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Approved

Approved

NuevoAllergan: Botox, Rogue Scientists, and the Ultimate Beauty Franchise18 de septiembre de 2026 · 3 h 37 min
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18 Sep 2026
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Life sciences, under the hood. Deep dives into the patent filings, regulatory gauntlets, and capital-risks that shape the business of biology.

Episodios 6

  1. Allergan: Botox, Rogue Scientists, and the Ultimate Beauty Franchise

    3 h 37 minEpisodio 5

    Rate & Subscribe!!!The wild story of how a Cold War bioweapon became Botox — and how Allergan turned a sleepy ophthalmology drug into an enduring aesthetic franchise.Every part of this story looks nothing like …

    Notas del episodio

    Rate & Subscribe!!!


    The wild story of how a Cold War bioweapon became Botox — and how Allergan turned a sleepy ophthalmology drug into an enduring aesthetic franchise.

    Every part of this story looks nothing like your normal blockbuster drug. Botox started its development storyas a Cold War bioweapon so lethal the CIA was thinking of using it on Castro. Decades later, an eye surgeon in San Francisco mortgaged his house and managed to bootstrap his way to a BLA– no venture capital needed! After a contentious sale to a sleepy eye-drop company called Allergan, it turned Botox into one of the most durable, recurring-revenue franchises in the history of medicine.

    That cash cow provoked all sorts of financial battles– a hostile takeover attempt involving Bill Ackman, a tax-inversion scheme with Pfizer that united Bernie Sanders and Donald Trump in opposition, and a far-fetched plan to rent a Native American tribe's sovereign immunity to protect a different drug's patents.


    In this episode, we trace Botox from a 19th-century German sausage poisoning, through a Cold War weapons lab, an eye surgeon's garage-scale manufacturing operation, and into Allergan's decades-long reign — covering the science of why the drug still has no biosimilar, the "aesthetics stack" that turned it into a subscription business for faces, and the corporate finance drama (Valeant, Actavis, Pfizer and AbbVie) that followed. Along the way: exclusive interviews with Allergan's 95-year-old founding CEO, the scientist who helped manufacture the original drug substance in an academic lab, and the dermatologist who tried to repurpose Botox to treat depression.

    In this episode:

    • How a Clostridium botulinum strain donated for free by a Harvard professor became the physical basis of a multi-billion-dollar drug
    • Why the FDA's insistence on unique nonproprietary names (onabotulinumtoxinA vs. abobotulinumtoxinA) created an accidental, unbreakable competitive moat
    • How Allergan built the "surround the ophthalmologist" sales playbook — and later applied the same tactics to the aesthetic space.
    • The 2014 Valeant/Ackman hostile takeover attempt, and how Allergan fought back
    • How nearly every foundational piece of IP in the Botox story was given away for free by the academics who created it
    • Is there a new aesthetic bundle to build around incretin-based weight loss products?


    Featuring quotes from:
    Gavin Herbert Jr. (Allergan founder and former chairman/CEO), Eric Johnson, PhD (Ed Schantz's research partner, University of Wisconsin), Eric Finzi, MD PHD (dermatologist and Botox-for-depression researcher), Brent Saunders (former CEO, Allergan/Actavis), and Amy Ingle, APRN (owner, Sweet Spot Medispo).

    Bibliography

    Selected sources. Compiled September 2026.

    Books

    Helveston, Eugene M. Death to Beauty: The Transformative History of Botox. Bloomington: Indiana University Press, 2023. iupress.org

    Berkowitz, Dana. Botox Nation: Changing the Face of America. New York: New York University Press, 2017. nyupress.org

    Finzi, Eric. The Face of Emotion: How Botox Affects Our Mood and Relationships. New York: Palgrave Macmillan, 2013. publishersweekly.com

    Essays and criticism

    Shaywitz, David. “Botox: A Luminous Example of Field Discovery.” Timmerman Report, February 9, 2024. timmermanreport.com

    Shaywitz, David. “‘Death to Beauty’ Review: The Birth of Botox.” The Wall Street Journal, February 12, 2024. aei.org

