Imagine being told that the medication you or your child depends on is no longer available, not because it stopped working, but because Medicaid no longer covers it. For many New Hampshire families living with chronic or rare diseases, this could become a harsh reality if the federal government implements a Most Favored Nation (MFN) drug pricing model under Medicaid.
As advocates for people living with lupus and other chronic conditions across New England, we at the Lupus Foundation New England are deeply concerned about the real-world consequences of this policy, especially for Granite Staters who depend on uninterrupted access to lifesaving treatments.
The MFN policy aims to lower prescription drug costs by tying U.S. prices to those paid in other countries. While that may sound reasonable in theory, the reality is far more troubling. In practice, the MFN model could drastically restrict access to medications for patients on Medicaid, Medicare, and the 340B program. These programs serve low-income, rural, and medically underserved communities. Here in New Hampshire, the patients most at risk would include children, seniors, and people managing chronic or rare diseases.
It’s important to understand that Medicaid already secures some of the steepest discounts on prescription drugs, often exceeding 50 percent off list prices. For Medicaid patients, out-of-pocket costs are already minimal or nonexistent. The MFN model doesn’t lower prices for these patients. Instead, it would require drug manufacturers to offer even steeper discounts, potentially to the point where it is no longer financially feasible for them to supply certain medications through Medicaid.
That’s not cost savings—it’s rationing care.
For people living with lupus, a complex autoimmune disease that can damage the skin, joints, and vital organs, treatment delays or disruptions can lead to irreversible harm. The same is true for children with asthma, adults managing diabetes or heart disease, and patients battling cancer or rare genetic disorders. When medications disappear from Medicaid formularies, these patients pay the price.
Worse still, this policy could have ripple effects beyond Medicaid. In order to sell drugs under Medicare Part B, a lifeline for many New Hampshire seniors, manufacturers must also participate in Medicaid and the 340B program. If they’re priced out of Medicaid participation, those drugs may vanish from Medicare as well, putting even more lives at risk.
The 340B Drug Pricing Program, which enables rural and community hospitals to buy drugs at a discount, is also in jeopardy. These facilities serve some of the most vulnerable people in our state — from single parents in Berlin caring for children with rare diseases, to retirees in Claremont managing chronic pain, to college students in Manchester striving to stay in school while living with lupus.
We absolutely agree: the cost of healthcare in America should be addressed. But the MFN model is not the answer. It doesn’t reduce costs for patients who need it most and instead threatens to destabilize the very programs designed to protect them.
We urge New Hampshire’s congressional delegation to reject this dangerous proposal. Please oppose any efforts to implement a Most Favored Nation pricing model under Medicaid and Medicare.
Granite Staters are counting on you. Let’s protect access, preserve innovation, and make sure no one in our state has to choose between their health and their future.
