ADVI Health analyzed the top 50 Part B that are subject to the Most Favored Nations (MFN) Model that will go into effect January 1, 2021. These drugs are currently reimbursed at Average Sales Price (ASP) plus 6% before sequestration. Under this MFN model, these drugs will be reimbursed a phased in combination of ASP and the MFN price. In lieu of a 6% add on, the model will pay providers a per administration add-on payment of $148.73 in the first quarter of 2021. The add-on payment will be inflated based on CPI-U for future quarters.

ADVI’s analysis found that Part B drug payments could be cut by nearly $4.2 billion in the first year of the model. This is a 14% reduction in payments for these 50 drugs. The study found that 92% of drugs would have lower average payments per administration under the model. Payments per administration will be reduced by ($1,012) on average, ranging from ($5,547) to $98. Subsequent years of the model will likely result in even larger payment cuts as the MFN price is more heavily weighted over ASP.

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