    Business school case studies

    Paine, Lynn S., Suraj Srinivasan, John C. Coates, and David Lane. “The Allergan Board Under Fire (A).” Harvard Business School Case 316-010. Boston: Harvard Business School, 2016 (rev. January 7, 2019). hbsp.harvard.edu

    Paine, Lynn S., Suraj Srinivasan, John C. Coates, and David Lane. “The Allergan Board Under Fire (B).” Harvard Business School Case 316-029. Boston: Harvard Business School, 2016 (rev. January 7, 2019). hbsp.harvard.edu

    Peterson, Randall S., and Lisa Duke. “David Pyott: The Battle for Allergan (A).” London Business School Case CS-16-001. London: London Business School, September 2018. Distributed by Harvard Business Publishing, no. LBS305. hbsp.harvard.edu

    Foroughi, Jaclyn, and Rebecca Lester. “The Pfizer-Allergan Tax Inversion.” Stanford Graduate School of Business Case A-230. Stanford, CA: Stanford GSB, 2017. Distributed by Harvard Business Publishing. hbsp.harvard.edu


    Primary scientific literature

    van Ermengem, Emile. “A New Anaerobic Bacillus and Its Relation to Botulism.” Reviews of Infectious Diseases 1, no. 4 (1979): 701–19. Translation of “Ueber einen neuen anaëroben Bacillus und seine Beziehungen zum Botulismus,” Zeitschrift für Hygiene und Infektionskrankheiten 26 (1897): 1–56. PMID 399378

    Erbguth, Frank J., and Markus Naumann. “Historical Aspects of Botulinum Toxin: Justinus Kerner (1786–1862) and the ‘Sausage Poison.’” Neurology 53, no. 8 (1999): 1850–53. PMID 10563638

    Schantz, Edward J., and Eric A. Johnson. “Properties and Use of Botulinum Toxin and Other Microbial Neurotoxins in Medicine.” Microbiological Reviews 56, no. 1 (1992): 80–99. PMID 1579114

    Scott, Alan B. “Botulinum Toxin Injection into Extraocular Muscles as an Alternative to Strabismus Surgery.” Ophthalmology 87, no. 10 (1980): 1044–49. PMID 7243198

    Carruthers, Jean D., and J. Alastair Carruthers. “Treatment of Glabellar Frown Lines with C. botulinum-A Exotoxin.” Journal of Dermatologic Surgery and Oncology 18, no. 1 (1992): 17–21. PMID 1740562

    Dodick, David W., et al. “OnabotulinumtoxinA for Treatment of Chronic Migraine: Pooled Results from the Double-Blind, Randomized, Placebo-Controlled Phases of the PREEMPT Clinical Program.” Headache 50, no. 6 (2010): 921–36. PMID 20487038

    Finzi, Eric, and Norman E. Rosenthal. “Treatment of Depression with OnabotulinumtoxinA: A Randomized, Double-Blind, Placebo Controlled Trial.” Journal of Psychiatric Research 52 (2014): 1–6. PMID 24345483

    Brin, Mitchell F., et al. “OnabotulinumtoxinA for the Treatment of Major Depressive Disorder: A Phase 2 Randomized, Double-Blind, Placebo-Controlled Trial in Adult Females.” International Clinical Psychopharmacology 35, no. 1 (2020): 19–28. PMID 31609787

    The depression program after Allergan

    Healis Therapeutics. “Healis Therapeutics Acquires Ownership of Key Botulin...

  2. What is Approved?

    3 minTráiler

    Approved tells the definitive stories behind the world's most interesting biotech ventures. Most people learn about the industry in a fragmented, ad hoc way-- an industry article here, a clinical trial readout …

    Notas del episodio

    Approved tells the definitive stories behind the world's most interesting biotech ventures.

