Who in the government helped sabotage Dendreon? Despite the
lobbying by the captured doctors, despite the Wall Street
whispering, despite the singing Sendek and the media mimics —
despite all of this, it still seemed likely that the FDA would heed
the advice of its advisory panel.
Instead, the FDA told Dendreon that it would not yet approve its
treatment — that the company had to get more data, which
would take years, by which time the company could easily run out of
money. The FDA handed Dendreon (and prostate cancer patients) what
seemed like a death sentence. This was a strange occurrence. It
must have followed some serious work by government officials in
high places.
One official who might have advocated against Dendreon was then
FDA Commissioner Andrew von Eschenbach, who was a close ally of
Michael Milken. Dr. von Eschenbach was a founding director of
Milken’s Prostate Cancer Foundation, and later he was at the
forefront of an ultimately unsuccessful effort to convince George
Bush to grant a presidential pardon forgiving Milken for his
crimes. But it is clear that von Eschenbach was not the only
official courted by Milken and his associates.
Long before I came along, an assortment of Dendreon
shareholders, prostate cancer patients, honest folks on Wall Street
(there are some), and concerned citizens spotted the connections
among Milken, ProQuest and the captured doctors who led the
lobbying effort against Dendreon. When the FDA failed to approve
Provenge, these folks saw that an injustice had been done, and they
hollered loudly. Soon after, a grass roots organization called
Care-to-Live was founded to
advocate on Dendreon’s behalf.
Care-to-Live (to whom I owe a debt of gratitude for uncovering
some of the information that appears in this story) has not only
chronicled Dendreon’s travails, but has also labored
tirelessly to right the wrongs. It has organized street
protests and letter-writing campaigns. It has lodged Freedom of
Information Act requests and it has filed a
lawsuit against the FDA. In the course of these efforts, it
managed to get a hold of various documents and email communications
between Dr. Scher (the physician with financial ties to
Milken’s companies and “philanthropy”) and
officials in the government bureaucracy.
What these
documents and emails show is that Dr. Scher and his allies
depended largely on support from a mid-level FDA employee and the
National Cancer Institute, which oversees government funding of
cancer initiatives, and has considerable, though unofficial,
influence over FDA decisions. Over the years, Milken and his
Prostate Cancer Foundation have made great efforts to ingratiate
themselves with the NCI, which may be one reason why Dendreon was
never able to receive government funding, despite the revolutionary
potential of its treatment.
On March 31, 2007, Alison Martin, who was in charge of the
prostate cancer division of the National Cancer Institute, emailed
Dr. Scher, who was busy crafting the missive that would be
published with mysterious immediacy by The Cancer Letter.
“Glad to hear letter is being drafted,” Martin wrote.
“If that [FDA] division’s vote suggests [that
Dendreon’s treatment] be considered for approval, I was
wondering if it then could go to ODAC, which is more clinically
savvy, i.e. this is just a step in a process.”
The “division” whose possible approval of
Dendreon’s treatment so discomfited Dr. Martin was the
FDA’s Center for Biologic Evaluation & Research (CBER),
which was assigned the task of evaluating Dendreon’s
application. Martin was suggesting that if CBER was going to
approve Provenge, perhaps the matter could be taken to ODAC –
the FDA’s Oncologic Drugs Advisory Committee, which was led
by an FDA official named Dr. Richard Pazdur.
Pazdur has a close relationship with a Washington lobbyist named
Samuel D. Turner. Some years ago, Turner, who helps run an
organization called the Cancer Leadership Council, led a campaign
to have Pazdur appointed as the commissioner of the FDA. Michael
Milken supported that campaign. And Milken’s advisors, such
as Dr. Donald Coffey of the Prostate Cancer Foundation, have
collaborated closely with Turner in another cancer lobbying group
called C-Change, of which the Cancer Leadership Council is an
affiliate.
As a result of this support, Milken and Pazdur have become very
close friends.
Some years ago, a U.S. Congressional investigation determined
that Pazdur, through his lobbyist friend Turner, had leaked inside
information that the FDA was going to reject Erbitux, a cancer drug
that was developed by ImClone. As you will recall, that inside
information made its way to Martha Stewart, setting in motion the
chain of events that landed her in jail. The ImClone inside
information also was first published in The Cancer Letter, the same
rag that published Dr. Scher’s “confidential”
letter to the FDA. And, remember, the records of phone calls
made to ImClone at that time raise the distinct possibility that
funds managed by Milken cronies Carl Icahn, Steve Cohen, and Dirk
Ziff also were privy to that information before it was made
public.
