single drug when [Tishler] joined the company” (p. 18) ignores the fact that the company had a well-established and productive research program in place at the time Tishler joined Merck. Furthermore, I am not aware of any reliable literature that suggests that the existence of penicillin “was a closely guarded military secret” (p. 21); actually, the publication by Florey’s group is precisely what stimulated interest in this drug. That, of course, was aided by the visit to the United States by Florey and Heatley (not Chain, as Marsa states on p. 19).

Marsa’s contempt for Gallo, justified or not, seems at times to be extended to the entire National Institutes of Health. Most remarkably, she states that “up until the 1960s, however, staff scientists at the NIH were considered government hacks by their colleagues at the top research universities, also-rans who couldn’t cut it in the competitive environs of academia” (p. 69). In fact, dozens of scientists such as Reid Hunt, Alice Catherine Evans, Carl Voegtlin, William Mansfield Clark, and Joseph Goldberger published in the same journals as their top academic colleagues, participated in and headed...