    Most people learn about the industry in a fragmented, ad hoc way-- an industry article here, a clinical trial readout there, some science twitter. In contrast, The Approved podcast tells comprehensive, definitive stories of how drugs are discovered, developed and sold. Whether we're tracking a single blockbuster drug's remarkable rise, or following a single startup’s decade-long path to approval, every episode we put out is an unvarnished look at how the biotech industry works. We break down what worked, what failed, and distill insights that you can apply to your own life science business. Every episode is accessible and entertaining, but ultimately designed for the life science professional.

    Hosted by Matthew Pech, PhD (cancer biologist and drug hunter) and Alex Kesin (biotech writer), every episode draws on hundreds of hours of research -- including Nature papers, corporate decks, SEC filings, and legal records. All that is supplemented with original interviews with the actual scientists, operators, and clinicians who brought the drugs to life.


    Season 1 Highlights

    • Keytruda: Featuring conversations with Roy Baynes and Greg Carven.
    • Blueprint Medicines: Featuring Christoph Lengauer and Alexis Borisy.
    • Botox: Featuring Gavin Herbert Jr. and Brent Saunders.

    Season 1 is wrapping up soon, with our upcoming episode on a drug worth 285 million times its weight in gold (guesses are welcome). Research for Season 2 is already underway...


    Subscribe on Apple Podcasts and Spotify, or visit approved.fm.

  3. Blueprint Medicines: Chasing Gleevec to a $9B Allergy Drug

    2 h 30 minEpisodio 4

    Blueprint Medicines was built to find the next Gleevec-style cancer drug. It ended up pivoting to allergic disease instead, and selling to Sanofi for $9B. This is the platform, the pivot, and who got …

  4. Keytruda: How Merck's Pembrolizumab Became the Best-Selling Cancer Drug of All Time

    2 h 8 minEpisodio 3

    Keytruda is Merck's $31 billion a year PD-1 inhibitor and the best-selling cancer drug of all time. In Episode 3 of Approved, Alex Kesin and Matthew Pech trace the development of pembrolizumab , featuring …

  5. Episode #2: Geron

    2 h 22 minEpisodio 2

    Listen on SpotifyListen on Apple PodcastsListen on YouTubeTABLE OF CONTENTS(00:00:00) - Introduction (00:01:19) - Hayflick Limit (00:08:30) - Michael West & Founding of Geron (00:15:16) - Early Science & IP …

    Notas del episodio

    Listen on Spotify

    Listen on Apple Podcasts

    Listen on YouTube

    TABLE OF CONTENTS

    (00:00:00) - Introduction

    (00:01:19) - Hayflick Limit

    (00:08:30) - Michael West & Founding of Geron

    (00:15:16) - Early Science & IP Strategy

    (00:27:25) - Cloning the Telomerase Gene

    (00:29:30) - Embryonic Stem Cells & Political Context

    (00:44:21) - Okarma, West’s Departure & Corporate Turmoil

    (01:05:08) - Spinal Cord Injury Trial

    (01:30:45) - Pivot to Blood Cancer

    (01:43:08) - Clinical & Commercial Drama

    (02:01:45) - Legacy & Lessons

    CREDITS

    Co-hosted by Alex Kesin and Matthew Pech

    Written, edited, and produced by Alex Kesin

    Music: “Food” by nerowski

    * Special thanks to the team at NFX for the use of their recording studio.

    SOURCES

    Last updated: March 2026

    I. BOOKS

    Hall, Stephen S. Merchants of Immortality: Chasing the Dream of Human Life Extension. Houghton Mifflin, 2003.

    Williams, Tory. Inevitable Collision: The Inspiring Story That Brought Stem Cell Research to Conservative America.Mary Ann Liebert, Inc., 2014.

    II. KEY SCIENTIFIC PUBLICATIONS

    Hayflick, L. & Moorhead, P.S. “The serial cultivation of human diploid cell strains.” Experimental Cell Research 25 (1961): 585–621.

    Kim, N.W. et al. “Specific association of human telomerase activity with immortal cells and cancer.” Science 266, no. 5193 (1994): 2011–2015.

