BRIAN DEER: HARD SELL Page 3

If Henry Wellcome's ghost stalks 183's marble and bronze, he might well be thinking that, with the passage of years, in some sense, the last laugh was his. At the time of their divorce, he could hardly stomach Syrie's betrayal, and the humiliating rumours about Maugham's sexuality. But in the final quarter of the twentieth century, it was precisely such lifestyles that was to create vital markets upon which his empire would thrive.

In the 1960s, which saw gonorrhoea cases jump 300%, the Wellcome Foundation was an obscure English enterprise, strong on publicity (and caffeine-based home remedies), but with few bright scientists - mostly in the US - and a modest reputation in cancer. But as "adultery" fell out of popular usage, and “promiscuity” began losing its stigma, the empire based in Euston Road was on the spot with relevant products.

The 1970s saw the rise of its antibacterial, Septrin, Septra or Septran, used commonly for urinary tract, and some sexually-transmitted, infections. The 1980s saw the unveiling of Zovirax, its antiviral for herpes simplex. And the 1990s was its decade for AZT, its therapy for HIV/Aids.

Septrin (in the UK) and Septra (in the US) was the first real blockbuster from the Wellcome Foundation - a true heir to the founder’s Big Idea. Although rooted in the inspiration of the company's US science chief Dr George Hitchings (who later won a Nobel Prize), where it really triumphed was in its packaging and marketing. Just like the magic ink.

Septrin is actually two drugs put together, both of which inhibit folic acid synthesis. One, trimethoprim, was patented by the company in 1957. The other is an obsolescent sulphonamide (called sulphamethoxazole) from the Swiss drugs giant Hoffman-La Roche. Tabloided together into a single pill, their worldwide gross is more than $5 billion.

But for nearly all infections, the drugs didn't need combining. There was no advantage in taking two. Reports in the medical literature said so plainly, beginning in 1973. The journal Chemotherapy said so. The Annals of Clinical Research said so. So did the Journal of Clinical Pathology. In 1978, the British Medical Journal said so. And in 1980, a team declared in The Lancet that, compared with Septrin "single therapy with trimethoprim has the advantage of smaller tablets and fewer side effects, and it is cheaper".

But in the 1960s, Roche was a major company and the late Henry's empire was still small. So a deal was done to piggyback the drugs together, and to market them, beginning in 1969, as possessing the magic ingredient of “synergy”.

It was classic Henry Wellcome, all set out in the will: the house style and corporate culture. Remembering the success of his Tabloid promotions, the founder had advised his successors in his memorandum: "I consider it in the best interests of the several industrial organisations and of all concerned that the publicity, advertising and other propaganda shall be steadily increased as the output is increased in volume and in profits."

With Septrin, moreover, his ideas were rolled-out for what was yet to come. The next phase was to tackle moneymaking another way: instead of selling more drugs by getting people to take two, selling more drugs by doubling the numbers who were considered to be suitable consumers. This was the story in the 1980s and 1990s with Zovirax and AZT.