\n\tDan Weissmann<\/span><\/p>\n

Why is treating drug-resistant tuberculosis so expensive?<\/p>\n

Pharmaceutical giant Johnson & Johnson\u2019s patents on a drug called bedaquiline have a lot to do with it.<\/p>\n

In this episode of \u201cAn Arm and a Leg,\u201d host Dan Weissmann speaks with writer and YouTube star John Green about how he mobilized his massive online community of \u201cnerdfighters\u201d<\/a> to change the company\u2019s policy and help make the drug more accessible.<\/p>\n

But not every lifesaving drug has a champion with a platform as big as Green\u2019s. Drug companies\u2019 patents limit access to affordable treatments as well.<\/p>\n

Weissmann also speaks with drug-patent expert Tahir Amin about how companies keep their drugs under patent for so long and the legal challenges that have been made to these policies around the world.<\/p>\n

\tDan Weissmann<\/p>\n

\t\t\t
\n\t\t\t\t@danweissmann\t\t\t<\/a><\/p>\n

\t\t\tHost and producer of “An Arm and a Leg.” Previously, Dan was a staff reporter for Marketplace and Chicago’s WBEZ. His work also appears on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.\t\t<\/p>\n

\n\t\tCredits\t<\/h3>\n
\tEmily Pisacreta
\n\tProducer<\/p>\n
\tAdam Raymonda
\n\tAudio wizard<\/p>\n
\tEllen Weiss
\n\tEditor<\/p>\n
\t\t\t\t\tClick to open the Transcript\t\t\t\t<\/p>\n
\t\t\t\t\t\tTranscript: John Green vs. Johnson & Johnson (Part 1)<\/strong>\t\t\t\t<\/p>\n
Note: \u201cAn Arm and a Leg\u201d uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.<\/em><\/p>\n
Dan: <\/strong>Hey there \u2014 A little while ago, I got to talk with this widely-beloved dude.\u00a0<\/p>\n
John Green:<\/strong> My name is John Green, and I\u2019m a writer and YouTuber.<\/p>\n
Dan:<\/strong> John Green, writer, may be the most likely to ring a bell. His best-known book, \u201cThe Fault in Our Stars,\u201d sold millions of copies and became a movie.<\/p>\n
But before he was such a big deal as a writer, he and his brother Hank were a big deal on YouTube. And they still are. We\u2019ll get into the details a little bit later.<\/p>\n
But for now the thing to know is: Pretty recently, John Green got on the main YouTube channel he and his brother share, and started talking to hundreds of thousands of people about how the drug-maker Johnson & Johnson was using legalistic drug patent games to deny access to life saving tuberculosis medicine to millions of people in poor countries. And John Green wanted anybody listening to stand up and do something about it.<\/p>\n
John Green:<\/strong> Tell your friends about this injustice, tell your family, tell the internet, because the only reason Johnson Johnson executives think they can get away with this is that they think we aren\u2019t paying attention in the part of the world where they sell most of their products, their Band Aids, their Tylenol, their Listerine.<\/p>\n
Dan:<\/strong> And a lot of the people who watch John Green\u2019s videos\u2013 the community calls themselves \u201cnerdfighters\u201d \u2014 made a fair amount of noise.<\/p>\n
And a few days later, Johnson & Johnson seemed to blink. The company issued a statement saying it would allow a cheaper generic version of that TB drug to be more widely distributed. Here\u2019s John\u2019s brother Hank from their next YouTube video.<\/p>\n
Hank Green: <\/strong>And this happened in a week, John, you made a video on Tuesday, \u201cit\u2019s Friday right now! I\u2019m really proud to be a part of this community I\u2019m really proud to be your brother\u2026\u201d<\/p>\n
Dan:<\/strong> I mean, that\u2019s a super-fun story that we\u2019re gonna get into: How a self-proclaimed nerd raised an internet posse to influence a global pharma giant to do something pretty decent-sounding.<\/p>\n
We are definitely going to tell that story.<\/p>\n
\u2026 But that story is just a first impression, because the whole thing is bigger and way more complicated.<\/p>\n
As John Green would tell you \u2013as he told me \u2013 he was adding his bit to a global movement \u2014 to advocates and lawyers in places like India, for instance, that have been doing the heavy, heavy lifting, for years.<\/p>\n
And, of course, to understand any of this, we are going to have to get into how pharma companies use drug patents. And what it means.<\/p>\n
And that is part of where this story comes home.<\/p>\n