As an aside, after ImClone’s stock crashed on the news,
the company was seized by Milken crony Carl Icahn. And soon after
Martha Stewart received the inside information, but before she was
caught, hedge funds in the Milken network began short selling
Martha Stewart’s company, Martha Stewart Living Omnivision.
One hypothesis that explains the exquisite timing of those hedge
funds is that the funds knew Martha was going to be arrested and
therefore shorted her company on the assumption that news of her
arrest would crash the stock. They may even have been the ones who
turned her in. But that is a story for another time.
For now, it merely needs to be emphasized that Pazdur, the FDA
official, has unusually close relationships with Milken and some of
his cronies. He was a key player in the ImClone scandal, which
displays remarkable similarities (such as insider information
mysteriously appearing in The Cancer Letter and the involvement of
hedge funds in the Milken network) to the Dendreon scandal. And
Pazdur appears to have been the FDA official most responsible for
derailing Dendreon’s prostate cancer treatment.
Pazdur was not supposed to be the one who decided whether
Dendreon’s drug was approved. Instead, because the drug is a
biologic, the decision rested with the FDA’s Center for
Biologics Evaluation and Research (CBER). Nonetheless, Pazdur
inserted himself into the decision process. It was at
Pazdur’s behest that Dr. Scher and Dr. Hussain were, despite
their ties to competing companies controlled by Milken’s
funds and friends, appointed to the advisory panel that voted on
Dendreon’s application.
As you will recall, Dr. Scher and Dr. Hussain were among the
four panelists who quickly voted “No” to the
incorrectly phrased question about Dendreon’s effectiveness.
When the phrasing was changed to the correct, legally mandated
question ( Is there “substantial evidence” that the
drug reduces mortality?) the remaining 13 experts on the panel
voted “Yes.”
According to eyewitnesses, just as panelists began voting
“Yes,” Pazdur began passing notes to Dr. Maha Hussain,
who then attempted to instill further confusion, apparently hoping
to have the remaining panelists continue to vote on the incorrect
question. Pazdur, who had come to the meeting uninvited and
unannounced, also spent a good deal of time conversing with Dr.
Hussain, giving the impression that they were working together to
devise arguments that might turn the panel against Dendreon.
Curious to know whether it was Pazdur who ultimately derailed
Dendreon’s application, perhaps even delivering the captured
doctors’ “confidential” letters to The Cancer
Letter – and wondering whether this had anything to do with
Pazdur’s relationship with Michael Milken —
Care-to-Live, as part of its lawsuit against the FDA, subpoenaed
Pazdur’s relevant emails and documents.
Pazdur
responded under oath as follows: “I searched both my
paper and computer files and was unable to locate any documents
that were responsive to Plaintiff’s requests. I recall
receiving…these letters…However, as these letters
related to a specific regulatory application conducted by a
different FDA Center (CBER), did not fall under my direct
regulatory supervision…I shredded my hard copies of these
letters and deleted any electronic copies. The documents were
shredded and deleted within a month of receipt.”
This response was strange. For one, Pazdur seemed to be stating
that he had no involvement in the Dendreon decision. If that were
the case, what was he doing at the advisory panel meeting?
Pazdur’s statement also contradicted an earlier statement
from the FDA. In response to complaints that Pazdur had
participated in a decision that was supposed to be left to the CBER
division, the FDA said that he had done so “at CBER’s
request.” Clearly, Pazdur had been involved in the decision,
so it was disingenuous for him to state otherwise in his efforts to
explain why he had (frantically?) shredded and deleted all the
relevant documents.
Moreover, if Pazdur is telling the truth (and not, that is,
simply obstructing justice), then Pazdur violated the spirit of
various initiatives, including a bill passed in the U.S. House of
Representatives and directives from the Archivist of the United
States, aimed at ensuring that government employees maintain
records of their official business. The reason that government
officials are asked to keep good records is that they are sometimes
involved in controversies – controversies such as the one
that was swirling around Dendreon’s FDA application when
Pazdur began shredding and deleting documents so promptly and
thoroughly.
In any case, most of the documents that Care-to-Live requested
had been transmitted electronically, meaning that a simple computer
excavation could have retrieved them, even if they were deleted.
Clearly, Dr. Pazdur had reason not to hand over those documents.
Perhaps he was advised not to by his lawyer, who happens also to be
the same lawyer who represents The Cancer Letter, the rag that
published the “confidential” letters that Dr. Scher and
Dr. Hussain wrote to Dr. Pazdur and FDA commissioners.
