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Last month, the administration released the “Most Favored Nation” (MFN) rule, which allows foreign governments to decide the value of Part B medicines, while also likely limiting seniors’ access to existing medicines and discouraging investments in future treatments and cures. No matter how you look at it, the MFN rule is bad policy. 

  • It is bad for patients. The MFN rule is likely to cause severe disruptions in many patients’ access to important medicines. In fact, the Centers for Medicare & Medicaid Services (CMS) admits outright that the policy will likely hurt patients, stating that, “beneficiaries may experience access to care impacts by…having to travel to seek care from an excluded provider, receiving an alternative therapy that may have lower efficacy or greater risks, or postponing or forgoing treatment.”  

  • It is bad for providers. The MFN rule will also burden many physicians and other health care providers with significant payment cuts and additional administrative hurdles, at a time when many are already under tremendous strain because of the pandemic. Ted Okon, Executive Director of the Community Oncology Alliance explained, “Rather than give community oncology providers the support they need during this third wave of the pandemic, as they struggle to keep their facilities and staff COVID-19 free while treating cancer patients, the Trump Administration is essentially throwing these providers under the bus.” And the American Hospital Association stated, “It is alarming that the Administration has issued this operationally burdensome rule after over two years, in the middle of a pandemic with cases at record levels, and with less than six weeks’ notice before the model begins.” 

  • It is bad for medical innovation. Biopharmaceutical researchers are making significant progress in the race to develop treatments and vaccines for COVID-19, but the MFN rule would undermine incentives for continued groundbreaking work in the United States. There is clear evidence from other countries of the negative impact from this type of policy change. For example, the adoption of government price setting and other anti-innovation policies across Europe in the 1980s and 1990s pushed most R&D investment away from the continent to countries with more pro-innovation policies, principally the United States. 

As PhRMA President and CEO Steve Ubl stated, “we’ve seen immense progress with vaccine candidates showing promising clinical trial results and treatments making their way through FDA review. This progress is possible largely because of America’s global leadership in biopharmaceutical R&D. Despite this, the administration is willing to upend the entire system with a reckless attack on the companies working around the clock to end this pandemic.” 

The bottom line: The MFN rule must be stopped.  

Nicole Longo

Nicole Longo is Deputy Vice President of public affairs at PhRMA focusing on Medicare, 340B, importation and more. She previously worked for a D.C.-based public affairs firm where she assisted a wide range of clients with communications efforts on everything from trade policy to agriculture policy to health care policy. Outside the office, Nicole can be found trying new restaurants (usually Italian), taking an occasional barre class and cheering on the Cincinnati Bengals.

Nicole Longo

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What AARP isn’t telling seniors about MFN

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CMS proposal could discourage patient-centered innovation

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Nearly 1 in 4 patients initially denied access to IRA medicines

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Medicare Part D at 20: Building on a strong foundation

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MFN won’t lower costs when insurers call the shots

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Insurers routinely block seniors’ access to medicines in Medicare Part D

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CMS puts patients and innovation at risk with MFN

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PhRMA calls on USTR to ensure foreign nations pay their fair share

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Medicare Part D plans initially denied medicines for more than 70% of patients in four chronic disease areas

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New “Balance the Scales” campaign highlights why Americans pay more for prescription medicines

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CMS, don’t fall behind the rest of the medical community on obesity

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Is CMS paying attention to the growing access barriers for Medicare patients under the IRA?

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Did the administration consider the importance of blood cancer medicines to patients in price setting process?

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The Inflation Reduction Act could increase costs and reduce access for millions of seniors

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New survey: Insurers confirm IRA will reduce patient treatment options

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PhRMA reiterates concerns with IRA price setting program, urges CMS to mitigate harm

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IRA is already negatively impacting access to medicines in Part D

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New study finds insurers and PBMs increasing access restrictions in Medicare Part D

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IRA threatens seniors’ access to robust treatment options

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Medicare Prescription Payment Plan will benefit patients if implemented correctly

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Correcting the record: IRA’s government price setting provisions are unconstitutional

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IRA changes to Part D risk access to medicines

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AARP’s latest misleading report

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Four things for CMS to keep in mind as they implement changes to Part D

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CMS guidance on IRA price setting process doubles down on bad policy

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CMS coverage policy is detrimental to Alzheimer’s patients

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How Part B’s ASP system helps control costs for the government and seniors

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Medicare Part B spending in four points

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Medicare Part D open enrollment and what recent changes mean for beneficiaries

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Many seniors are paying more for Part D medicines than their insurer

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Biosimilar uptake is increasing and so are health savings

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Busting 3 Myths About Copay Coupons

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CMS coverage policies restrict patient access to important treatment options for Alzheimer’s disease

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Myth vs. Fact: The Senate’s latest price setting proposal

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The Senate’s latest price setting proposal will undermine U.S. economic growth

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The Senate’s latest price setting proposal will undermine: Our health care system

July 28, 2022

The Senate’s latest price setting proposal will undermine: Patient access to medicines

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New research shows competition driven by biosimilars helps control costs in Part B

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Polling continues to show voters reject so-called Medicare “negotiation” once they learn about consequences for patients

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CMS coverage decision restricts access to treatments for Alzheimer’s disease

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Annual projections from NHE compared to actual health care spending

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PhRMA submits comments urging CMS to withdraw coverage proposal

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ICYMI: New study confirms policies like H.R. 3 could significantly reduce drug development

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New poll shows Americans reject Medicare negotiation once they learn more about the policy

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Industry leaders discuss the impact of the drug pricing debate

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Five reasons tying VA prices to Medicare Part D misses the mark