As John Green mentioned in his video, the story of this tuberculosis drug wouldn\u2019t normally draw a lot of attention in the U.S. TB isn\u2019t one of our top health issues.<\/p>\n
But \u2026 the mechanisms at play with this tuberculosis drug \u2013 the patent games \u2013 are some of the same mechanisms that make so many drugs here so expensive: Drugs like Humira, and insulin, and pretty much everything else.<\/p>\n
And here\u2019s what\u2019s actually the most interesting part:<\/p>\n
Behind the first impression version of this story \u2013 nerds in the U.S. and their online posse for people in what\u2019s called the Global South \u2013<\/p>\n
There\u2019s a story about people and ideas from the Global South coming here to save the U.S. from our own messed-up drug patent system.<\/p>\n
Because they\u2019ve figured out that unless we save ourselves, they\u2019re screwed too. That\u2019s a LOT! And it\u2019s gonna take us two episodes to connect all the dots.\u00a0<\/p>\n
You ready? Here we go\u2026<\/p>\n
This is An Arm and a Leg. A show about why health care costs so freaking much, and what we can maybe do about it. I\u2019m Dan Weissmann. I\u2019m a reporter, and I like a challenge. So our job on this show is to take one of the most enraging, terrifying, depressing parts of American life, and to bring you something entertaining, empowering, and useful.<\/p>\n
And so, let\u2019s start with John Green \u2014 YouTuber.<\/p>\n
John and his brother Hank were among the people who invented the idea of being a professional quote-unquote \u201ccreator\u201d on the internet \u2013 maybe kind of by accident, at first. But they were hugely successful at it.<\/p>\n
In 2007, they started posting video messages to each other on this still-kinda-new website called YouTube. They thought a few hundred people might be interested, if they kept it up for a year.<\/p>\n
Then Hank posted a song about waiting for the last Harry Potter book to come out.<\/p>\n
Hank Green:<\/strong> [Singing<\/em>] \u2026 I\u2019m getting kind of petrified. What would Ron do if Hermione died or if Voldemort killed Hedwig, Just for yucks? \u2026<\/p>\n
Dan:<\/strong> It got a million views\u2013 which, early YouTube? That was huge. And they were off. Today, that original YouTube channel has more than three and a half million subscribers. Hank now manages more than a hundred full-time employees and a whole bunch of contractors.<\/p>\n
And, you know, it\u2019s impossible to sum up the thousands of videos they\u2019ve shared.<\/p>\n
Hank Green: <\/strong>Good morning, John. Today we\u2019re gonna be making cinnamon toast two different ways.<\/p>\n
John Green:<\/strong> Good morning, Hank, it\u2019s Tuesday. So I need your help with the thing I\u2019m working on. I need to learn some jokes, but not just any jokes.<\/p>\n
Dan<\/strong>: But it\u2019s fair to say digressive, ranty arguments are kind of a staple.<\/p>\n
John Green:<\/strong> Good morning Hank, it\u2019s Tuesday. I kind of hate Batman.<\/p>\n
Hank Green:<\/strong> Good morning, John, you pretty much got Batman entirely wrong.<\/p>\n
John Green:<\/strong> Batman is just a rich guy with an affinity for bats who\u2019s playing out his insane fantasy of single-handedly ridding Gotham of crime. How is that heroic?<\/p>\n
Hank Green:<\/strong> Of course, I know that Your video on Tuesday wasn\u2019t really about Batman, it was just using Batman as a tool to say something.<\/p>\n
Dan:<\/strong> The arguing may have something to do with why they call their community nerd-fighters.<\/p>\n
But the idea is more that this is a community of nerds fighting for something. As they put it: fighting to \u2018reduce the amount of suck in the world.\u2019<\/p>\n
Partly by producing things that can be amusing and sweet and thoughtful \u2013 but also by giving money to worthy causes and encouraging others to do the same.<\/p>\n
Every year, since the beginning, they have hosted a kind of online telethon called the Project for Awesome.<\/p>\n
John Green:<\/strong> Good morning, Hank. It\u2019s Thursday, December 17th, 2009. Time for the Project for Awesome! Hooray! Oh! [crashing sound<\/em>] Ow! Whoa! I got too excited about the awesome.<\/p>\n
Dan:<\/strong> It is SUPER-interactive: People upload videos pitching their favorite charities, they vote, they give. They\u2019ve raised more than 30 million dollars. And a lot of it has gone to an organization called Partners in Health, which provides incredibly effective health services in places like Haiti and Sierra Leone.<\/p>\n
