The Trump administration has finalized a new model that aims to bring its most-favored nation pricing approach to Medicare Part B.
Called the Global Benchmark for Efficient Drug Pricing, or GLOBE, Model, the program will begin on Jan. 1 and run through March, 31, 2032. The model deploys an alternative approach to calculating drug inflation rebates in Part B, which covers therapies administered in healthcare settings, per an announcement from the Centers for Medicare & Medicaid Services.
Under GLOBE, regulators would use international pricing information to set a benchmark that reflects the cost of a therapy in economically similar countries. The administration has put a spotlight on most-favored nation pricing agreements to drive down drug costs, as a slew of medications are far more expensive in the U.S. than they are internationally.
CMS projects that the model will lead to out-of-pocket cost savings for beneficiaries without reducing quality. Lowered coinsurance under GLOBE will be offered from April 1, 2027 to March 31, 2032.
"Medicare Part B patients and American taxpayers have paid significantly more for prescription medications than people in comparable countries," said CMS Administrator Mehmet Oz, M.D., in the announcement. "At CMS, we’re focused on more than promises to make healthcare more affordable — we’re taking action to pilot a new approach to lower costs and strengthen the quality of care while preserving medical innovation."
The model was first announced in December 2025 alongside a similar model for Medicare Part D called GUARD, or the Guarding U.S. Medicare Against Rising Drug Costs model. The GUARD model has yet to be finalized.
CMS said it decided to take aim at costs in Part B as it's the fastest-growing spend category, increasing nearly four times as quickly as drug spending across other payers, such as commercial and Medicaid, between 2008 and 2021. Therapies covered under Part D may be complex and costly, driving the accelerated spending.
A change from the proposed design for GLOBE, CMS said, is that the final model will exclude biosimilars and their reference biologic medication once a biosimilar hits the market. GLOBE will also exclude orphan drugs, plasma-derived products and some cell and gene therapies.
The agency said this shift followed public comments on the proposed version of the model.
CMS said that model participants will include beneficiaries in a randomly-selected subset of geographic regions, with participation encompassing about 25% of people enrolled in traditional Medicare.
The administration also unveiled a model that similarly aimed to bring MFN pricing to Medicaid, called GENErating cost Reductions fOr U.S. Medicaid, or GENEROUS. The White House said earlier this month that all 50 states, the District of Columbia and Puerto Rico have applied to participate.