Explore every episode of the podcast Approved
| Title | Pub. Date | Duration | |
|---|---|---|---|
| Allergan: Botox, Rogue Scientists, and the Ultimate Beauty Franchise | 18 Sep 2026 | 03:36:36 | |
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:
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 Botulinum Toxin Patent.” PR Newswire, January... | |||
| What is Approved? | 14 Sep 2026 | 00:03:03 | |
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 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...
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| Blueprint Medicines: Chasing Gleevec to a $9B Allergy Drug | 04 Aug 2026 | 02:29:41 | |
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 paid.
A decade later, Sanofi paid roughly $9 billion for the company... just not for a cancer drug. Blueprint's blockbuster asset, avapritinib (AYVAKIT), found its real market almost by accident: indolent systemic mastocytosis, a debilitating, often-undiagnosed mast-cell disease that took patients years to get diagnosed and had no approved treatment.
Featuring interviews with:
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. * This episode is presented by JLL. Featuring Grant Dettmer on biotech real estate strategy. Sources
Blueprint Medicines (CIK 1597264)
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| Keytruda: How Merck's Pembrolizumab Became the Best-Selling Cancer Drug of All Time | 14 May 2026 | 02:07:36 | |
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 interviews the scientists who drove the program forward : co-inventors Gregory Carven and Michel Streuli, and former Merck oncology CMO Roy Baynes. Topics include preclinical PD1 / CTLA-4 checkpoint biology that brought industry attention to the target (Jim Allison's CTLA-4 work and Tasuku Honjo's PD-1 discovery); how pembro started as a failed rheumatoid arthritis antibody program at a Dutch subsidiary of a paint company; the two mega-mergers that nearly killed the program; the biomarker enrichment trial design behind KEYNOTE-024 that let Merck break BMS's lead in lung cancer; the 41-patient Johns Hopkins MSI-H trial behind the first tissue-agnostic FDA approval, and the Jimmy Carter melanoma case that brought pembrolizumab to the public conscious. The episode closes on what comes next for Merck: the 2028 patent cliff, the Keytruda QLEX subcutaneous launch, and efforts to find the next blockbuster checkpoint inhibitor, including Summit/Akeso's PD-1 / VEGF bispecific ivonescimab. This episode is presented by JLL. Featuring Grant Dettmer on biotech real estate strategy. CHAPTERS
Sources Last updated: May 2026
Greg Carven, Michel Streuli, Roy Baynes — Approved podcast interviews (2026). Quotes attributed to these speakers come from these conversations unless otherwise noted.
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| Episode #2: Geron | 13 Mar 2026 | 02:22:06 | |
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 II. KEY SCIENTIFIC PUBLICATIONS Feng, J. et al. “The RNA component of human telomerase.” Science 269, no. 5228 (1995): 1236–1241. III. REGULATORY & CLINICAL 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 | |||
| Episode #1: Amylin Pharmaceuticals | 30 Jan 2026 | 01:46:28 | |
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) * Clinical Pharmacology & Biopharmaceutics Review * Administrative Documents & Correspondence Byetta (exenatide) - NDA 21-773 * Approval Letter & Package (April 28, 2005) * Clinical Pharmacology & Biopharmaceutics Review * Administrative Documents & Correspondence Bydureon (exenatide ER) - NDA 22-200 * Approval Letter (January 27, 2012) * Other Action Letters (Complete Response) * 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 | |||