CMS finalizes Part B drug model covering 25 percent of Original Medicare
CMS finalized a mandatory Medicare Part B drug model Wednesday that will use international prices when calculating inflation rebates for selected clinician-administered medicines.
The GLOBE model begins January 1, 2027. It will apply in randomly selected areas covering about 25 percent of Original Medicare beneficiaries, with lower beneficiary cost sharing possible from April 1. Medicare Advantage enrollment is outside the model.
The agency excluded biosimilars and their reference products after a biosimilar enters the US market, along with orphan-only drugs, plasma-derived products and certain cell and gene therapies. CMS estimates $440m in net Part B savings over the seven-year payment period.
Beneficiaries do not enroll. The final rule says coverage and provider choice will not change, and it provides no opt-out.
