The Trump administration has published a final rule for a Medicare pilot program aimed at lowering prices for physician-administered drugs. The program, called GLOBE, is one of two mandatory pilots tied to the administration’s most-favored-nation pricing strategy. Under the final rule, GLOBE applies to just four companies, though the rule does not name them. The initial proposal would have covered many more drugs and did not exempt companies that had struck separate voluntary deals with the administration.
Medicare actuaries now estimate the pilot will save about $440 million, a 96% reduction from the nearly $12 billion projected in the proposed rule. Harvard researcher Thomas Hwang, who studied GLOBE’s potential savings, said the reduction matches his own estimate. The final rule also excludes drugs for rare diseases, unless a drug treats both a rare disease and a non-rare condition.
The other mandatory pilot, called GUARD, remains in the proposed stage. The source article does not provide additional details on GUARD or on why the administration chose to narrow GLOBE’s scope beyond the exemptions and rare-disease exclusion.