MFN Impact on Patients
The American Cancer Society’s Cancer Action Network is working in every state across the country. They worry, “the executive order involving Medicare drug coverage creates significant questions around drug accessibility, which could potentially make it much harder for cancer patients to get the drugs necessary to treat their disease.”
MFN Impact on Providers
The American College of Rheumatology (ACR) is dedicated to improving the care of patients with rheumatic diseases like arthritis that cause the immune system to attack joints, muscles, bones and organs. ACR has determined that, “the (MFN) rule threatens the financial solvency of many rheumatology practices… and jeopardizes the ability of rheumatologists to provide treatments to patients most in need. This will be detrimental to provider solvency and patient access to medications.”
POLICY IMPACT
Patient Impact
Today, patients in the U.S. have access to novel, innovative therapies made possible through clinical research, and many of these treatments are not available in other countries. U.S. patients have the option of receiving care from dedicated physicians in their own communities. The Most Favored Nation (MFN) proposal would complicate care plans for patients by interfering with physician-prescribed treatments. Medicare estimates MFN would save the government almost $85 billion. Some of this savings is achieved by reducing patient access to innovative medications.
How does the MFN proposal impact patients?
1 Reduced Access to Therapies. Medicare’s untested MFN Model for drugs administered by physicians and infusion clinics could mean seniors with complex chronic diseases could lose access to the most effective and innovative therapies. The mortality rate for cancers is lower in the U.S. than in other countries because breakthrough medications are available to patients.
2 Longer Travel Times. Patients may meet with their physician only to learn that the clinic was not able to acquire their preferred treatment due to the MFN Model, forcing them to seek care from an alternate provider. This could be particularly detrimental for severely sick patients in rural areas, who may be forced to search for a new healthcare provider much further from home.
3 Disrupted or Lost Care. The MFN Model may disrupt patient treatment, threatening therapy adherence and ultimately yielding poorer outcomes. Even worse, Medicare anticipates some seniors will not be able to access the care they need at all. This model fails to protect America’s most vulnerable under the guise of reducing drug costs. Lower care costs mean nothing when patients cannot access care at all.
Navigating a complex chronic disease diagnosis shouldn’t be further complicated by an unproven Medicare payment experiment that places obstacles between physicians and patients, disrupts personalized treatment and jeopardizes access to medical care close to home. Patients and their family caregivers should focus on healing and quality of life, rather than long travel times and increased uncertainty.