Health Advocacy Inc.:

How Pharmaceutical Funding Changed the Breast Cancer Movement

By Colleen Fuller

by Sharon Batt
UBC Press
2017/$39.95/368 pp.

Three years ago Sprout Pharmaceuticals hired a PR firm to help ensure that the US Food and Drug Administration approved its drug, flibanserin, to treat women with low libido. Described by critics as “an antidepressant-turned-aphrodisiac,” flibanserin had been twice rejected because of concerns about safety and effectiveness. As part of its PR strategy, the firm created a fake feminist group which claimed the drug was rejected because the FDA was sexist, launching a nationwide campaign demanding the drug be allowed on the market. On August 18, 2015, the “female Viagra” was approved in the US. Two days later Sprout sold the drug to a Canadian company for US$1-billion. Soon after, the fake group disappeared. Critics—and there were many—said consumer advocacy groups that take money from drug companies “don’t truly represent the best interest of the constituencies they claim to stand for” but rather of the companies whose money they take.

That issue is at the heart of Health Advocacy Inc., by Sharon Batt, a scholar at Dalhousie University and former Edmonton-based editor of the feminist magazine Branching Out. Batt has written a compassionate account of the debates among breast cancer activists in Canada and internationally about whether to accept money from the pharmaceutical industry. Those on one side fear pharma funding weakens their ability to effectively represent and speak on behalf of women with breast cancer; the other side fears that without pharma funding, the breast cancer movement would have no voice at all.

As Batt reports, these debates emerged as Canada hopped on the globalization bandwagon, shifting the regulatory landscape to protect the powerful brand-name drug industry from competition from lower-cost, generic producers. While one hand of government was helping pharma increase its profits, the other was initiating drastic cuts in public funding for community-based advocacy. As industry began to fund and cultivate alliances with breast cancer and other patient groups, advocacy shifted away from the goal of keeping medical science honest to echoing the demands of the industry for faster drug approvals and coverage by public and private drug plans.

These strategies are still widely in play, as the flibanserin example shows. Batt challenges consumer advocacy groups to use their key asset—the trust of patients and the wider public—to advance the interests of the people they represent. She calls on governments to create a funding source so that patient and consumer advocacy groups can reclaim their independence. Now more than ever we need advocates who put drug safety, effectiveness and affordability above the interests of pharma.

Colleen Fuller is the co-founder of PharmaWatch Canada.

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