Fortunately, Alison Martin of the National Cancer Institute did
not shred everything – she handed over at least some
of her documents. And the email quoted above strongly suggests that
her plan was to get Dendreon’s application out of the hands
of the designated authority, CBER, and into the hands of Richard
Pazdur. In response to that email, Dr. Scher wrote to Martin that
he, too, would try to have Dendreon’s application
“reviewed by ODAC” (which was controlled by Pazdur). In
a follow-up email, Dr. Scher wrote: “Got a minute for quick
question related to FDA processes?”
A minute later, Martin responded: “Consider this
confidential, please…but I wanted you to know.” As to
what confidential information she delivered to Scher, that is
unclear from the documents received by Care-to-Live. Apparently,
the telling documents were also promptly shredded.
But other documents and emails show that by early April, Martin
was fully engaged in helping Scher draft his letter trashing
Dendreon — the “confidential” letter to the FDA
that would be quickly published by The Cancer Letter. Indeed, a
copy of a half-edited draft of Dr. Scher’s letter was found
on Martin’s computer. And in one email, Martin appears
to complain about all the work she has done on this letter.
“Maybe you should write a letter, too,” she jokes.
So an employee of the federal government was helping a
conflicted doctor lobby the federal government. That is, Martin,
the head of the prostate cancer unit at the National Cancer
Institute, was helping a doctor – a doctor with financial
ties to Michael Milken and to a competing, Milken-invested company
— sabotage Dendreon’s treatment for prostate
cancer.
As news of this started to reach Dendreon’s supporters,
Martin left her job at the National Cancer Institute. Soon after,
she
was appointed president and chief executive officer of the
Melanoma Research Alliance (where one can safely suppose her
compensation exceeds her previous government salary).
The Melanoma Research Alliance was a brand new
“philanthropic” outfit. It had just been set up by a
“prominent philanthropist.”
The name of the “prominent philanthropist” is, of
course, Michael Milken.
Milken founded the Melanoma Research Alliance and hired Alison
Martin with an initial grant from Leon Black, the
“prominent” billionaire and Milken crony who does
business with an alleged Russian mobster named Felix Sater.
Sater, remember, is the fellow who
allegedly was behind the threat to have Deep Capture
reporter Patrick Byrne murdered if Patrick did not end his crusade
against abusive short selling and the “deep capture” of
the nation’s regulatory bodies.
* * * * * * * *
On May 11, three days after the FDA failed to approve
Dendreon’s treatment, The Wall Street Journal published a
report that purported to investigate the allegations that the
government approval process had been compromised. This
“investigation” entailed asking Dr. Scher whether he
had any conflicts of interest.
“’I try to keep to the high ground,’”
Dr. Scher told The Journal. Apparently content with his reply, and
eager to assuage any suspicions that something nefarious had gone
down, The Journal added that Dr. Scher “serves as an advisor
to Innovive, a small biotech not involved in prostate cancer, and
works with Bristol-Myers Squibb in an unpaid capacity on early
stage drugs that may hold promise in prostate cancer. He and his
wife hold small amounts of stock in Biogen, Idec and
Pfizer.”
That was it. According to the Journal, Scher had no conflicts of
interest.
The Journal did not mention that Dr. Scher was a board member
and executive of Milken’s ProQuest Investments. It did
not mention the fact that ProQuest was heavily invested in Novacea,
a Dendreon competitor. It did not mention that Dr. Scher was
leading the trials of Novacea’s prostate cancer drug, or that
he was a paid director on the advisory board of another Dendreon
competitor – Milken crony Lindsay Rosenwald’s Cougar
Biotechnology. And it did not mention that Dr. Scher was leading
clinical trials for yet another Dendreon competitor, Cell Genesys,
which, like Cougar and Novacea, was supported by Milken’s
Prostate Cancer Foundation, whose “Therapeutic
Consortium,” was chaired by none other than Dr. Scher.
The Wall Street Journal did not mention any of this, despite the
fact that concerned citizens had plastered the information all over
the Internet.
Four days after the Journal article appeared– May 15, 2007
– the FDA issued new guidelines for evaluating immunotherapy
agents, such as Dendreon’s treatment. Now it was official
– Pazdur’s division would have some influence.
This seemed like the FDA was papering
over a scandal. If Pazdur had violated the guidelines by
influencing the Dendreon decision, now the FDA could say that, in
fact, there were new guidelines, and Pazdur had followed them
(never mind that the new guidelines were written one week after the
FDA failed to approve Dendreon’s treatment, possibly because
Pazdur had violated the old guidelines).
