Facebook Live Recap – Is MFN an Imminent Threat?

Last Wednesday Seniors Speak Out held another Facebook live event to discuss an issue that is a “clear and present danger” to our healthcare. Now you may think that using this old movie title is somewhat of an exaggeration, that nothing in our government is ever clear and never happens in the present and I agree, that‘s usually the case. But not this time, the Most Favored Nation (MFN) drug pricing policy is a danger right now. I’ve written a lot about MFN, but we thought a Facebook live event would be an excellent way to simplify how it will impact our healthcare and explain why it is a present danger. You can go here to view a recording of the event.

I started off the Facebook live event by acknowledging and thanking Mark Gibbons, President and CEO of RetireSafe for joining me to discuss this important issue. I then gave a little background on where this concept came from, how it had morphed from a medieval free trade approach to ensure fair treatment, to another way for a government to enact price controls. I pointed out that using MFN for drug pricing was importing other countries’ controls and methods of allocating resources. Additionally, many of these countries use algorithms like Quality-Adjusted Life year or QUALY to decide who receives treatments, which, according to our latest satisfaction survey, seniors are very concerned about. I then turned it over to Mark for his introduction and opening statement. ‍

He opened by stating that RetireSafe is a nonprofit that seeks to promote and protect the health, independence, and rights of seniors through advocacy and education and that MFN implementation will threaten seniors’ access to the quality care that Medicare provides. He reminded us that Medicare has delivered reliable access to the treatments seniors rely on, and there is a real concern that applying foreign price controls to Part D could limit access to newer, cutting-edge medicines without meaningfully lowering seniors’ out-of-pocket costs. He concluded by pointing out that RetireSafe has been sounding the alarm for seniors on the dangers of MFN pricing through statements, social media, and other forms of engagement and, like SSO, they stand firmly behind policies that promote quality, accessible care for seniors—a standard that MFN fails to meet.

I then asked a few questions, the first one being, from your perspective, why should seniors be concerned about price controls? Mark answered by saying that tying U.S. drug prices to foreign countries doesn't account for the fact that those countries often ration care and delay access to new treatments. This approach in the U.S. would drive costs up, slow innovation and increase premiums. He pointed out that R&D is costly, and those foreign nations that free ride on American innovation create a genuine fairness problem, but MFN is not the solution to foreign freeloading. I pointed out that the U.S. has built a fertile innovation environment that is threatened due to the negative impact of our recent policies.

I then asked Mark to talk about value assessments, like the Quality-Adjusted Life Year, or QALY and why are these metrics so dangerous for seniors?  Mark defined QALY as a formula that assigns a dollar value to a year of human life, weighted by a person's health status, and warned that this is particularly dangerous for seniors because the metric systematically disadvantages older patients. I then got a little blunt and stated that the Quality-Adjusted Life Year has nothing to do with improving our healthcare. It’s not taught in any required class to become a doctor. No care provider ever says to their patient—you need a dose of QALY. It was invented by governments for only one reason, to ration care, to decide where to restrict treatment. I got off my soapbox by saying that I didn’t think anyone in this country believes this is good at any level.

My next question was whether Mark thought that government interference in Medicare through foreign price-setting would ruin the integrity of Part D for seniors? He answered emphatically, absolutely! He said that importing foreign price-setting mechanisms into our system introduces rationing logic that was never part of the program's design. Seniors will be the first to feel those consequences, whether through fewer drug options, higher cost-sharing, or plans exiting the market. You don't fix a working program by grafting a foreign government's rationing model onto it. I added that different citizens of different countries have different expectations of their healthcare system. America’s seniors expect to get many options and quick access to life-changing medicines. We shouldn’t be importing other countries’ expectations.

I then wondered where does MFN stand today in terms of policy and legislation? Mark said that the push to pass permanent legislation is alive and well. This is evidenced by the fact that members of Congress on both sides of the aisle have introduced bills that incorporate international reference pricing in various forms, meaning the threat of codifying MFN-style policies into law remains active. I added that there is a reconciliation bill that was being debated right now that contains MFN language.

Given that, I asked Mark what are effective ways can seniors advocate their concerns to members of Congress? Mark said that the most powerful thing seniors can do is make their voices heard directly. That means calling their senators' and representatives' offices, attending town halls, writing personal letters or emails, and engaging with their content on social media platforms like Facebook. Seniors should urge their lawmakers to reject any legislative effort to codify MFN pricing into Medicare. They should be clear that importing foreign price controls is not a solution to drug affordability. It is a trade-off that sacrifices American patients' access and innovation to achieve short-term savings.

I concluded the event by thanking Mark for joining us and said that staying engaged is essential for seniors. Contacting your lawmaker is important, especially now. You can get help in doing that by going to seniorsspeakout.org, click on the “take action” tab and select “contact your lawmaker.” You will then be guided as to how you can contact your particular Representative or Senators.

I hope this Facebook live event gave you the information you need to understand the impact that international referencing pricing will have on your healthcare and motivate you to contact your lawmakers and tell them how you feel. Again, you can see the entire event by clicking here.

Best, Thair