Making Waves

by Laura Moore

  Not trusting himself to rein in his anger, he hadn’t called her last night, instead texting when he arrived at his office to say he wasn’t sure when he’d be returning, letting her draw her own conclusions.

  He’d felt like the jerk he was when he received her instantaneous response: I understand and am sorry. Yet he didn’t reply with either a text or a call. He couldn’t. Not until he could talk about Rosie and his father without being shredded to the bone.

  Bob’s ascetic face was looking positively jolly. “Higher volumes, cheaper production costs…I’m liking this, Chris. You’re hitting it out of the park.”

  “I haven’t even shown you my good stuff, Bob.” Chris was sucking up. He knew how much Elders loved baseball analogies.

  Bob glanced at him, and Max lifted the corners of his mouth to demonstrate his amusement.

  “Well, then, Chris, bring it on.”

  From the eagerness of Bob’s tone, Max knew he was picturing the big, golden, cream-stuffed Twinkie he so craved right in front of him. There for the grabbing, there for the gorging.

  Chris assumed a cocksure position, leaning back in the leather and chrome armchair, his hands clasped behind his head, ankles crossed. “Zeph3 is on schedule for its rollout in January. We have reps around the country talking it up, so doctors and hospitals are aware of when it will become available. We’ve hired Taylor & Gibbs to run the ad campaign. They charge top dollar, but they’re totally worth it.”

  “What’s your pricing strategy for Zeph3?” Max asked.

  “For total treatment duration, eighty thou.”

  “On the high side.”

  Chris blew him off with a shrug. “We’ve got the corner on the market. Have to take advantage of that.”

  Max glanced at Bob. He didn’t seem fazed.

  “And while I was at the San Fran medical conference,” Chris continued, “I talked to a bunch of consultants, doctors, and insurance reps. They got me thinking about some of the other drugs in Chiron’s portfolio. I went and took a good, hard look.”

  This was it, Max thought, straightening in his chair. What had left Chris gloating with barely contained glee the night they’d had drinks in San Francisco.

  “And what did you find, Chris?” Bob asked.

  “That while Kauffmann was Chiron’s CEO, the drugs were way undervalued. Their pricing history? Flat as my grandmother’s ass.” He paused to chuckle. “I’ve spotted one that’s just crying out for a little padding,” he said with a smirk.

  “Which one is that?” Max asked.

  “Mitrilocin.”

  Max had spent the night reviewing his files on Chiron. It was better than thinking about what Dakota had said to him or replaying the night of Rosie’s death and the terrible twelve months that followed it, or allowing his father’s words to echo in his head.

  “Mitrilocin, that’s the cystic fibrosis drug.” At Chris’s nod, he continued, “Mitrilocin is a macrolide antibiotic, Bob, that’s proven very effective in fighting lung infections in patients suffering from cystic fibrosis. It’s still got five more years under patent, right?”

  “Yeah.” Lowering his arms, Chris shifted in his chair.

  What, had he thought Max wouldn’t come prepared?

  “I’m already taking steps to extend its patent. But in the meantime, the drug is overdue for a price increase. We should act while we control the market,” Chris said.

  “What are you thinking of in terms of an increase?” Bob asked.

  “It’s at one hundred and forty dollars. I’m going to up it to one thousand five hundred and forty.”

  “Jesus, Chris, that’s a thousand percent increase.”

  He shrugged. “Mitrilocin’s track record justifies a higher price point. After all, we ain’t in the charity business. We can’t just give it away.”

  “One hundred and forty dollars a dose isn’t exactly a giveaway,” Max shot back.

  Chris ignored him. “What do you think, Bob?”

  “It sounds to me like not taking advantage of a more aggressive market price might be a big reason Mark Kauffmann got his company taken away from him,” Bob replied.

