WeInfuse Blog

WeInfuse joins the National Infusion Center Association and infusion providers across the country to voice our deep concern and opposition to the new Most Favored Nation (MFN) rule recently announced by the Center for Medicare & Medicaid Services (CMS). This MFN rule will restrict access to infusion medications and harm providers who are already suffering from the COVID-19 pandemic. While there may be a consensus that drug prices are too high, we believe infusion providers and patients should not bear the weight of policy experiments especially in the midst of a worldwide pandemic. For more information and details on the new rule, visit NICA’s website here. 

What is Most Favored Nation Pricing?

On November 20, 2020, the Centers for Medicare and Medicaid Services (CMS) released its interim final rule with comment period (IFC) implementing the Most Favored Nation (MFN) Model. Starting in January 2021, this model will test an innovative way for Medicare to pay no more than the lowest price charged in other similar countries for high cost, physician-administered Medicare Part B drugs. The new Medicare payment model is being implemented under section 1115A of the Social Security Act.

Why is this such a big issue? How would this affect infusion center providers and patients?

This MFN model will restrict access to infusion medications and harm providers who are already suffering from the COVID-19 pandemic. While the MFN model may initially reduce drug prices, it would disrupt access to care in the lowest cost care setting for provider-administered therapies. The model fails to ensure that vulnerable Medicare beneficiaries have access to safe, unrestricted care when they need it. Given the challenges associated with the ongoing pandemic, patients deserve stable care now more than ever. We have serious concerns that this program change will interfere with care plans prescribed by physicians and cause delays in receiving new, innovative drugs and bringing treatments to market.

What is NICA doing to push back against this Interim Final Rule?

NICA has expressed its disappointment with the Trump Administration regarding its decision to operationalize this drug pricing approach. While NICA agrees that the cost of prescription drugs is a major issue plaguing American patients, this model would jeopardize patient access to quality care and necessary, life-saving treatments. NICA urges the Trump Administration to reconsider and abandon these imminently harmful policy initiatives and work to provide common-sense reforms that increase access to high-quality care and directly address high out-of-pocket costs for patients. NICA has created a campaign to stop the MFN rule and ensure patients keep receiving their infusion therapy.

For more information and details, please contact NICA here.