    Feng, J. et al. “The RNA component of human telomerase.” Science 269, no. 5228 (1995): 1236–1241.

    Nakamura, T.M. et al. “Telomerase catalytic subunit homologs from fission yeast and human.” Science 277, no. 5328 (1997): 955–959.

    Meyerson, M. et al. “hEST2, the putative human telomerase catalytic subunit gene, is up-regulated in tumor cells and during immortalization.” Cell 90, no. 4 (1997): 785–795.

    Bodnar, A.G. et al. “Extension of life-span by introduction of telomerase into normal human cells.” Science 279, no. 5349 (1998): 349–352.

    Thomson, J.A. et al. “Embryonic stem cell lines derived from human blastocysts.” Science 282, no. 5391 (1998): 1145–1147.

    Asai, A. et al. “A novel telomerase template antagonist (GRN163) as a potential anticancer agent.” Cancer Research 63, no. 14 (2003): 3931–3939.

    Herbert, B-S et al. “Effect of the lipid modification of GRN163.” Nature: Oncogene 24 (2005): 5765–5772.

    Baerlochr, G. et al. “A pilot study of the telomerase inhibitor imetelstat for myelofibrosis.” New England Journal of Medicine 373 (2015): 908–919.

    Platzbecker, U. et al. “Imetelstat in patients with lower-risk myelodysplastic syndromes who have relapsed or are refractory to erythropoiesis-stimulating agents (IMerge).” The Lancet (2024).

    Lennox, A.L et al. “Imetelstat, a novel, first-in-class telomerase inhibitor: Mechanism of action, clinical, and translational science.” Clinical and Translational Science 17, no. 11 (2024).

    Scott, C. & Magnus, D. “Wrongful Termination: Lessons From the Geron Clinical Trial” Stem Cell Reports 3, no. 5 (2014): 721–723.

    III. REGULATORY & CLINICAL

    Prescribing Information (Label) U.S. Food and Drug Administration. “RYTELO (imetelstat) for injection: Highlights of Prescribing Information.” NDA 217779. June 2024.

    NDA Approval Letter U.S. Food and Drug Administration. “NDA Approval Letter: RYTELO (imetelstat) for injection.” NDA 217779. June 6, 2024.

    Multi-Discipline Review & Evaluation U.S. Food and Drug Administration. “NDA Multi-Disciplinary Review and Evaluation: RYTELO (imetelstat).” NDA 217779Orig1s000. 2024.

    ODAC Briefing Document U.S. Food and Drug Administration. “FDA Briefing Document: Oncologic Drugs Advisory Committee Meeting, NDA 217779, Imetelstat.” March 14, 2024.

    REMS/Risk Assessment Review U.S. Food and Drug Administration. “Risk Assessment and Risk Mitigation Review: RYTELO (imetelstat).” NDA 217779Orig1s000. 2024.

    Kim, N. et al. “US Food and Drug Administration Approval Summary: Imetelstat for Selected Patients With Low- to Intermediate-1 Risk Myelodysplastic Syndromes With Transfusion-Dependent Anemia.” The Oncologist (2025). PMID: 41135032.

    FDA. “FDA Approves Imetelstat for Low- to Intermediate-1-Risk Myelodysplastic Syndromes with Transfusion-Dependent Anemia.” June 2024.

    ICER. “Evidence Report: Treatment for Anemia in Myelodysplastic Syndrome.” August 2024.

    ICER. Press Release on Imetelstat Evidence Assessment.

    ClinicalTrials.gov. GRNOPC1 Phase I Trial. NCT01217008.

    Myelodysplastic Syndrome Epidemiology. PMC4553145.

    MDS Risk and AML Progression. Blood (2023).

