Journal of Public Health | Vol. 40, No. 2, p. 447 Book Review of the groups played an important part in legitimizing a par- Health Advocacy Inc.: How Pharmaceutical Funding ticular view of the meaning of being a citizen patient, the role Changed the Breast Cancer Movement. Sharon Batt. and content of information about treatment options, and not Vancouver: University of British Columbia Press, ISBN: 978- least the social meaning of the drugs themselves: a view that 0-7758-3384-4 (hardcover) 383 pages $39.95 (Canadian), favoured the interests of the drug companies as they sought ISBN: 978-0-7758-3384-4 (hardcover) 383 pp, 2017. regulatory approval for new and more proﬁtable drugs. The emergence of patient advocacy as an important com- ponent of public policy concerned with the regulation and Sharon Batt’s terriﬁc new book carefully dissects the story of approval of drug treatments made it a target for drugs com- the women’s breast cancer movement in Canada, showing panies seeking to inﬂuence meaning construction within this how neoliberal regulatory reform of both health policy and policy ﬁeld. Batt shows how the industry used tactics that the place of civil society in the Canadian system of govern- were remarkably similar to those used to inﬂuence clinicians ance turned a movement to democratize public health policy to construct the patient as citizen consumers with rights to into an arm of pharmaceutical company marketing. The access the latest drugs without reference to the public cost book constitutes a powerful case study of how neoliberal and sometimes in the absence of evidence about their efﬁ- reform intersects with private corporate interests seeking to cacy. Drug regulation came to be viewed as a hurdle to be shape public policy in favour of proﬁt maximization. overcome and, most troubling, the groups’ original mission Her indictment of the drugs companies, which were able to provide unbiased information about how to live with a to ‘exploit’ the legitimacy crisis of patient groups as they cancer diagnosis was subordinated to providing information experienced cuts in government funding and routes of inﬂu- about new drugs coming to market. ence, and her critique of neoliberal policy reform have The book is thorough and the evidence and analysis com- already received widespread treatment in the literature. But it pelling. Batt, herself a breast cancer survivor and a former forms the essential backdrop to the real value of the book, a activist, is careful not to overstate her case. But the book’s painstaking recreation of the 20-year history of the women’s measured tone and scholarly approach reinforce its import- breast cancer movement. ant contribution to the literature. The history reveals difﬁcult and traumatic discussions within and among patient advocacy groups about whether they should accept funding from pharmaceutical companies Nick Acheson and if so under what terms. The debates produced splits Centre for Social Innovation, University of Trinity College, within and between organizations. This is fascinating in the Dublin, Ireland ways it reveals the tactics adopted by the drugs companies *Address correspondence to Nick Acheson, E-mail: and the dilemmas created for the advocacy groups they firstname.lastname@example.org approached. But it begs the question of why the companies should be interested. The core insight of the book is in the doi: 10.1093/pubmed/fdy019 way it addresses this question. The gradual insertion of drug Advance Access Publication February 23, 2018 company money into the educational and information work © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com 447 Downloaded from https://academic.oup.com/jpubhealth/article-abstract/40/2/447/4904070 by Ed 'DeepDyve' Gillespie user on 24 July 2018
Journal of Public Health – Oxford University Press
Published: Feb 23, 2018
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