Myriad Britain and Culture Clash

Once systems of genetic testing for breast cancer had been built and integrated into health care in the United States and Britain, Myriad Genetics attempted to expand its testing service and its sources of revenue to Canada, Europe, South America, and Asia.1 The first target of these efforts was Britain. Perhaps Myriad assumed that it would be simple to transfer its technology to a country that had reported incidences of breast and ovarian cancer similar to those in the United States and seemed to have a strong commitment to genetic medicine. Hoping to shut down the National Health Service's BRCA-testing system and to have the blood samples that were collected in Britain analyzed at its laboratory in Salt Lake City, Myriad began trying to convince health-care professionals of the value of its technology and threatening legal action (on the grounds of patent infringement) against those who continued to provide testing.

What happened when Myriad tried to expand its version of BRCA-testing services to Britain and the rest of Europe? Would Myriad's technology and way of structuring the identities of clients and health-care professionals be neatly transferable to the British context? And how would the British government, British scientists, British clinicians, and British patients respond to Myriad's attempt to insinuate its approach to BRCA testing into their institutions? Would they be able to accept Myriad's definition of a good health outcome, or would they remain loyal to the British approach?

This chapter explores Myriad's attempt to develop a transnational service of genetic testing for breast cancer, and how British scientists, healthcare professionals, and activists responded to these efforts. As will be evident, ongoing tensions emerged, for in working to extend its patent rights Myriad was not simply trying to introduce a single entity of narrow scope into a new geographic region; it was trying to introduce an entire system—encompassing the clinical and technical dimensions of the test, particular roles for testing system participants such as clients and health-care professionals, and specific definitions of a good health outcome—into a cultural context that differed greatly from the one in which it had been built.

The chapter begins by describing how Myriad attempted to expand its testing service to Britain. It then explores how British scientists, healthcare professionals, and activists challenged Myriad in three ways: they questioned its use of patent rights as a justification for expansion of its testing service; they disputed the validity of a BRCA-testing system focused on laboratory services; and they argued that Myriad's system prescribed roles for health-care professionals and clients that were inappropriate in the British context. Finally, the chapter describes the negotiations between Myriad and the National Health Service and the eventual resolution of Myriad's attempt at technology transfer.

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