    IV. CORPORATE FILINGS & PRESENTATIONS

  6. Episode #1: Amylin Pharmaceuticals

    1 h 46 minEpisodio 1

    Listen on SpotifyListen on Apple PodcastsListen on YouTubeTABLE OF CONTENTS(00:00:00) - Introduction(00:04:40) - $50 of Dried Lizard Venom(00:29:17) - Fax of Death(00:43:04) - Sleeping Beauty Awakens(00:52:07) …

    Notas del episodio

    Listen on Spotify

    Listen on Apple Podcasts

    Listen on YouTube

    TABLE OF CONTENTS

    (00:00:00) - Introduction

    (00:04:40) - $50 of Dried Lizard Venom

    (00:29:17) - Fax of Death

    (00:43:04) - Sleeping Beauty Awakens

    (00:52:07) - Carl Icahn Sends a Letter

    (01:09:19) - Endgame

    (01:13:40) - Postmortem & Playbook

    CREDITS

    Co-hosted by Alex Kesin and Matthew Pech

    Written, edited, and produced by Alex Kesin

    Music: “Food” by nerowski

    * Special thanks to the team at NFX for the use of their recording studio.

    SOURCES

    Last updated: January 2026

    I. PRIMARY DOCUMENTS

    FDA Regulatory Documents

    Symlin (pramlintide acetate) - NDA 21-332

    * Approval Letter & Package (March 16, 2005)

    * Medical Review

    * Statistical Review

    * Clinical Pharmacology & Biopharmaceutics Review

    * Administrative Documents & Correspondence

    Byetta (exenatide) - NDA 21-773

    * Approval Letter & Package (April 28, 2005)

    * Medical Review

    * Statistical Review

    * Clinical Pharmacology & Biopharmaceutics Review

    * Administrative Documents & Correspondence

    Bydureon (exenatide ER) - NDA 22-200

    * Approval Letter (January 27, 2012)

    * Other Action Letters (Complete Response)

    * Summary Review

    * REMS

    * Administrative Correspondence

    SEC Filings & Financial Documents

    * Amylin 2005 Results Press Release (Ex-99.1, 8-K)

    * Amylin 2007 Results Press Release (Ex-99.1)

    * Amylin 2011 Form 10-K (Net Product Sales)

    * Carl Icahn SEC Filing (Schedule 13D)

    Proxy Fight & Legal Documents

    * Carl Icahn Letter to Amylin (April 15, 2009)

    * Amylin Response to Icahn (April 20, 2009)

    * Police Fund v. Bradbury (Amylin) Trial (May 4, 2009)

    * Lilly Litigation Ruling (May 25, 2011)

    II. ORAL HISTORY & INTERVIEWS

    * Howard Greene Oral History (UCSD Library, October 8, 2008) - Primary source for Hybritech founding, Ted Greene’s background, and early Amylin history

    III. NEWS & TRADE PRESS

    2000

    * “The Rumsfeld Resume” - CBS News (December 28, 2000) - Donald Rumsfeld’s board tenure at Amylin (1991-1996)

    * “Roller Coasting” - Forbes (July 24, 2000) - Joe Cook narrative, J&J partnership collapse

    2005

    * “Investing for a Profit and a Daughter’s Health” - NYT (March 19, 2005) - Allen Andersson investment story, “tablecloth deal”

    2006

    * “Diabetics see hope (and weight loss) in new drug” - NYT (March 2, 2006) - “Lizzie” nickname, patient testimonials

    * “4 Diabetes Drugs Are Seen Raising Hope and Profit” - NYT (June 22, 2006) - Manufacturing shortage, 400,000+ patients

    * “Don’t kill off life-saving drugs” - Heritage Foundation (August 15, 2006) - Policy perspective on Byetta’s potential impact

    * “Byetta Craze Is First Salvo in Promising New Line of Drugs” - diaTribe - ADA conference chaos, “one man cried”

    2007

    * Dr. John Eng Profile - Diabetes In Control (September 18, 2007) - Eng’s discovery story, patent struggles, Amylin vs. Lilly negotiations

    2008

    * Xenome/Amylin Partnership - BioSpace (February 5, 2008) - Venom peptide library partnership

    2009

    * Eastbourne Capital Sells Stake - San Diego Union-Tribune (October 10, 2009) - End of Eastbourne activist campaign

    * Survey: Additional Diabetes Dru...

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