A coalition of 34 scientific and medical organizations led by the American Association of Immunologists and the American College of Physicians released the following statement.
AMCP Summary of Medicare Part B Most Favored Nation Model
On November 20, HHS released an Interim Final Rule with Comment Period (IFC) establishing a Most Favored Nation (MFN) Model for Medicare Part B drugs. The MFN Model will calculate the payment rate for included drugs based on a price that reflects the lowest per capita GDP-adjusted price among a group of OECD countries, with an additional flat payment based on the average payment for MFN Model drugs in 2019 adjusted quarterly for inflation.
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The Protecting Pharmacies in Medicaid Act would prohibit the use of spread pricing arrangements in Medicaid programs. Pharmacy benefit managers (PBMs) would be required to pass through to pharmacies the full amount of the money paid to the PBMs by Medicaid programs, except for a fixed administrative fee. The total reimbursement amount will be determined by a survey of national average drug acquisition costs administered by the Department of Health & Human Services.
In AMCP's latest comments to the FDA, we emphasize the need for standardized public reporting of confirmatory trial progress, ensuring payers and health care providers have the necessary data to make informed coverage decisions. By supporting proactive communication and rigorous confirmatory trials, AMCP aims to balance early access to innovative treatments with patient safety and long-term therapeutic value.
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