Four Cents per Beneficiary a Month: Breaking Down GLOBE’s Medicare Part B Premium Savings

CMS proposed the Global Benchmark for Efficient Drug Pricing (GLOBE) Model in December 2025 as one of three demonstrations built around international price benchmarks. The aim was to determine whether Medicare could pay less for included drugs by measuring U.S. prices against prices in economically comparable countries. As proposed, GLOBE would have begun on October 1, 2026. CMS published the final rule on October 2, 2026, and the model now starts later. Manufacturers may submit international pricing data beginning January 1, 2027, and the five performance years run from April 1, 2027, through March 31, 2032.¹

GLOBE applies an international price benchmark as an alternative calculation of the Medicare Part B drug inflation rebate. It includes certain high-spend, single-source Part B drugs and sole-source biologics in several therapeutic categories. A drug must also account for more than $100 million in annual Part B Original Medicare (OM)^a spending. The model will cover about 25% of OM beneficiaries living in randomly selected geographic areas and does not apply to Medicare Advantage (MA) drug use.¹

The final rule keeps the geographic design but includes new exemptions and waivers for certain drugs and manufacturers. CMS adopted its proposed exclusion of drugs with a Maximum Fair Price in effect and, in the final rule, added exclusions for orphan-only drugs, certain cell and gene therapies, and plasma-derived products. It also stated that CMS intends to waive mandatory participation for manufacturers in the GENEROUS Model. CMS estimates that four manufacturers of GLOBE drugs remain based on 2024 Part B OM data. These changes, together with the delayed start, lead to significantly lower projected model savings.¹

The proposed rule projected $11.9 billion in Medicare Part B net savings. The final rule estimates that figure at $440 million over the model’s payment period.¹ Since premiums are calculated across all beneficiaries, including beneficiaries outside the model cohort¹, any Part B premium reduction would apply across both OM and MA because lower OM costs reduce MA benchmarks and bids.

• Only part of the $440 million projected model savings is expected to reach beneficiaries through lower Part B premiums: $90 million for MA beneficiaries and $61 million for OM beneficiaries, or $151 million combined.¹
• Across MA and OM, the Trustees project 66.4 million Part B beneficiaries in 2027 and 72.6 million in 2032, an average of 69.5 million.² The $151 million premium offset is $2.17 per beneficiary over five years, $0.43 per beneficiary per year, or about $0.04 a month.
• For OM beneficiaries, the Trustees project 29.0 million beneficiaries in 2027 and 29.6 million in 2032, an average of 29.3 million.² The $61 million premium offset is $2.08 per beneficiary over five years, $0.42 per beneficiary per year, or about $0.03 a month.

As evident from these estimates, GLOBE does not produce a meaningful Part B premium reduction. In both groups of beneficiaries, savings each month amount to about 0.02% of the standard monthly premium, which is $202.90 in 2026 and projected to be $209.50 for 2027.

ᵃ Also known as Medicare fee-for-service (FFS).

References

1. Centers for Medicare & Medicaid Services (CMS). Global Benchmark for Efficient Drug Pricing (GLOBE) Model. Table 14. https://www.federalregister.gov/documents/2026/10/02/2026-20281/global-benchmark-for-efficient-drug-pricing-globe-model
2. CMS. Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2026 Annual Report (June 9, 2026).
   Table IV.B2 and Table V.B3. https://www.cms.gov/data-research/statistics-trends-and-reports/trustees-report-trust-funds