And just to indulge my own tendency to nerdy digression here: A book about Partners in Health and its founder, Paul Farmer, is one of my favorite books of all time.<\/p>\n
It\u2019s called Mountains Beyond Mountains<\/em>, and when we finally do start a book club \u2013 and I haven\u2019t forgotten making that suggestion here \u2013 I want to nominate it as one of our first picks.<\/p>\n
Anyway, the Green brothers are huge supporters of Partners in Health. And then, three years ago, John started one of his weekly videos this way.<\/p>\n
John Green:<\/strong> Good morning, Hank, it\u2019s Tuesday. So over the next five years, our families are donating six and a half million dollars to Partners in Health Sierra Leone. Also we need your help\u2026<\/p>\n
Dan:<\/strong> And here\u2019s where we get to tuberculosis. In the run up to that commitment, John Green visited Sierra Leone with his wife Sarah, and met some of the folks there from Partners in Health.<\/p>\n
Here\u2019s how he told the story to me. I\u2019m not gonna interrupt:<\/p>\n
John Green:<\/strong> On the last day, two of the physicians from Partners in Health, who we were visiting with said, \u201cHey, if it\u2019s not a big deal to you, we\u2019d really like to stop by this TB hospital on the way back to the capitol because we have a case we\u2019re really concerned about.\u201d And I said, \u201cYeah, of course, I\u2019m not going to get in the way of actual doctoring.\u201d So \u2026 But I, you know, I didn\u2019t think much of it at the time.<\/p>\n
So we get to this TB hospital. And immediately upon arriving, the doctors go off to do doctor stuff. And Sarah and I are just sort of sitting there in this little nine year old boy who tells me his name is Henry, which is my son\u2019s name, at the time, my son was nine, kind of grabs me by the shirt and starts walking me around. And he takes me to the lab, shows me how to look into the microscope to see if a specimen has tuberculosis, introduces me to the lab technician, he takes me to the patient wards, he takes me to the kitchen where they make the food, he takes me all over the hospital, and then eventually I end up in the room with where the doctors are, and, uh, and the, and the kid has departed and I said, you know, \u201cI just spent 30 minutes with an extraordinary child named Henry and he gave me a tour of the whole facility and I have no idea who he is. Is he somebody\u2019s kid? Is he a doctor\u2019s kid?\u201d And one of the doctors said, \u201cyou know, that\u2019s what I thought when I first got here, uh, about Henry because he does seem like that. And actually he\u2019s the case that we\u2019re so concerned about that we, um, needed to come here.\u201d And he wasn\u2019t nine. He was 16. He was just really stunted and emaciated by tuberculosis.\u00a0<\/p>\n
And, um, even though he was feeling pretty good at the time, the doctors knew that his treatment for multidrug resistant TB was failing, and that he needed access to a new cocktail that included bedaquiline, this drug that\u2019s been around in the U.S. since 2013, but was, was at the time totally unavailable in Sierra Leone. And so, that was my introduction to TB and we were on our way to the airport and I said, \u201cwhat\u2019s gonna, what\u2019s gonna happen to that kid?\u201d And they were like, \u201cit\u2019s going to be a difficult path for him um, if we can\u2019t get, if we can\u2019t get the new treatment cocktail to him, he has a very low chance of survival.\u201d<\/p>\n
So that\u2019s the beginning of the story for me, is meeting Henry.<\/p>\n
Dan:<\/strong> I\u2019m going to skip to the end of this part of the story: Henry\u2019s OK. He\u2019s alive, because he did get the drug cocktail that included Bedaquiline.<\/p>\n
But, after that visit, John Green did not know that, and he started obsessing a bit about tuberculosis. Reading about it, thinking about it. And over the last year or so, he started occasionally sharing, making videos about TB. Some of them were fun, short, nerdy explainers.<\/p>\n
John Green:<\/strong> What if I told you that tuberculosis gave us the cowboy hat?\u00a0<\/p>\n
John Green: <\/strong>How did TB reinvigorate women\u2019s shoe fashions?<\/p>\n
John Green:<\/strong> How did tuberculosis help New Mexico become a state? I\u2019m so glad you asked.<\/p>\n
