Most Favored Nation NOT Favored by Lupus Advocates

Those with cancer and rheumatoid arthritis aren’t the only patients that will come face-to-face with the effects of Medicare’s Most Favored Nation (MFN) policy. Those with chronic autoimmune conditions such as lupus will feel the impact of MFN too. MFN is a new 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. 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. In response to the MFN policy, the Lupus Foundation said “we are deeply concerned that the Administration’s Most Favored Nation rule may limit patient access to current and future therapies.”

It’s not surprising a premier advocacy organization seeking to improve life for people living with lupus would feel this way about MFN. Lupus is an unpredictable and misunderstood disease that it is a challenge to treat. Policies like MFN limit the medical decision-making of physicians and make it harder for patients to get the drugs they need 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.