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MedPage Today spoke with former Forbes senior editor Nathan Vardi about his new book, For Blood and Money, which tells the "extreme" story of the development of two game-changing medications for chronic lymphocytic leukemia (CLL). During that Q&A, Vardi made the case for why the "golden age" of biotech may be slowing. A lightly edited version of his comments follows.

I think there was definitely a golden age in biotechnology investing. Now we take it for granted, but there was a change in leadership and innovation from big pharma to small biotechnology companies that really took the lead when it came to innovation.

That happened for a number of reasons. A lot of the big pharma companies started to become more risk-averse. They wanted to buy de-risked risk assets from smaller companies after they knew that there was a reasonable chance that they were going to succeed. They were interested in arbitrage, tax arbitrages, and big mergers -- those sorts of things. A lot of the dynamism seemed to be coming out of the biotech sector.

You can see it in the stock market. The biotech stocks performed very, very well between 2010 and 2020. In fact, they outperformed the NASDAQ, which is incredible, given , Netflix, Facebook, Google, and so forth.

We had a lot of drug approvals as a result -- almost 400 of them. Now it seems like we're moving into a different era, where things are going to be harder. It doesn't mean we're not going to get innovation. It doesn't mean that good science isn't going to be funded. And it doesn't mean that there isn't incredible science going on. But it does feel to me that the landscape is shifting a little bit for structural, political, and regulatory reasons. We'll see what the outcome will be.

My book looked at the era that occurred through 2020. I do believe that Pharmacyclics and Acerta represented the peak of the biotech boom. Their drugs [ibrutinib (Imbruvica) and acalabrutinib (Calquence)] have been taken by hundreds of thousands of patients and made a huge difference. From a financial perspective, they are huge wins. Pharmacyclics was sold for $21 billion, and they own half of Imbruvica so there was an implied value of about $42 billion for that single drug. I think that's the peak of the biotech boom.

The other thing is that now we see pharma companies are saying, "Wait a second, we want in. We're much more interested in being part of this innovation."

An example of that is Pfizer. What were they doing between 2010 and 2020? They were pursuing big mergers. They were trying to move their headquarters out of the United States for tax reasons. That's what they were about. If you look at Pfizer today, what do we see? We see that they've divested their veterinary business. They've divested their consumer products business, they've divested their generics business, and they are all-in on innovation.

So I think it's going to be harder for biotech companies to see the same sort of acquisition frenzy that went on in the previous decade. Any biotech person you'll meet today will tell you that when they talk about potential acquisitions, or when they have discussions with pharma companies, or a business development person for pharma will always say, "Well, okay, this is nice, but let me check, I need to go back and look at our internal pipeline to see what we're doing, because we might be doing this."

So that has changed, and I think that's going to change the biotech sector profoundly. It's not that the pharma companies don't have a lot of money. There will be deals when that makes sense. But it just seems like there's now this kind of question for them: are we going to do it ourselves, or are we going to buy it?

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