Dan:<\/strong> But he also dug into the deeper reason he\u2019d become obsessed with TB. Because it\u2019s a surprisingly big deal, still.<\/p>\n
John Green:<\/strong> It\u2019s almost certain that in the last 2, 000 years, more people died just from tuberculosis than died from all wars combined.<\/p>\n
And before you think like, oh, but that\u2019s ancient history. No, more people died last year from tuberculosis than died in war, and every year going back to World War II<\/p>\n
Dan:<\/strong> We fact checked that. He\u2019s actually understating things. By a lot.<\/p>\n
TB is a growing problem. In the middle of the 20th Century, new medicines took TB off the list of diseases that most people in the rich parts of the world had to worry about. But it never got wiped out.<\/p>\n
And in less-rich parts of the world, where access to the best treatments was spottier, drug-resistant strains of TB developed and developed. But no new drugs came out\u2013 no drugs for drug-resistant TB.<\/p>\n
Until bedaquiline, produced by Johnson & Johnson. The drug that did eventually help save Henry, the kid that John Green met in Sierra Leone.<\/p>\n
But bedaquiline is expensive. So people in less-rich parts of the world often can\u2019t get it. One study estimated that eight out of nine people who needed treatment with a drug like bedaquiline weren\u2019t getting it.<\/p>\n
And of course medicines stay expensive when they\u2019re under patent protection: Once the patent on a drug expires, anybody can make and sell a generic version of the drug. Which, you know, competition, usually allows prices to fall.<\/p>\n
And in one way, as John Green started making tuberculosis videos in 2022, it might have seemed like there was hope coming up:<\/p>\n
Bedaquiline was patented in 2003. Patents last twenty years. By 2023, that patent would expire.<\/p>\n
Except, not really. Because it turns out, patents on drugs have ways of living for way more than twenty years.<\/p>\n
That\u2019s next.<\/p>\n
MIDROLL:<\/strong> This episode of An Arm and a Leg is produced in partnership with KFF Health News. That\u2019s a nonprofit newsroom that covers health care in America. KFF Health News are amazing journalists \u2013 their work wins all kinds of awards every year \u2013 and I\u2019m honored to work with them. We\u2019ll have a little more information about KFF at the end of this episode.<\/p>\n
Dan:<\/strong> So, let\u2019s talk about drug patents and how they work\u2013 and why they don\u2019t just last 20 years. And this is something my colleague Emily Pisacreta has been interested in for a long time.<\/p>\n
Emily:<\/strong> It\u2019s true. As I\u2019ve said before on the show, I\u2019m an insulin-dependent diabetic. If I can\u2019t get insulin, I\u2019m literally dead. And, insulin is super expensive. And insulins have became so expensive in part because of the kinds of patents on them \u2013 even though those patents are way more than twenty years old! ..<\/p>\n
Dan:<\/strong> Right, so you\u2019ve got a big interest in this question: How can a patent last more than twenty years?<\/p>\n
Emily:<\/strong> And Dan, my answer to that question is a riddle: When is a patent not a patent?<\/p>\n
Dan:<\/strong> OK, I give up. When is a patent not a patent.\u00a0<\/p>\n
Emily:<\/strong> When it\u2019s 74 patents.<\/p>\n
Dan:<\/strong> Yeah, this riddle is going to need some explaining.<\/p>\n
Emily:<\/strong> Right. So, for a while I used an insulin called Lantus.It\u2019s a once-a-day, long acting insulin made by the French company Sanofi. Sanofi first patented Lantus in 1994. So, that should mean it\u2019s out of patent protection by 2014, right?<\/p>\n
Dan:<\/strong> Uh-huh<\/p>\n
Emily:<\/strong> Except, according to a report from a few years back, Sanofi actually filed for 74 patents on Lantus. And a lot of those patents were filed WAY after 1994. So, ONE patent from 1994 would\u2019ve lasted till 2014. 74 patents could\u2019ve lasted until 2031.<\/p>\n
Dan:<\/strong> Ah, hence the very-specific answer for your riddle. I mean, I knew the principle \u2013 these insulin products have multiple patents on them, but 74 is \u2026 more than I\u2019d imagined. What are 74 things you even COULD patent?<\/p>\n
Emily:<\/strong> I mean, for Lantus, there are patents on formulations to improve stability. Like, all right \u2026 But there are also patents on the pen cartridge that Lantus comes in. And inside of that, a whole bunch of patents on the drive mechanisms, like the little plastic piston that lets you pick the right dose. These kinds of things.<\/p>\n
