CMS proposes 2 Medicare drug pricing models

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CMS has proposed two new models aimed at curbing Medicare drug spending by linking payments to international benchmarks. The proposals — GUARD for Part D drugs and GLOBE for Part B — are the latest in the CMS Innovation Center’s efforts to make prescription drugs more affordable for beneficiaries while preserving the long-term sustainability of the Medicare program.

Here are four things to know, according to two news releases shared with Becker’s:

1. Two models

The GUARD model applies to prescription drugs covered under Medicare Part D, while GLOBE targets drugs reimbursed under Medicare Part B, such as injectables administered in physician offices.

2. International reference pricing

Both models would benchmark U.S. Medicare payments to prices paid in economically comparable countries, aiming to reduce inflated domestic costs for high-expenditure drugs.

3. Policy goals: affordability and access

CMS said the models are intended to make critical medications more accessible, improve treatment adherence and relieve financial strain on both the Medicare program and its beneficiaries.

4. Public comment period is open

The models were published via a notice of proposed rulemaking and are now open for public comment through the Federal Register. 

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