Open Letter to the Community: Mission Cancer + Blood Responds to Recent Most Favored Nation (MFN) Model Rule

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An Open Letter to our Community,

Some of you may be aware that on November 20 President Trump made an announcement of a mandatory model regarding drug pricing called Most Favored Nation (MFN). Under this MFN rule, Medicare’s payments under Part B, which covers medicines typically administered in doctors’ offices like ours, along with Part D, which covers self-administered medicines mostly obtained from pharmacies, could not exceed the lowest price paid in any developed country.

While we agree that drug pricing needs to be brought under control, we believe that this is a dangerous and ill-advised approach at the worst possible time. Senator Grassley has nobly led the effort with Senator Wyden to advance a bipartisan approach, which is where we believe our collective energy should be directed. The MFN rule, by CMS’ own admission, will significantly limit access to patient care and to critical existing medications. We believe the MFN rule will threaten the solvency of smaller, independent healthcare providers like us and discourage Pharma from making investments in future cancer treatments and cures.

At Mission Cancer + Blood, we strongly oppose the MFN rule for two critical reasons:

MFN is bad for patients. If passed, this rule will likely cause severe disruptions in access to important medications. The Center 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.”

In addition, CMS admits that in 2021, the MFN will force 9 percent of Medicare beneficiaries to forgo access to treatment with another 10 percent being forced to seek care through a 340b hospital.  These are not numbers.  These are people.  People currently being treated for life threatening dangerous diseases.  Any disruption to care is unacceptable.  The number of patients with no access increases to 19 percent of Medicare beneficiaries in 2023.

MFN is bad for healthcare providers. 36 of the 50 covered drugs under MFN are used in oncology and hematology. While we understand and agree that action is needed to address the rising cost of prescription drugs, including cancer treatments, the MFN is a rushed policy that is likely to have significant unintended and disastrous consequences on America’s seniors and independent community oncology practices. 

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.”

The staff and physicians at Mission Cancer + Blood care deeply about the health and well-being of all of our patients, and more broadly, the members of our community that will be affected if this rule passes. As an organization whose mission it is to fight cancer, the impact this can have on our patients and future treatment developments is alarming.

Your voice matters in helping us make the difference in stopping the MFN from moving forward prior to January. Today, I am asking you join Mission Cancer + Blood in reaching out to your legislative representatives, urging them to oppose the passage of MFN. We encourage you to send a letter to all of the Iowa congressional representatives and senators (email addresses of congressional staffers at the end of the blog post).

Click the link here for the letter to send to the honorable Senator Grassley.

Below is an outline for your use if desired:

Dear Senator (or Representative) _____________,

I am writing you today as a concerned citizen, advocating on behalf of the individuals who will be negatively impacted if President Trump’s push for Most Favored Nation (MFN) status with Medicare Part B drug and treatment pricing is passed. Not only would the MFN model drastically change the way Medicare pays for certain drugs, including oncology drugs, it could limit patients’ access to life-saving therapies for treatment.

It is especially alarming to me that the Administration has issued this rule during the middle of COVID-19, when so many patients are already burdened and dealing with increased stress – health, financial, social and emotional.  

On behalf of all Iowans fighting cancer, now and in the future, I urge you to stop the implementation of the MFN rule.


[Your name]

Thank you for your support on behalf of all Iowans as we move forward to fight this legislation together.


The Physicians and Management at Mission Cancer + Blood.  

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