Dan:<\/strong> OK. Now, I notice you said, those 74 patents COULD\u2019ve lasted until 2031?<\/p>\n
Emily:<\/strong> That\u2019s right. As it turns out, in the case of Lantus, another drug maker actually did fight some of Sanofi\u2019s later patents and won. But more often \u2013 and I mean a lot more often \u2014 simply filing for a patent is enough to keep generic makers away.<\/p>\n
Dan:<\/strong> Sure. Who wants to spend money fighting a patent lawsuit when you could just y\u2019know, manufacture some other drug?<\/p>\n
Emily:<\/strong> Right. And of course this is not just insulin.<\/p>\n
Tahir Amin:<\/strong> Oh, this is the standard practice. This happens with every drug.<\/p>\n
Emily:<\/strong> That\u2019s Tahir Amin \u2013 one of the big global experts on drug patents. Tahir the CEO and cofounder of a non-profit called I-MAK, which stands for \u2026<\/p>\n
Tahir Amin:<\/strong> The Initiative for Medicines Access and Knowledge. We work on building a more just and equitable access to medicine system.<\/p>\n
Emily:<\/strong> The report that documented 74 patents on Lantus, that one insulinI used to use? Tahir\u2019s group wrote it. And Tahir says this is business as usual, because it means big money.<\/p>\n
Tahir Amin:<\/strong> Particularly when you\u2019re talking about some of the drugs that you see in the US market, like for rheumatoid arthritis, these are worth billions of dollars.<\/p>\n
Emily:<\/strong> Tahir\u2019s group did a study on the 12 best-selling drugs in the U.S. They had an average of 131 patents each. If all the patents stick, that\u2019s an average of 38 years of patent protection.<\/p>\n
Dan:<\/strong> So maybe we can update your riddle:\u00a0<\/p>\n
When is a patent not a patent?\u00a0<\/p>\n
When it\u2019s 131 patents.<\/p>\n
Emily:<\/strong> Yeah, activists and experts call this kind of thing \u201cpatent thicketing\u201d or \u201cevergreening.\u201d<\/p>\n
Dan:<\/strong> I\u2019ve been reading up on this too. Drug companies have their own name for this practice. They call it\u00a0 \u201clife-cycle management.\u201d<\/p>\n
Emily:<\/strong> What a term of art. And actually bedaquiline, the TB drug,is a great example. In 2014, Tahir did what they call a \u201cpatent landscape\u201d on bedaquiline, mapping all the different patents J&J filed around the world.<\/p>\n
Tahir Amin:<\/strong> We all knew that with the advent of multiple drug resistance TB, we needed to know how we\u2019re gonna get these drugs to the communities and the countries that need them most.<\/p>\n
Emily:<\/strong> He identified a long list of patents J&J filed. And the most important being the original formula for the drug, set to expire in 2023, and the second most important patent was on something called the salt formulation for the drug.<\/p>\n
Dan:<\/strong> Salt formulation.<\/p>\n
Emily:<\/strong> Yep, and it\u2019s kind of worth getting into the weeds here just for a second. Because this sort of thing is at the absolute heart of these drug patent games. When you develop a drug, the first step is finding a molecule that works in a test tube, that does the thing you want, like kills the germ. That gonna be the first patent, that molecule. But the molecule isn\u2019t medicine.<\/p>\n
Tahir Amin:<\/strong> You have to develop it, formulate it so that it\u2019s actually more bioavailable, that it can get into the bloodstream and, and do whatever biological activity that it does. And this is classic organic chemistry stuff that is routine.<\/p>\n
Emily:<\/strong> It\u2019s routine. SO what he\u2019s saying here, and other experts agree, by the way, identifying a salt formulation that can work as medicine isn\u2019t where the innovation is. And most importantly, it doesn\u2019t have to take a long time. But J&J didn\u2019t apply for their secondary patent on it until a full four years after their initial patent.<\/p>\n
Dan:<\/strong> I\u2019ve started reading about \u201clifecycle management,\u201d you know, what the pharma industry calls all this. And this is literally the playbook. One lawyer has advice about when to file this kind of secondary patent, here\u2019s what he says, quote:<\/p>\n
\u201cYou want to do this as late as possible, but before clinical trials. If Company X can hold off filing for two or three years during the drug discovery phase, it will buy more time on the back end of the patent\u2019s term.\u201d<\/p>\n