September 22, 2021

America’s biopharmaceutical companies to Congress: Government “negotiation” is the wrong approach

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End of year Part D reading List

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ICYMI: The latest as America’s biopharmaceutical companies work to beat COVID-19

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Executive order threatens R&D when we need it most to fight COVID-19

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PhRMA submits comments to CMS on policy changes for in-home care under Part B during COVID-19

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April 29, 2020

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January 31, 2020

Event tomorrow: Maintaining America’s leadership in access and innovation

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October 16, 2019

What they are saying: Broad opposition to Pelosi’s radical drug pricing plan

October 10, 2019

Guest Post: Following my stroke, having access to ground-breaking medical innovation has never been more important

September 4, 2019

New analysis: Government intervention in Part B threatens patient access to medicines

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Setting the record straight on international reference pricing

July 16, 2019

No matter how you structure it, government arbitration is wrong for Medicare drug coverage

June 27, 2019

What you should know: Government arbitration is the wrong way to change Medicare

June 10, 2019

By the numbers: A look at the Part B International Pricing Index Model

June 6, 2019

How the rebate rule would help reduce patients’ out-of-pocket costs

June 3, 2019

Ask About Adherence: Improving adherence among osteoporosis patients could save up to $6.52 billion

May 29, 2019

Ask About Adherence: OIG proposed rule to reform the rebate system could improve adherence

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May 9, 2019

Event tomorrow: Improving access and affordability for America’s seniors

May 7, 2019

Fact Check: How the Part B International Pricing Index Model replaces market competition with government-set prices

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April 9, 2019

PhRMA comments on OIG proposed rule to reform the rebate system

April 8, 2019

340B continues to drive shift in site of care for physician-administered medicines to more expensive hospital settings

April 5, 2019

Fact Check: How the Part B International Pricing Index model threatens patient access

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March 25, 2019

Bipartisan lawmakers urge Administration to rethink proposed changes to six protected classes policy

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Special 301 submission calls for a level playing field for American innovators

March 13, 2019

New analysis finds Average Sales Price system has led to significant cost savings for Medicare and seniors

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New “Prescription for Medicare” campaign focuses on impacts of wrong and right solutions for Medicare

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New study shows why insurers should share rebates with Medicare Part D beneficiaries on a mandatory basis

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PhRMA comments to administration on Medicare Part D proposed rule

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New research shows changes to the six protected classes would harm most vulnerable patients and are unnecessary

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ICYMI: New study reinforces dangers of proposed IPI model

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PhRMA comments to administration on International Pricing Index Model

January 3, 2019

10 things you should know about medicine spending and costs

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ICYMI: WSJ and NYT highlight concerns with Part B International Pricing Index Model

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Groups sound the alarm on administration’s new Part B proposal

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4 things you need to know about the administration’s latest Part B proposal

November 5, 2018

PhRMA comments in response to request for information on competitive bidding program in Medicare Part B

September 25, 2018

What if a couple of small fixes could protect seniors in the donut hole and save them money on out-of-pocket costs?

September 13, 2018

Fact Check Friday: Getting the facts straight about negotiation in Medicare Part B

August 24, 2018

How much do you know about Medicare Part B?

July 31, 2018

PhRMA submission to HHS on blueprint to lower drug prices and reduce out-of-pocket costs

July 16, 2018

Pass-through rebates do not violate non-interference clause but they do increase savings for seniors

July 2, 2018

Medicare Part D cliff ahead

June 21, 2018

Part D cliff looms for seniors, as program stability could be in jeopardy

June 18, 2018

New analysis shows negative impact of ICER’s value framework on patient access in Medicare Part B

May 31, 2018

Sharing negotiated discounts at the pharmacy counter could save seniors with diabetes more than $350 annually

May 17, 2018

New “Let’s Talk About Medicare” campaign focuses on solutions to improve affordability and predictability for seniors in Part D

May 9, 2018

Medicare Monday: New Xcenda white paper looks at four strengths of Part B

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Medicare Monday: Moran finds Part B medicine prices are stable, not a key driver of Medicare costs

March 26, 2018

ICYMI: Two PBM reports show dramatic slowdown in medicine spending growth

March 2, 2018

Guess what? Part B drug spending remains stable share of Medicare spending

January 23, 2018

PhRMA urges CMS to share the savings with seniors

January 17, 2018

Medicare Monday: Helping beneficiaries access vaccines

December 18, 2017

Medicare Monday: PhRMA’s comments on new direction for CMMI

November 20, 2017

Medicare Monday: Same bad ideas continue to threaten Part D and beneficiary access to medicines

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Medicare Monday: CMS withdraws Part B demo, takes positive step forward on CMMI

October 30, 2017

Medicare Monday: Open enrollment is here again

October 16, 2017

Medicare Monday: Medicare Part D by the numbers

September 11, 2017

Medicare Monday: Call for repeal of IPAB intensifies

August 28, 2017

Medicare Monday: What is the Extra Help program?

August 21, 2017

Medicare Monday: Strengthening access to vaccines for seniors

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Medicare Monday: Medicare turns 52!

July 31, 2017

Medicare Monday: How Part B has evolved over the years

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Medicare Monday: What you need to know about the latest Medicare Trustees report

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Medicare Monday: Study finds mortality rates for elderly have decreased every year since creation of Part D

July 10, 2017

Medicare Monday: It is Medicare’s birthday month!

July 3, 2017

Medicare Monday: 3 reasons why repealing Part D’s noninterference clause is a bad idea

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Medicare Monday: New report highlights progress in fighting cancer with new physician-administered medicines

June 12, 2017

Fact Check Friday: The truth about IPAB

June 9, 2017

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