The Trump administration has officially finalized the Global Benchmark for Efficient Drug Pricing (GLOBE) Model, a mandatory payment model designed to bring most-favored nation (MFN) pricing to Medicare Part B. The program kicks off January 1 and runs through March 31, 2032, with reduced coinsurance for beneficiaries rolling out from April 2027. It will cover a randomly selected subset of geographic regions, reaching about 25% of traditional Medicare enrollees.

Under GLOBE, CMS will use international pricing data to set drug payment benchmarks based on what economically similar countries pay — a direct response to the reality that many medications cost significantly more in the U.S. than abroad. CMS Administrator Dr. Mehmet Oz described it as moving beyond promises to actual action on affordability. A companion model for Medicare Part D, called GUARD, was proposed alongside GLOBE but has not yet been finalized.

By the Numbers:

• Part B drug spending grew nearly 4x faster than spending across commercial and Medicaid payers between 2008 and 2021
• Reduced coinsurance available from April 1, 2027 – March 31, 2032
• ~25% of traditional Medicare beneficiaries will be covered under the model
• A parallel Medicaid model (GENEROUS) has drawn applications from all 50 states, D.C., and Puerto Rico

Why it matters: Part B is Medicare's fastest-growing drug spend category, and GLOBE represents a significant policy shift toward international price benchmarking. For providers and patients, it could meaningfully reduce costs for infused and injected therapies administered in clinical settings — though biosimilars, orphan drugs, and certain cell and gene therapies are carved out.