Dec 19 (Reuters) – The U.S. government on Friday announced pilot programs to start in 2026 and 2027 that are aimed at reducing out-of-pocket drug costs under the Medicare healthcare program for older and disabled Americans to prices on par with economically comparable countries.
The Centers for Medicare and Medicaid Services said the programs, titled Guarding U.S. Medicare Against Rising Drug Costs (GUARD) and Global Benchmark for Efficient Drug Pricing (GLOBE), would assess a rebate for certain drugs payable under Medicare part D and Part B, respectively, if they exceed the prices paid in other similar countries.
Under the GLOBE model, CMS would use global price data to calculate manufacturer rebates and set patients’ out-of-pocket costs for certain drugs included in Medicare Part B, comprising treatments for cancer, autoimmune diseases, eye disorders, and hormonal conditions.
GLOBE would launch on October 1 next year and run through 2031, the agency said.
Under the GUARD model, the agency would use international price benchmarks to determine manufacturer rebates and patients’ out-of-pocket costs for certain Medicare Part D drugs and is set to launch on January 1, 2027, through December 31, 2031.
Medicare Part D is the prescription drug benefit that helps Medicare enrollees pay for outpatient medications through private plans approved by Medicare.
Out-of-pocket costs include co-pays, flat fees, and coinsurance, which is a percentage of the drug price.
(Reporting by Mariam Sunny in Bengaluru; Editing by Shailesh Kuber)
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