Journal of Public Health | p. 1 Book Review company money into the educational and information work Health Advocacy Inc.: How Pharmaceutical Funding of the groups played an important part in legitimizing a par- Changed the Breast Cancer Movement. Sharon Batt. ticular view of the meaning of being a citizen patient, the role Vancouver: University of British Columbia Press, ISBN: 978- and content of information about treatment options, and not 0-7758-3384-4 (hardcover) 383 pages $39.95 (Canadian), least the social meaning of the drugs themselves: a view that ISBN: 978-0-7758-3384-4 (hardcover) 383 pp, 2017. favoured the interests of the drug companies as they sought regulatory approval for new and more proﬁtable drugs. The emergence of patient advocacy as an important com- Sharon Batt’s terriﬁc new book carefully dissects the story of ponent of public policy concerned with the regulation and the women’s breast cancer movement in Canada, showing approval of drug treatments made it a target for drugs com- how neoliberal regulatory reform of both health policy and panies seeking to inﬂuence meaning construction within this the place of civil society in the Canadian system of govern- policy ﬁeld. Batt shows how the industry used tactics that ance turned a movement to democratize public health policy were remarkably similar to those used to inﬂuence clinicians into an arm of pharmaceutical company marketing. The to construct the patient as citizen consumers with rights to book constitutes a powerful case study of how neoliberal access the latest drugs without reference to the public cost reform intersects with private corporate interests seeking to and sometimes in the absence of evidence about their efﬁ- shape public policy in favour of proﬁt maximization. cacy. Drug regulation came to be viewed as a hurdle to be Her indictment of the drugs companies, which were able overcome and, most troubling, the groups’ original mission to ‘exploit’ the legitimacy crisis of patient groups as they to provide unbiased information about how to live with a experienced cuts in government funding and routes of inﬂu- cancer diagnosis was subordinated to providing information ence, and her critique of neoliberal policy reform have about new drugs coming to market. already received widespread treatment in the literature. But it The book is thorough and the evidence and analysis com- forms the essential backdrop to the real value of the book, a pelling. Batt, herself a breast cancer survivor and a former painstaking recreation of the 20-year history of the women’s activist, is careful not to overstate her case. But the book’s breast cancer movement. measured tone and scholarly approach reinforce its import- The history reveals difﬁcult and traumatic discussions ant contribution to the literature. within and among patient advocacy groups about whether they should accept funding from pharmaceutical companies and if so under what terms. The debates produced splits Nick Acheson within and between organizations. This is fascinating in the Centre for Social Innovation, University of Trinity College, ways it reveals the tactics adopted by the drugs companies Dublin, Ireland and the dilemmas created for the advocacy groups they *Address correspondence to Nick Acheson, E-mail: approached. But it begs the question of why the companies email@example.com should be interested. The core insight of the book is in the way it addresses this question. The gradual insertion of drug doi: 10.1093/pubmed/fdy019 © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org 1 Downloaded from https://academic.oup.com/jpubhealth/advance-article-abstract/doi/10.1093/pubmed/fdy019/4904070 by Ed 'DeepDyve' Gillespie user on 08 June 2018
Journal of Public Health – Oxford University Press
Published: Feb 23, 2018
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