Pick Your Poison

I love drugs. They’re the currency with which I practice my profession. Not a day in the office goes by without completing at least one transaction that involves them.

I’ve learned to field questions about the over-the-counter varieties (Which cough medicine do you recommend?). I’ve learned to negotiate the economic value others place them (If I get this one off the $4 list, will it work as well?). I’ve heard men in highly-polished shoes wax poetic about pills. I’ve seen doctors draw their ethical shades of objectivity when being paid to discuss them. I’ve laughed with late night comedians as they crack jokes about their potency. Magazines devote back covers to their potentials. Football games air commercials about them…often pairing grey-haired men with younger women.

Dr. William Osler, master clinician at Johns Hopkins Hospital at the turn of the twentieth century, was onto something when he wrote that, “the desire to take medicine is perhaps the greatest feature which distinguishes man from animals.”

Ever since my pharmacology class in medical school, much of my training has been devoted to learning the form and function of pharmaceuticals. Much less time has been devoted to their names. One creative joy of writing Control Group was building a pharmaceutical company that needed a medicine cabinet full of blockbuster drugs.

BioloGen Pharmaceuticals is my fictional baby-biotech born in the pastoral beauty of southwest Ohio, founded on the idea that more perfect drugs can be created by mechanizing the process of research and development. Rather than testing for side effects in rats and humans, the founders of BioloGen developed an Automated Device to Acquire Molecule, affectionately called ADAM. This machine runs potential chemicals through a battery of tests to see if they will be harmful in humans. When promising “hits” are discovered, ADAM can then test these compounds against computer-simulated biologic systems to see if side effects will develop.

Never underestimate the hubris of a human with a good idea. The story takes place in 1993, ten years before completion of the human genome project, yet the founders of BioloGen have unparalleled faith that their machine has enough information to bypass the traditional regulatory process of drug development to offer safe medicines quickly.

My research for the pharmaceutical industry initially came in the form of drug detailers, a.k.a. pharmaceutical representatives, coming to the office or hospital to educate physicians about their goods. I had an occasion to visit the administrative wing of a pharmaceutical company years ago, and even had a “back stage tour” of some of the mechanisms used to create new drugs. The soaring potential of Big Pharma is experienced by anyone who’s been on the receiving end of a medical transaction. The fun in fiction, though, comes in finding the fly in the ointment.

In naming the drugs in Control Group, I tried to stick to what I’ve observed in the pharmaceutical industry: “X” sells, as does a three-syllable name. If the sound can piggyback onto something aspirational, all the better. Second-best is simply sounding like the condition that’s being treated.

Here’s a roster of BioloGen Pharmaceuticals’ greatest hits:

  • ArthroDerm : this was low-hanging fruit in the name-game. “Arthro=arthritis, Derm=skin”. This patch is used to help arthritis pain. In fact, with several arthritis patches already on the market, I was surprised that the name ArthroDerm was not already taken.
  • HepataZyme : in the opening chapter, something stirs—and then dies—at the National Institutes of Health. This is not really a spoiler alert. It’s in the first sentence of the book, and if I can’t maintain a readership beyond sentence one, I’ve likely not maintained it this far into a blog. The story for Control Group sprung from a publicly traded pharmaceutical company hiding safety data about their diabetes drug in the late 1990s. HepataZyme is a drug of that type. Since it affects enzymes of the liver (hepata=liver, zyme=enzyme), the name fit.
  • Lyvoxx : in 2004, the then-best selling arthritis drug Vioxx was pulled from the market for safety concerns that had also been hidden from FDA regulators. Sensing a pattern? This name, almost an anagram of that drug, is even better…”dos equis” and a “y”. Boom.
  • NuCor : in the late 1990s and early 2000s, nothing boasted lack of pharmaceutical originality than a new statin (or cholesterol drug). Once statins started coming out, it seemed every pharmaceutical company had one. All the FDA required (besides safety data), was effectiveness similar to the original medicines. This was dubbed a “me-too” phenomena and was an end-around heavy investment in research and development in favor of a steady revenue stream. For BioloGen Pharmaceuticals, their version was NuCor, a “new” drug for “cor”-onary artery disease. Like ArthroDerm, I was surprised this one had not been taken either (perhaps because, as I later found out, there is a steel company by the same name).
  • Anginex : this is BioloGen’s flagship drug, and the one that drives the story. I wrestled for a while with the best name for the head-lining drug, and actually incorporated some early editorial feedback into the dialog of the book. “Anginex,” Mackie said to his boss. “Sounds like a cardiac drug.” Pescatelli grumbled back at him, “It’s cancer, not cardiac” and later Karen explains that it “ex-es out angiogenesis”—or new blood vessel growth, which offers its best way to prevent cancer. It’s also the drug’s Achilles heel. Notice the three syllables and the “X”? Pure money.

If drugs are the currency of modern medicine, then any alchemy I’ve created in Control Group is the equivalent of counterfeiting. But in fiction, it’s the proximity to the truth that sells the lie.

“What we are selling at BioloGen Pharmaceuticals,” Red Pescatelli tells his audience in a near manic state, “is the promise of a cure at the cost of one pill a day.”

That, and the slight risk of a prolonged and painful death.

Pick your poison.