* * * * * * * *
Just a few weeks after the FDA said it would not yet approve
Dendreon’s treatment, it was easier to understand why Dr.
Scher, Milken and their allies were so eager to see Dendreon fail.
On May 30, 2007, Novacea, the company whose largest investors were
Milken’s ProQuest Investments and the affiliated Domain
Associates, announced that it had signed a $500 million deal to
jointly develop its prostate cancer treatment with pharmaceutical
giant Schering Plough. Within 24 hours, Novacea’s stock price
jumped 86 percent.
In subsequent days, the business media reported this
“news” as if it were not just a business triumph, but
also a major breakthrough in the world of medicine. “On
Tuesday, Novacea was just another young biotech, with a modest
market capitalization of $187 million,”
enthused Forbes magazine. “That all changed on Wednesday
when the drug maker announced it had signed a deal worth over $500
million with pharma juggernaut Schering-Plough.”
Forbes added that Novacea’s treatment “appears to
significantly increase the chance of survival among
androgen-independent prostate cancer patients…”
As this $500 million figure and news of Novacea’s medical
miracle made its way around the other news organizations, and
appeared everywhere on the Internet, Novacea’s stock
continued to soar.
Nobody in the media paused to consider whether a “$500
million deal” constitutes a medical breakthrough (like, for
example, reducing mortality by 20% in late-stage prostate cancer
patients, as Dendreon had done). The assumption was, if there is
big money and the stock is soaring, the company’s prostate
cancer treatment must be good.
Furthermore, nobody in the media paused to consider that had
Dendreon received approval for its competing treatment, this
“$500 million deal” would almost certainly not have
happened. Nor did anybody in the media report that the people
(Milken and friends) who stymied Dendreon were the same people who
stood to profit from this purported “$500 million”
deal.
At any rate, the deal was not quite what it was made out to be.
Novacea did not receive $500 million. It received $60 million up
front. Meanwhile, Schering-Plough was given $12 million worth of
Novacea stock at a bargain price. By cashing out of the stock after
it soared in value, Schering-Plough could significantly reduce that
upfront investment. The rest of the much-trumpeted $500 million was
dependent on Novacea’s clinical trials showing that its
cancer treatment actually improved the health of patients.
Sure enough, just a few months later, in November 2007, Novacea
announced that the clinical trial of its treatment had been
terminated “due to an unexplained imbalance of
deaths…” In other words, Novacea’s drug was not
improving the health of patients. It was killing patients. And as
soon as this news was released, the much-heralded $500 million
Schering-Plough deal was cancelled.
Either shortly before or soon after the trials were terminated
due to an “imbalance of deaths,” Milken’s
ProQuest Investments and Domain Associates
sold their stock in Novacea. Given the enormous boost the stock
price had received after the “$500 million” news, it
appears that ProQuest and Domain (i.e. Michael Milken and
friends) sold their stock at a significant profit.
So the questions remain: Did Dr. Scher (who worked for ProQuest
and lead Novacea’s clinical trials) really believe that
Novacea’s treatment was superior, as he claimed during his
successful campaign to get the FDA to reject Dendreon’s drug?
Did Michael Milken’s Prostate Cancer Foundation, which was an
extension of ProQuest and snubbed its nose at Dendreon’s
treatment, really believe that there were better treatments in the
pipeline?
Did ProQuest and its affiliate Domain, which founded Novacea,
ever care about producing a marketable drug? Or was Novacea a scam?
A scam that was built on real science (though Dr. Scher was less
than upfront about the results of his clinical trials, his efforts
to develop Novacea’s treatment were no doubt sincere).
A scam that was more sophisticated than those perpetrated by the
bucket shops of yore, and whose every component may have been
technically legal.
But nonetheless a scam – an
old-fashioned pump and dump scam.
* * * * * * * *
This is part 11 of a 15-part series.
The remaining installments will appear on Deep Capture over the
next several weeks, after which point the story will be published
in its entirety at DeepCapture.com. It is a
story about the travails of just one small company, but it
describes market machinations that have affected hundreds of other
companies, and it contains a larger message for anyone concerned
about the “deep capture” of our nation’s media
and regulatory bodies.
Mark Mitchell is a
reporter for DeepCapture.com. He
previously worked as an editorial page writer for The Wall Street
Journal in Europe, a business correspondent for Time magazine
in Asia, and as an assistant managing editor responsible for the
Columbia Journalism Review’s online critique of business
journalism. He holds an MBA from the Kellogg Graduate School of
Management at Northwestern University. Email:
mitch0033@gmail.com