Medicare Will Pilot Matching 19 Countries’ Drug Prices. It Starts Narrow
Globe starts Jan. 1. It covers a small slice of Part B drugs. If it saves money without hurting care, it could widen. Legal challenges are already teed up.
By Sean Anees Saifi · Capital Wealth · Published Thursday, October 1, 2026 · Source: The Wall Street Journal, Thursday, October 1, 2026 edition, whose market figures are the Wednesday, September 30 close
Key Points
The Trump administration is rolling out Globe, a program aimed at getting Medicare to match prices in other countries for certain high-cost drugs such as cancer and autoimmune medicines, Liz Essley Whyte and Lizzy Lawrence report. Officials said it would start Jan. 1.
The final rule, issued Wednesday, applies to few drugs and is less ambitious than first proposed. It is still one of the more legally significant attempts by this administration to link U.S. drug costs to overseas prices.
Medicare would set what it pays for certain drugs based on what 19 other countries with similar economies pay. The test, run by Medicare’s Innovation Center, covers some patients receiving some Part B drugs — generally expensive medicines doctors or hospitals administer in person. An example: Entyvio, made by Takeda, for Crohn’s and ulcerative colitis.
If the five-year program shows it saves taxpayers money without sacrificing quality, it could be expanded nationwide. Drugmakers who already cut earlier deals with the White House are expected to be exempt from this round.
PhRMA called the move unlawful and said it does nothing to lower patients’ out-of-pocket costs. CMS administrator Mehmet Oz framed it as a pilot to lower costs while preserving innovation. The program is expected to face legal challenges.
Jan. 1
Globe start date, under Wednesday’s final rule
19
comparison countries with similar economies
Part B
in-person hospital/clinic drugs, not home pills
5 years
CMMI test before any nationwide expansion
The pilot starts with the infused Part B drugs — the chair, not the pharmacy counter.
In one line: Medicare will test matching 19 countries’ prices on some clinic-administered drugs starting Jan. 1. It is a pilot, not a nationwide cut, and lawsuits are coming.
Health officials plowed past drugmaker objections and said Globe starts Jan. 1. The idea: Medicare matches what 19 similar countries pay for certain high-cost drugs — cancer, autoimmune, the ones that show up as a chair in a clinic, not a bottle in a cabinet. The final rule landed Wednesday. The Journal reports it covers few drugs and is less ambitious than the first draft. It is still one of the more legally significant tries this administration has made to import an overseas price.
The test sits at Medicare’s Innovation Center. Part B: expensive drugs a doctor or hospital gives in person. The paper’s example is Entyvio, Takeda’s treatment for Crohn’s and ulcerative colitis. Five years. If it saves taxpayers money without hurting quality, it could go nationwide. Firms that already cut earlier White House deals are expected to sit this round out. Mehmet Oz, who runs CMS, called it a pilot. The drug-industry trade group called it unlawful, said it doesn’t cut what patients pay at the counter, and said it imports foreign price controls. Both quotes are the press conference. The household question is the explanation of benefits.
A pilot is not your copay — until a claim denies
Globe applies to a small slice of medicines. The paper says the implications get large if it survives court and shows savings. That is the watch, not the panic. Medicare Part B billing is already a different animal from a pharmacy card: coinsurance, supplements, Advantage networks. If you or a parent is on an infused drug, the useful sitting is the 2027 Annual Notice of Change and the specialty-pharmacy line, not a headline about 19 countries. Out-of-pocket is not automatically the overseas price.
Our read
Insurance (M11) / Retirement (M10): do not rebuild a retirement withdrawal plan around a five-year experiment. If a household lives on an infused Part B drug, ask the clinician and the plan what Globe does to that code — coverage, site of care, whether a supplement still wraps the coinsurance. Keep a cash buffer for the year a specialty claim comes back weird. You don’t wait for the first denial to find the umbrella.
Drugmakers who already cut a deal may be exempt. That is another reason not to assume every high-cost drug just got cheaper. Fifteen minutes: the drug name, the Part B vs Part D bucket, and who pays the 20% if a Medigap isn’t in the stack.
What It Means For Your Portfolio
Watch — a Jan. 1 Part B pilot is not a nationwide copay cut; check the drug you actually take
Medicare will test matching 19 countries’ prices on some clinic drugs from Jan. 1. It is a five-year pilot, and lawsuits are already queued.
General planning principles, not advice for anyone in particular. A CMMI experiment is not a new household copay. If someone in the house receives a Part B infused drug, the work is to ask the plan how that code will be paid in 2027 — site of care, coinsurance, whether a supplement still wraps it — not to assume 19 countries just cut the bill.
Keep a cash buffer for a weird specialty claim. Do not spend a hoped-for savings. If the drug is on an earlier White House deal, it may sit this round out. Read the Annual Notice of Change when it lands.
