CMS Finalizes New Drug Pricing Benchmark Model
The new GLOBE model changes how Medicare Part B rebates are calculated, impacting the administrative costs for medical practices.
Updated on Oct. 16, 2026 in Healthcare
Live Poll
Do you feel the financial burden of prescription drug costs is getting worse for your household?
CMS finalized the Global Benchmark for Efficient Drug Pricing (GLOBE) model on September 30, 2026, aimed at lowering drug costs for Medicare beneficiaries. The program, which takes effect January 1, 2027, alters how rebates are calculated under the Medicare Part B Drug Inflation Rebate Program.
Why it matters
The model seeks to address systemic issues where nearly 30% of Americans report skipping prescribed medications due to high prices, a trend that currently consumes significant administrative time for physician practices.
A survey of 104 physicians indicates that 96% have dealt with patients abandoning medication due to cost. Projections suggest Medicare Advantage premiums may fall more than 16% and prescription drug premiums by 38% between 2026 and 2027.
The players
Centers for Medicare & Medicaid Services
The federal agency that administers the Medicare program and sets national health coverage policy.
United States Congress
The legislative body currently considering companion bills to improve biosimilar market access.
The details
The GLOBE model utilizes an international benchmark to calculate rebates for the Medicare Part B Drug Inflation Rebate Program. For medical practices, this marks a shift in the administrative burden currently driven by the 42% of offices managing more than 30 prior authorization requests per week. While the initiative targets drug pricing, only 44% of physicians report confidence in prescribing biosimilars, a factor that may impact how the industry realizes potential savings.
Timeline
September 30, 2026: CMS finalized the GLOBE model.
Late September 2026: Congress introduced the Biosimilars Access and Affordability Act.
January 1, 2027: The GLOBE model launches.
Market Landscape
The GLOBE model extends the regulatory reach of the Medicare Part B Drug Inflation Rebate Program by adding an international benchmark component. This shift follows ongoing efforts to increase predictability for biosimilar launches as introduced in the Biosimilars Access and Affordability Act.
Physician practices should prepare for potential shifts in prior authorization workflows as the industry transitions to the new rebate calculation benchmark. Administrators should monitor billing cycles beginning in 2027 to assess how these changes influence patient adherence and coverage demands.
The takeaway
The move toward international pricing benchmarks signals a structural change in how Medicare calculates drug inflation, which may ultimately reduce the administrative time practices spend resolving cost disputes. Operators should track the 2027 implementation date to calibrate their internal billing and patient-support resources.
What happens next
The GLOBE model is scheduled to officially launch on January 1, 2027, with anticipated impacts on Medicare Advantage premiums projected for the 2027 plan year.
Further reading
For updates on how regulatory shifts impact clinical operations, visit Healthcare.
More information
View the CMS Medicare Advantage program news release for full details.
Source note: This article includes information reported by Ajmc.
Live Poll
Do you feel the financial burden of prescription drug costs is getting worse for your household?