  Max looked at him. Bob, an avid cyclist, had never been sick a day in his life. Even on the grueling century rides he entered, a type A personality’s favorite race, when his heart was pumping and his lungs working overtime on the long, mountainous climbs, he doubtless exalted in the moment. Understandably so. Having to suck in air while his chest worked like a bellows showed his fitness, his toughness, his unsurpassed drive. Moreover, those moments were temporary, sought after by a fitness junkie. Taking his strength for granted, Bob wouldn’t wonder what it would be like to be afflicted with a disease where that condition was permanent, the act of breathing a constant effort. To live a life plagued and weakened by chronic lung infections.

  There was another thing about Bob: he specialized in media and communication companies. Nobody died in those transactions. He didn’t research deals where he had to look at stats that showed what the company’s drugs did to help people with diseases and illnesses.

  But Max did.

  And he knew that if a patient with cystic fibrosis had an insurance plan that refused to cover the drug after its price was raised a thousand percent, that person—a child, perhaps—might die.

  If he didn’t protest this price hike, that death would be partly Max’s fault.

  Fuck. Fuck. Fuck.

  It was as if he’d cursed aloud.

  Chris looked at him, his eyes as flat and menacing as a shark’s, and smiled. “Exactly.” Then, shifting his attention across the black desk, he said, “Mark Kauffmann didn’t have the balls to make Chiron a major-league player, Bob. I do.”

  “Bob, Chris, I gotta tell you, I don’t think this is the right move to make. Such a dramatic price hike is a mistake.”

  “I disagree, Max. I don’t see any problem with Chris’s plan. I don’t believe the board will, either,” Bob said, the twin lines between his brows adding severity to his face. “Chiron’s producing a much-needed and beneficial drug that eases suffering. Yes, the insurers and some patients will have to pay more for it. But a portion of the revenue generated will be going toward R&D. Chiron’s chemists have already developed a drug to fight cystic fibrosis’s symptoms. Perhaps they’ll find a drug that actually cures the disease.”

  Bob might not do pharma deals, but it hadn’t prevented him from picking up the industry’s standard line. It was the stock response companies parroted over and over again to justify jacking up prices: Discovering new and successful drugs and then putting them through the rigorous trials required for FDA approval was lengthy and costly. Immensely so. Raising drug prices was necessary, vital, for the companies to survive.

  Anyone who’d looked at the year-end profits for the majority of pharma companies knew that was a crock.

  God, why couldn’t Chris have made Max’s life easier by picking a drug that treated acne? Toenail fungus? Male pattern baldness? Max wouldn’t have cared if that drug’s price had been raised through the roof.

  But this plan was going to hurt people. People who were already suffering.

  Max knew better than to press the issue in front of Chris, however. Bob hated any show of dissent.

  Bob glanced at his watch. “I think we’ve gone over everything we need before we convene tomorrow,” he said, a clear signal that any further discussion was unwelcome. For the sake of propriety, he added, “Unless there’s anything else?”

  Rising to his feet, Chris shook his head. “Nope. All good on my end.”

  Max stood but remained silent.

  “Again, Chris, really pleased with what you’ve accomplished so far. Keep it up,” Bob said after they shook hands.

  “Glad you approve. Only wish Max here weren’t so down in the mouth. Looking a little hangdog, bro.”

  The little prick, thought Max. “Not at all, Chris.”

  Chris’s eyes widened. “My mistake. Hey, want to grab a bite to eat?”

/>   “Sorry, I have a meeting out of the office. Don’t know how long it will take.”

  “Maybe after the board meeting, then.”

  Not if he could avoid it. “Sure thing.”

  “Then see you guys mañana.”

  —

  Max waited until Chris was out the door and out of earshot. “If I could speak to you for a moment?”

  “Sure, Max. Shoot.”

  “Bob, I’ve got to level with you. It’s a really bad idea to increase Mitrilocin’s cost so dramatically. The drug works, Bob. That means for the patients whose insurance companies refuse coverage for it, they’ll have to look for alternative treatments that might not fight the infection as effectively. Or they’ll go bankrupt paying out of pocket because it’s the only treatment that helps. That’s kind of adding insult to injury, don’t you think?”

  “Actually, I don’t.” He leaned forward in his chair and, propping his elbows on his desk, steepled his fingers together. “Who’d have thought it—Max Carr sounding like a bleeding-heart liberal? Next you’re going to be arguing for socialized medicine. Max, you know as well as anyone you don’t make billions by being nice.”

