Compared to, say, espionage or alien warfare, the drug development business rarely appears on the big screen, and its few cinematic portrayals generally involve sinister white-coated characters doing shadowy experiments. In that sense, the new film Extraordinary Measures, in which a desperate father and biochemist race to develop a cure for a rare genetic disease, marks a refreshing departure. Although not exactly the stuff of industry jingles, there are no bad guys here, either.
Brendan Fraser plays John Crowley, whose two young children suffer from the inherited acid maltase deficiency, Pompe’s disease. As his kids descend to death’s door while the doctors helplessly wring their hands, Crowley, a drug company marketing executive, decides to take matters into his own hands.
Faced with a similar dilemma, Denzel Washington’s character in the 2002 film John Q held an entire emergency room hostage; while Susan Sarandon and Nick Nolte as distraught parents in 1992’s Lorenzo’s Oil did groundbreaking research. Crowley, a businessman who has "everything under control", as his wife smoothly intones, opts for the miracles of the market. In partnership with curmudgeonly biochemist Robert Stonehill, played by Harrison Ford, and a slew of supercilious venture capitalists, Crowley launches a biotech startup aimed at bringing a lifesaving Pompe drug into clinical trials.
Loosely based on Crowley’s real-life role in the development of Genzyme’s drug Myozyme (alglucosidase alfa)-as described in Geeta Anand’s fine 2006 book, The Cure-the film chronicles an array of challenges on the path to the wonder drug. Stonehill’s academic research is promising, but his university pays its football coach more than his entire research budget, despite his brilliant scientific breakthroughs. Tight-fisted venture capitalists won’t underwrite Crowley and Stonehill’s startup unless the drug can be brought into clinical trials within the impossible timeframe of 12 months. The biotech giant that ultimately buys the startup won’t develop the drug until convinced they can capture a profitable market.
Much of this will be enlightening material for viewers unfamiliar with the travails of drug development. To its credit, the fi lm neither shies away from the heartless calculations of commercial research, nor condemns them; after all, regulators must be appeased and the costs of doing business recouped. And there’s some good fun to be had watching an old action-hero star defend the virtues of scientific freedom.
It’s too bad that the fi lm’s emotional depth rivals that of an afternoon TV special. Keri Russell, who plays Crowley’s wife Aileen, cares for two dying children in wheelchairs with a bland perkiness. You’d think she’d spent the afternoon vacuuming.
Brendan Fraser’s soppy portrayal of Crowley has him meeting every business setback with the woeful dutifulness of a dog delivering a wet newspaper. Stonehill’s character is particularly shallow. He’s meant to be an eccentric academic-we know this because he’s shown blasting Grateful Dead and guzzling Budweisers while scribbling mathematical gobbledygook on his chalkboard-but he comes off more like a petulant diva, fl ouncing off whenever anyone off ends his delicate scientific sensibilities. He expounds on his commitment to research-"I don’t care about money! I’m a scientist! I care about more important things than that!"-and yet dumps his university lab for a $6 million cheque and a job at a biotech company.
But what really had me scratching my head was the film’s presentation of the obstacles to creating a drug for Pompe’s disease as primarily economic, rather than scientific and technical. The technical challenges in synthesising enzyme-replacement therapies are legion. Genzyme is still plagued with manufacturing difficulties, with the US Food and Drug Administration (FDA) discovering particles of trash and viral contamination in some of its enzyme-replacement drugs last year. By contrast, economic obstacles to development are minimal. Regulatory authorities provide generous incentives for orphan drugs, and insurance companies can be shamed into paying astronomically high prices for them.
That’s why Genzyme and its cinematic counterpart already had three drugs for Pompe’s disease in the pipeline before buying Crowley’s startup (the one they ended up launching was not Crowley’s). And it’s why about a third of all new drugs approved by the FDA last year were the so-called orphan drugs, aimed at rare diseases. Myozyme, priced at $200 000 a year, netted Genzyme over $300 million last year. What demands superhuman action is launching drugs and interventions that aren’t profitable for drug companies, such as those that are off -patent, or which cater to the illnesses of the poor and poorly insured. John Crowley is undoubtedly a driven, heroic figure. But for bringing a lucrative drug like Myozyme to market, few "extraordinary measures" are really required.