Most Favored Nation Will Devastate Cancer Care

The American Society of Clinical Oncology (ASCO) weighed in with CMS and in 3 court cases to stop Medicare’s new Most Favored Nation policy, citing devastating consequences for people with cancer. Shockingly, ASCO analysis found the MFN policy “would drastically cut reimbursement for four immune checkpoint inhibitors commonly used to treat advanced and metastatic lung and other cancers, and that as many as 87,556 years of life would be lost by patients with lung cancer due to the loss of access to these four drugs alone…”

Medicare’s MFN policy that goes into effect January 1, 2021 has a stated goal of lowering drug costs. However, nothing in the policy achieves that goal; instead it produces substandard care options for patients and physicians. Under MFN, Medicare payment rates for Part B drugs may be lower than the physician’s cost of acquiring and administering these therapies needed to treat cancer and other life-threatening complex medical conditions. MFN forces providers to choose between operating at a loss, shifting patients from first line therapies to less effective alternatives or forgoing treatment of Medicare patients altogether. None of those options are sustainable, slow the progression of cancer or yield high quality care.

Physicians do not set or control the price of a drug. But they do control the treatment plan. The course of treatment selected for a patient should be a decision that is made between the patient and their physician to achieve successful outcomes – not driven by a policy solely focused on cost control. Join with Patients and Providers United to LET CONGRESS KNOW that Medicare policy should never strip physicians of the right to develop plans-of-care that deliver the best possible outcomes for patients.