Global Benchmark for Efficient Drug Pricing (GLOBE) Model
Key claim: Medicare will run a mandatory test that uses a new method to calculate inflation rebates on certain Part B drugs, aiming to cut costs for traditional Medicare patients and the program without reducing quality of care.
Abstract
(Rule · Health and Human Services Department, Centers for Medicare & Medicaid Services) This final rule implements the Global Benchmark for Efficient Drug Pricing Model (GLOBE Model), a new mandatory Medicare payment model under section 1115A of the Social Security Act. The GLOBE Model will test whether a payment model that uses an alternative method for calculating Medicare Part B drug inflation rebate amounts for certain separately payable Medicare Part B drugs and biological products reduces costs for Original Medicare (OM) beneficiaries and the Medicare program while preserving quality of care. The term OM has the same meaning as Medicare fee-for-service and the traditional Medicare program.
Why this matters
Part B drug spending—covering clinician-administered drugs like infusions and injections—is a major cost driver for Medicare and for the 20% coinsurance beneficiaries pay. By testing a new inflation-rebate calculation on a mandatory basis, CMS is probing whether an alternative benchmark can reduce what traditional Medicare patients and the program pay without changing coverage. The mandatory structure means affected manufacturers and providers cannot opt out, giving the demonstration broader reach than voluntary models.