  “Chiron will be making a profit on Zeph3 alone, Bob. A thousand percent price hike for a Mitrilocin is outrageous.”

  “I disagree. The Summit Group’s principal duty is to our investors. We have a fiduciary responsibility to maximize our profits. You know this, Max. What’s gotten into you lately? First you piss off Steffen—when he was the one you put forward to run Chiron—and now you’re actively going against him on a business decision that, as CEO, is his to make. I’m having trouble recognizing the team player I depend on.”

  Dakota had gotten to him. Her words yesterday, arguing that he wasn’t to blame for Rosie’s death or his mother’s, that he was a good man, had found their way inside him. He might not be the direct cause of Rosie’s death, but he’d nevertheless failed his twin in a crucial moment. Max could blame immaturity for his unthinking selfishness. But how would he ever justify being part of a plan to hike the price of a drug used by people already fighting a terrible disease? Impossible. Impossible, too, to pretend that he was even remotely a good man if he went along with this.

  Since he couldn’t persuade Bob with a moral argument, he decided to try a regulatory one. “There’s another thing to consider. A thousand percent price increase is going to raise a hue and cry among patients and industry watchdogs. The last thing we want is to attract the attention of the feds. That will cost Chiron not only in legal fees but also in reputation. It could lead to a PR disaster. That in turn could affect Zeph3’s rollout.”

  “Again, I disagree. Steffen’s not stupid. He knows the market and what he can get away with. If he’d gone and jacked up the amount by four thousand percent, well, then we might have a problem on our hands. But a thousand percent? That’s the sign of an aggressive CEO who’s fully prepared to wield the pricing power he holds. Time to get on board, Max.”

  Max returned to his office, sat down at his desk, and opened his Chiron files. He reread everything he had on Mitrilocin and cystic fibrosis to make sure his gut reaction at the meeting with Bob and Chris hadn’t been a sloppy side effect of all the emotions—the guilt, the regret—resulting from his and Dakota’s fight.

  He checked stats, compared competing drugs, looked at follow-up studies on the drug, and cursed as frustration and anger grew inside him. Mitrilocin was as effective as he’d thought. The majority of patients given the drug were free of chest infections for up to six months and reported weight gain, as well—because with CF, it was damned hard to keep weight on when the lungs and gut were being attacked. Adverse effects were minimal.

  It was small consolation that Max didn’t believe Chris had intentionally duped him. He didn’t think that Chris had set his sights on Mitrilocin from the get-go rather than on Zeph3, the melanoma drug that Chris had originally touted as their goldmine.

  And what if Chris had recognized the potential for Mitrilocin to be an amazing windfall and shared it with him when they first sat down to talk about acquiring Chiron? Max might very well have decided that it only made the deal sweeter.

  Because nine months ago, Max had been a different person.

  He had a wife now. A pregnant wife. Yesterday the ultrasound tech had said that everything seemed fine with the baby, but so much could still go wrong.

  Restless, he stood and went over to the bank of windows overlooking Park Avenue. It was midmorning in midtown, so the traffic had crawled to a stop, idling cars and delivery trucks spewing exhaust into the air.

  He thought of how he’d come to love stepping outside Windhaven and drawing the salty air deep into his lungs. For people afflicted with cystic fibrosis, their lungs were filled with thick mucus; it was a battle to draw any kind of air at all. He thought of his daughter, his tiny perfect daughter. Her lungs were still developing.

  How would he feel if, by some horrible twist of fate, it turned out that she had the genetic mutation and developed the disease? His wealth would allow him to afford every treatment available. But how would he live with himself knowing so many other parents, sisters, and brothers couldn’t do the same for their loved ones? How could anyone live with that?

  Max shouldn’t have let Rosie, an inexperienced driver, take the car home that night. The knowledge would probably haunt him forever. He couldn’t repeat the mistake and sit back, doing nothing while Chris raised Mitrilocin’s price sky-high.

