Don't Jeopardize My Sight Campaign: Stop MFN Policy

ASRS Patient Issue Brief: Most Favored Nation Policy

The American Society of Retina Specialists (ASRS) opposes Medicare's Most Favored Nation (MFN) policy set to begin on January 1, 2021. This policy puts your sight in jeopardy by limiting access to sight-saving treatments for age-related macular degeneration (AMD), diabetic retinopathy, and other blinding retinal conditions.

Issue Details:
On November 20, 2020, the Trump Administration announced the MFN policy designed to reduce drug prices. While we agree with the intention, the MFN plan as written is flawed and may reduce your access to sight-saving drugs.

Starting January 1, 2021, the MFN policy will require Medicare to reduce payment for certain physician-administered Part B drugs (including Eylea and Lucentis) to align with the lowest prices found in comparable countries. As a result, your physician will have to pay more for these drugs than Medicare will reimburse. This flawed policy creates a very difficult situation in which your doctor will be forced to choose between financial stability and optimal patient care.

Retina specialists rely on Eylea and Lucentis to help patients maintain their vision and slow the progression of AMD, diabetic retinopathy, and other retina diseases. However, the MFN policy threatens to disrupt your treatment plan by creating barriers to these sight-saving drugs. Medicare has acknowledged as much by saying Medicare patients may "experience access to care impacts" by being forced to use "alternative therapy that may have lower efficacy or greater risks, or postponing or forgoing treatment."

Treatment options for retina conditions are not interchangeable, and the MFN policy limits retina specialists' ability to ensure patients receive the most appropriate treatment. 

ASRS opposes Medicare's MFN policy as it establishes barriers to obtaining sight-saving drugs and increases patients' risk of vision loss. If you agree, please take action today.


Call to Action: Contact Medicare

Contact Medicare and tell them to stop the Most Favored Nation policy set to begin on January 1, 2021.

1.  Call 1-800-MEDICARE (1-800-633-4227)

2.  Tell the operator: 

  • Please stop the Most Favored Nation policy because it threatens my eyesight by limiting access to the medicine I need to maintain my vision.

3.  Select a talking point:

  • I have paid into Medicare for many years. [Eylea or Lucentis] is saving my vision. Why are you taking it away from me?
  • I need [Eylea or Lucentis] to keep my sight. I may lose my vision if I have to change drugs or delay my treatments. Is that what Medicare is asking patients to do?
  • Why is Medicare trying to take away medicine that helps me see?

4.  Ask the operator to submit your complaint to the Medicare Beneficiary Ombudsman (MBO)

or

Tailor and send the following message to Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS): Seema.Verma@cms.hhs.gov

Email subject line: Don’t Jeopardize My Eyesight: Stop Most Favored Nation Policy

Dear Administrator Verma,

I am an Original Medicare beneficiary and am deeply concerned that the Most Favored Nation policy will jeopardize my eyesight by limiting access to the medicine I need to maintain my vision.

[Insert your personal story explaining why you must have access to either Lucentis or Eylea].

As a result of the MFN policy, my retina specialist will have to pay more for these drugs than Medicare will reimburse.

This flawed policy creates a difficult situation in which my retina specialist will be forced to choose between financial stability and my care.

I have paid into Medicare for years, now you are taking away the medications that help me see. This cannot stand.

Pleasestop implementation of this policy immediately to protect my access to sight-saving drugs for my retinal condition.

[Insert your name and address]


Call to Action: Contact Congress

Contact your members of Congress and ask them to pass legislation to stop Medicare's Most Favored Nation policy set to begin on January 1, 2021.

1.   Find your members of Congress:

 2.   Call your members of Congress and tell them:

  •  Please stop the Most Favored Nation policy because it threatens my eyesight by limiting access to the medicine I need to maintain my vision.

3.   Select a talking point

  • Tell your personal story and why you must have access to either Eylea or Lucentis. Tip – keep your comments brief.
  •  I paid into Medicare for many years. [Eylea or Lucentis] is saving my vision. I urge you to pass legislation to protect my access to sight-saving drugs for my retinal condition.
  •  All Americans deserve the highest-quality care. I urge you to act and block the MFN policy immediately.

or 

Tailor the following message to reflect your situation and email it to your members of Congress.

Email subject line: Don’t Jeopardize My Eyesight: Stop Most Favored Nation Policy

 Dear [Name of member of Congress]

I am one of your constituents and an Original Medicare beneficiary. I am deeply concerned that the Most Favored Nation policy will jeopardize my eyesight by limiting access to the medicine I need to maintain my vision. I urge you to act and block the MFN policy immediately.

[Insert your personal story explaining why you must have access to either Lucentis or Eylea].

The MFN policy will reduce payment for Medicare physician-administered Part B drugs (including Eylea and Lucentis) to align with the lowest price found in comparable countries. As a result, my retina specialist will have to pay more for these drugs than Medicare will reimburse.

This flawed policy creates a difficult situation in which my retina specialist will be forced to choose between financial stability and my care.

Please pass legislation immediately to protect my access to sight-saving drugs for my retinal condition.

[Insert your name and address]

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