CMS finalizes the GLOBE Model: what it means for Part B drug costs

The headline is lower drug prices. Whether that reaches you depends on three things: the coverage you have, where you live, and which drugs you get. CMS’s own final rule also says only a fraction of the people in the model will see a direct cut in cost sharing. Here is what CMS finalized and how to read it.

What CMS finalized

GLOBE is a test run by CMS’s Innovation Center. It changes the formula behind the Part B drug inflation rebate program, which already bills drug makers when a drug’s price rises faster than inflation. For drugs in the model, the yardstick becomes an international benchmark: what a set of economically comparable countries pay, adjusted for differences in income and purchasing power. When Medicare’s price is above that benchmark, the manufacturer owes a rebate, and the rebates go to the Medicare trust fund that pays for Part B.

CMS’s reason is cost growth. It cites the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services: from 2008 to 2021, drug spending in Original Medicare Part B grew nearly four times as fast as drug spending across all payers.

• Dates. The model runs from January 1, 2027 through March 31, 2032. Lower coinsurance applies from April 1, 2027 through March 31, 2032. Billing drug makers for rebates, and reconciling them, continues until March 31, 2034.
• Drugs. Certain Part B drugs that have no generic or biosimilar version (CMS’s terms are single-source drugs and sole-source biological products), from five areas of care: cancer, rheumatology, immunology, eye care and endocrinology. Each must be a drug on which Original Medicare spends more than $100 million a year. CMS will post the list by billing code before each calendar quarter and update it quarterly.
• Left out. Biosimilars, and the biologics they copy once a biosimilar is sold in the U.S.; drugs approved only for rare conditions; plasma-derived products; and certain cell and gene therapies. CMS added the last three after public comments on its proposal. It also intends to waive the model, quarter by quarter, for drug makers taking part in GENEROUS, a separate CMS drug-pricing model for Medicaid.
• The comparison countries. Australia, Austria, Belgium, Canada, the Czech Republic, Denmark, France, Germany, Ireland, Israel, Italy, Japan, the Netherlands, Norway, South Korea, Spain, Sweden, Switzerland and the United Kingdom.
• Who has to take part. The makers of the included drugs, for whom it is mandatory. Doctors, hospitals and patients are not participants and have nothing to join.

Who it applies to

CMS calls the people in the model the model cohort. You are in it only if both of these are true:

• You have Part B, and Original Medicare pays first for you.
• The address Medicare has on file for you is in one of the ZIP code areas CMS selected at random, either when CMS draws the cohort or when you first join Original Medicare during the model.

CMS expects the cohort to be about a quarter of people with Original Medicare. It leaves out anyone whose primary coverage is something else, and CMS names Medicare Advantage as the example. People with both Medicare and Medicaid can be in it.

There is nothing to sign up for. CMS says people cannot and do not need to do anything; it checks whether you qualify when it processes the claim for a GLOBE drug. Once you are in the cohort, you stay in it if you move or your ZIP code changes, as long as Original Medicare stays your primary coverage.

CMS will post the GLOBE Model ZIP Codes List on its model page by January 16, 2027. Until then, no one can say which areas were picked, in Clark County or anywhere else.

What changes in what you pay

For people in the cohort, coinsurance on a GLOBE drug can be lower than the usual Part B coinsurance from April 1, 2027. CMS says it will post the reduction for each drug on its model page. How much you save depends, in CMS’s words, on the drug, the rebate calculation and your own circumstances, such as supplemental insurance.

That last part matters. If a Medicare Supplement plan or Medicaid already pays your Part B coinsurance, a smaller coinsurance amount mostly means a smaller bill for them, not for you. CMS acknowledges this in the final rule: because many of the people who qualify are also on Medicaid or have supplemental coverage, only a fraction of the people in the model will see a direct cut in cost sharing. The people most likely to notice are those who pay some or all of their Part B coinsurance themselves.

Your doctor’s office is paid the same total. The allowed amount doesn’t change: Medicare pays a larger share and you pay a smaller one. If your clinic collects coinsurance at the visit, CMS has told providers they may need to refund part of it once Medicare processes the claim.

CMS also says savings from the model may lower Part B premiums for everyone with Part B, whether or not they are in the cohort. It has not said what that means for the monthly premium, and it had not announced the 2027 Part B premium as of the date on this page.

How big CMS expects the effect to be

The final rule includes CMS’s own estimates, and they are much smaller than the proposal’s. CMS now estimates Original Medicare Part B savings of $298 million over the life of the model, down from $8.4 billion in its December 2025 proposal. For people with Original Medicare it estimates $111 million in total: $50 million in lower cost sharing and $61 million in lower Part B premiums. Those are national totals for the whole model, not a figure for any one person.

The final estimates reflect the changes in the final rule, including the new exclusions. They also assume that drug makers taking part in GENEROUS as of August 17, 2026 will not be in GLOBE.

For Medicare Advantage members, CMS’s estimates show indirect effects: lower Part B premiums and, from 2028, slightly smaller supplemental benefits, the extras such as lower cost sharing that plans fund from their Medicare payments. That second one follows from how plans are paid, since Medicare Advantage payments are tied to Original Medicare spending. CMS’s estimate shows no change to those benefits in 2027.

What it does not do

• It does not cut Medicare Advantage cost sharing directly. The lower coinsurance applies only to the Original Medicare cohort. If you have a Medicare Advantage plan, your plan’s cost sharing for Part B drugs applies, as its Evidence of Coverage shows.
• It does not change Part D. GLOBE is a Part B model. Most prescriptions filled at a pharmacy are covered under Part D, which the model does not touch.
• It does not limit which drugs you can get. CMS says the model does not restrict access to Part B drugs or other covered services, and that it will watch for problems. If you run into one you think is related, CMS asks you to call 1-800-MEDICARE.
• It cannot guide a 2027 coverage choice. Annual Enrollment runs October 15 – December 7, 2026, and the ZIP code list is due January 16, 2027. Choose on what you can check now: your doctors, your prescriptions, and what your coverage costs in total.

What to do now

• Put clinic-given drugs on your medication list. Infusions and injections you get at a doctor’s office, infusion center or eye clinic are billed differently from pharmacy prescriptions, and they are the kind of drug GLOBE covers. Write down the name and how often you get it.
• If you have a Medicare Advantage or drug plan, read your Annual Notice of Change. It shows your own plan’s 2027 costs and coverage, which you can act on this fall. Here is how to read it.
• Check back after January 16, 2027. CMS will post the ZIP code list on its GLOBE page, and we will update this page once we have read it.

Questions people ask about the GLOBE Model

Keep reading

• Medicare in 2027: what changes for Clark County seniors
• What CMS announced for 2027 Medicare Advantage and Part D
• Medicare 2027 vs 2026: what actually changed
• Medicare help in Vancouver, WA

Checked September 30, 2026 against CMS’s press release, the GLOBE Model page, CMS’s GLOBE FAQ and the final rule, scheduled to publish in the Federal Register on October 2, 2026. Dollar figures are CMS’s national estimates, not what any one person will pay or save.