If you were to go make a movie, youd go to Hollywood; if you want to develop a new medicine, Boston is the place, said Daphne Zohar, founder and CEO of PureTech Health, a Boston-based biotech company.

There are more than 700 biotech companies in the state, according to the Massachusetts Biotechnology Council, with roughly 500 residing in Boston and Cambridge. They employ some 75,000 people in Massachusetts, according to the Bureau of Labor Statistics, accounting for about $12 billion in wages 2018.

It all works because the nexus of top-tier research universities, world-class teaching hospitals, fledgling startups, and a few multinational pharma companies have created a critical mass straddling the Charles River.

Take, for example, Alnylam Pharmaceuticals. In 2002, the company began to explore a theory, co-discovered by a scientist at the University of Massachusetts Medical School, that tinkering with extracellular RNA communication might treat disease. It raised money from Boston VC Polaris Partners, leased a cramped space in Cambridge, and recruited a team from nearby biotech stalwarts Millennium Pharmaceuticals and Biogen. Fast-forward through a couple decades of scientific peaks and valleys, and Alnylam now has two FDA-approved medicines, a pipeline of nine more potential ones, and roughly 1,200 employees to bring the plan to fruition. All while staying in Massachusetts.

Such success stories were unimaginable about four decades prior, when Kendall Square was a stretch of warehouses and factories. Lita Nelsen, who enrolled at MIT in the 1960s, recalls that one could tell which way the wind was blowing by whether it smelled like the Lever Brothers soap plant or the Necco wafer factory.

All that would change in 1977, when Cambridge became the first city in the world to set rules around genetic engineering. The idea was to prevent an apocalyptic superbug from crawling out of some over-ambitious lab, but the effect was like an open-for-business sign to biotech entrepreneurs around the globe. Where other cities offered uncertainty, Cambridge had a workable blueprint.

Nelsen, who spent 30 years leading MITs office for out-licensing discoveries, was there to see Kendalls nascent biotech scene flourish. Biogen, Genzyme, and Repligen arrived in the early 1980s. Then came VCs from New York and California, lured by the promise of cutting-edge biology. By the late 1990s, Big Pharma took notice and began building research hubs alongside Cambridges many startups. In time, the biotech sector became a self-sufficient economic force.

I dont know what to say but that it happened, and then it built on itself, Nelsen said. Its a pretty complicated sauce. Youre never sure which ingredients are absolutely critical and which just help it along.

Massachusetts biotech companies are constantly getting launched, shuttered, or consumed, but the ecosystem persists because the people tend to stick around, said Samantha Truex, CEO of the recently formed Quench Bio. That makes it easy to recruit for the next startup idea, and it creates a multigenerational brain trust, available for free consulting in the line for coffee.

Its almost like an upward spiral, if you will, Truex said. Thats what has made it grow and flourish.

Massachusetts decades of success in biotech have inspired more than a few cities, states, and nations to try replicate that complicated sauce. It often creates a tricky game of chicken-or-egg. How do you attract entrepreneurial scientists if theres no anchor industry? And how do you rope in major drug companies if you dont have researchers to fill their pipelines?

There are way more failure stories than there are success stories, said Michael Ringel, a senior partner at Boston Consulting Group, who focuses on research and development. The failures tend to be around just throwing money at it and not realizing that theres a system that has to be put in place.

Damian Garde covers biotech for STAT. He can be reached at damian.garde@statnews.com. Follow him on Twitter @damiangarde.

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If you want to develop a new medicine, Boston is the place - The Boston Globe