ACS Warns Medicare Patients Lose Access to Life-Saving Therapies

The American Cancer Society (ACS) paints a grim picture of the impact of Medicare’s Most Favored Nation (MFN) policy on cancer patients. MFN is a new payment policy for Medicare Part B therapies that goes into effect on January 1, 2021. It calculates the price of a drug in 22 foreign countries to determine the Medicare payment for that Part B drug. After analyzing the policy, Lisa Lacasse, president of the ACS Cancer Action Network expressed concern that it “could potentially make it much harder for cancer patients to get the drugs necessary to treat their disease.”

When the price of the drug internationally is lower than what a U.S. physician is able to purchase it, the Medicare patient would have to forgo that particular medication, even if it’s the therapy the physician knows would best treat their condition. A physician would have to shift to an alternative, less effective therapy or a patient would have to find a new care provider that is not restricted by MFN. Using the second or third best medication is not an appropriate cancer treatment protocol.

Navigating a cancer diagnosis shouldn’t be further complicated by Medicare policy that places obstacles between physicians caring for patients, disrupts personalized treatment and jeopardizes access to medical care close to home. Tying Medicare drug reimbursement for therapies used to treat cancer and other serious chronic conditions to that of prices paid in select foreign countries limits the medical decision-making of physicians and makes it harder for Medicare patients to get the drugs they need when they need them to treat their disease. Patients win when they can access the medication, procedures and care recommended in the comprehensive treatment plan their physician tailors for them. Join with Patients and Providers United and TAKE ACTION to keep patients and providers – not government cost controls – at the center of medical decision making.