  Unless he convinced Bob to back him, Chris’s performance as Chiron’s new CEO would likely receive a standing ovation at tomorrow’s board meeting. After their conversation, Max knew what a long shot it was.

  For so long, Max’s world had been shaped by deals and dollar signs. His route had been linear, straight to the top. He was on track to achieve the goals he’d set for himself, raking in millions with each successive and successful deal and burnishing his image in Bob Elders’s eyes, essential to taking over as the Summit Group’s next managing director when Elders stepped down.

  Refusing to go along with Chris’s plans could very well derail his own. And he had no map for what that world would look like.

  A knock sounded on his open door. He glanced over his shoulder to see Roger Cohen enter.

  “Hey, Max. How’d the meeting with Bob and Steffen go?”

  He turned away from the windows and shrugged. “Fucked six ways to Sunday.” Removing his hands from his pockets, he gestured for Roger to sit and then dropped into the chair angled opposite him. “Remember how I told you about the drink I had with Chris in San Francisco, and how it was clear he was up to something? Well, he just shared it. He wants to take a drug Chiron manufactures that’s frequently prescribed to cystic fibrosis patients to fight lung infections and up its price tag by a thousand percent.”

  Roger whistled softly. “Bob’s on board with that?”

  “Yeah. And he told me I’d better be, too.” Max rubbed his face wearily. Damn, he wished he were home on Long Island with Dakota, far away from this shit storm. “I laid out the drug’s role, argued the negatives against the price hike, warned about the potential for a federal investigation, and told him that already sick people might very well die if Chiron takes this step. Bob talked about fiduciary responsibility.”

  “What are you going to do?”

  Max’s laugh was bitter. “You’re the lawyer, Rog. You tell me. I’m not about to leak Chris’s plan to the media.” That kind of move was for rats. Besides, what Chris was doing wasn’t illegal; it was simply loathsome. In short, not especially newsworthy. “What the hell can I do except go into Bob’s office and try again? If he’s not willing to second me, then I have no chance of swaying the board.”

  Roger’s silence told Max what he already knew. They had both observed Bob’s responses to criticism. There was no way to come out of this battle unbloodied.

  “Hell of a time to develop a conscience, right?” Max said.

  “Better late than never.”
/>
  Max managed the semblance of a grin. “It’s been good working with you, Roger.”

  Roger cleared his throat. “Listen,” he said. He reached into the inside pocket of his suit and pulled out a business card and a slim silver pen and scrawled on the back of the card. “Here’s the name and number of a good lawyer. Your shares in Summit are fully vested, Max, but you’ll still need top-notch representation. Mike Gaddis is your guy. Before you head into Bob’s, call Mike. Drop my name and make sure you’ve got him on retainer before you hang up the phone.”

  Max took the card. “Thanks, Roger.”

  They stood and shook hands. “Fuckin’ Steffen,” Roger said with weary disbelief.

  “Yeah.”

  Roger smiled sadly and moved toward the door. Then he stopped and turned. “Look, you’re smart. You’ve been wildly successful. You have enough money to live out the rest of your life in champagne and caviar. You can do anything. What is it you really want, Max?”

  What sprang to Max’s mind wasn’t what he had expected. But he knew it was the truth. He smiled.

  Roger returned it. “Good luck, man.”

  “You too. And hey, you and the family should come out to East Hampton and stay with us this summer. Dakota’s not due until the end of August. There’s plenty of room at the house.”

  “We’d like that.”

  Max nodded. “I’ll be in touch.”

  —

  Max murmured “Thanks” when Susan Hughes, Bob’s assistant, ushered him back into the spacious corner office. On the phone, his long legs propped on his desk, Bob held up an index finger to indicate that the conversation would be wrapping up shortly.

  Max lowered himself into the chair he’d occupied only an hour before.

  While Bob talked about media market growth drivers to whoever was on the line, Max let his glance travel around the office, its gleaming surfaces reflecting power.

  His phone vibrated. He reached into his jacket pocket, pulled it out and glanced at the screen. It was a text from Dakota. Hope the meeting went okay. Thinking of you.

  Damn, he needed her. He’d only begun to realize just how much.