Trump's GLOBE Drug Rule Saves 96% Less Than Proposed — SkimNews
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- GLOBE final rule applies to only four companies, a steep narrowing from the initial proposal, which had not contemplated exempting firms with voluntary most-favored nation deals.
- Estimated savings fell from nearly $12 billion in the proposed rule to $440 million in the final version — a roughly 96% drop that Harvard researcher Thomas Hwang said lines up with his own projections.
- GLOBE is one of two mandatory most-favored nation pricing pilots in Trump's Medicare drug pricing plan; the companion program, GUARD, remains in the proposed stage.
- Companies that struck voluntary MFN pricing deals for Medicaid are now carved out of GLOBE, a structural change the original proposal did not include and that shrinks the pilot's reach.
- The final rule excludes drugs for rare diseases, though treatments addressing both rare and non-rare conditions remain in scope.
Why it matters: The 96% savings cut means taxpayers and Medicare beneficiaries capture a small fraction of what the administration originally projected. By exempting companies with voluntary Medicaid MFN deals and rare-disease drugs, the rule narrows its mandatory scope to four firms — leaving most of the administration's most-favored nation drug pricing agenda sitting in voluntary territory, where there is no enforcement lever if manufacturers refuse.
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