STAT+: Trump’s watered-down Medicare drug pricing rule saves 96% less than initial proposal

The Trump administration published a final rule aimed at lowering Medicare prices for drugs administered in doctor offices. The rule covers the Global Benchmark for Efficient Drug Pricing, or GLOBE, one of two mandatory pilot programs in President Trump’s plan to push drugmakers to lower Medicare prices to levels charged in other wealthy countries—a policy generally called most-favored-nation pricing. The other pilot, GUARD, is still in the proposed stage.

The final rule applies to only four companies. It also exempts the drugmakers that struck Trump’s separate voluntary deals to offer MFN prices for drugs for Medicaid recipients, according to the GLOBE model’s final rule. Those voluntary Medicaid deals are tied to the two mandatory pilots.

The rule is watered down relative to the initial proposal: according to STAT, it saves 96% less than the original plan. That limited scope—four companies and exemptions for those with voluntary Medicaid MFN agreements—leaves the GLOBE pilot with a much smaller reach, while GUARD remains only proposed.