Emily:<\/strong> Yep, and J & J waited four years. A little extra.<\/p>\n
Dan:<\/strong> And we asked Johnson & Johnson: Hey, did you put off filing this secondary patent on the salt formulation to stretch out your patent rights? We haven\u2019t heard back.<\/p>\n
So: TB advocates kind of had their eye on July 2023. Because in July 2023 the original patent that Johnson & Johnson had on bedaquiline was set to expire. And the secondary patent, this sort of basic add on, was to become the next big obstacle.<\/p>\n
So, back to John Green. He\u2019s learning all this stuff about TB \u2013 including about how the secondary patent on bedaquiline is gonna keep clamping down access.<\/p>\n
And he\u2019s making all these TB videos, but it\u2019s not like he has some kind of big plan:<\/p>\n
John Green:<\/strong> But the, for me, You know, this is all I was thinking about. It was the first thing I thought about in the morning and the last thing I thought about before I went to sleep, is how did we end up in a world where the world\u2019s deadliest infectious disease is largely ignored in the richest parts of the world?<\/p>\n
Dan:<\/strong> And he was getting kind of discouraged.<\/p>\n
John Green:<\/strong> I felt powerless before it. And this is one of the real lessons for me is that I felt like, well, what \u2026 what are we going to do? It\u2019s not like Johnson & Johnson is going to abandon the idea of secondary patents, right?<\/p>\n
Dan:<\/strong> He knew: secondary patents can be worth billions of dollars.<\/p>\n
John Green:<\/strong> And so they\u2019re not going to abandon these attempts to make their patents last longer than they should because they\u2019re a for profit company. And I felt really \u2026 Yeah, I just felt powerless.<\/p>\n
Dan:<\/strong> And then, earlier this year, something changed. It was not something that John Green, or an army of nerds could have done, or could\u2019ve done anything about.<\/p>\n
It was done by India\u2019s patent office \u2013 responding to a legal challenge brought by two young women who had survived tuberculosis \u2013 one from India and one from South Africa.<\/p>\n
It was based on legal work that our new pal Tahir Amin and others did in India almost twenty years ago.<\/p>\n
And gave John Green an idea of how an army of nerdfighters could join this battle.<\/p>\n
That\u2019s next time, on An Arm and a Leg. Till then, take care of yourself.<\/p>\n
This episode of An Arm and a Leg was produced by me, Dan Weissmann, and Emily Pisacreta \u2013 with help from Bella Cjazkowski, and edited by Ellen Weiss.<\/p>\n
Daisy Rosario is our consulting managing producer.\u00a0<\/p>\n
Adam Raymonda is our audio wizard.\u00a0<\/p>\n
Our music is by Dave Winer and Blue Dot Sessions.<\/p>\n
Gabrielle Healy is our managing editor for audience. She edits the First Aid Kit Newsletter.<\/p>\n
Bea Bosco is our consulting director of operations.\u00a0<\/p>\n
Sarah Ballema is our operations manager.<\/p>\n
An Arm and a Leg is produced in partnership with KFF Health News\u2013formerly known as Kaiser Health News. That\u2019s a national newsroom producing in-depth journalism about health care in America, and a core program at KFF \u2014 an independent source of health policy research, polling, and journalism.<\/p>\n
And yes, you did hear the name Kaiser in there, and no: KFF isn\u2019t affiliated with the health care giant Kaiser Permanente. You can learn more about KFF Health News<\/a> at armandalegshow.com\/KFF.<\/a><\/p>\n
Zach Dyer is senior audio producer at KFF Health News. He is editorial liaison to this show.<\/p>\n
Thanks to Public Narrative \u2014 that\u2019s a Chicago-based group that helps journalists and nonprofits tell better stories \u2014 for serving as our fiscal sponsor, allowing us to accept tax-exempt donations. You can learn more about Public Narrative at www.publicnarrative.org.<\/a><\/p>\n
And thanks to everybody who supports this show financially.<\/p>\n
If you haven\u2019t yet, we\u2019d love for you to join us. The place for that is armandalegshow.com\/support.<\/a> That\u2019s armandalegshow.com\/support.<\/a>\u00a0<\/p>\n
It helps us out a lot, so thanks for pitching in if you can! And thanks for listening!<\/p>\n
\u201cAn Arm and a Leg\u201d is a co-production of KFF Health News and Public Road Productions.<\/p>\n
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