Nobody in Medicare signs up for the new drug-price model, and nobody can opt out of it by ZIP code. The Centers for Medicare & Medicaid Services finalized the Global Benchmark for Efficient Drug Pricing Model, called GLOBE, and the final rule states: “These regulations are effective on November 30, 2026.”
GLOBE applies to “approximately 25 percent of beneficiaries who are enrolled in OM Part B,” meaning Original Medicare Part B, the part that covers outpatient care. The rule says the areas are picked by chance: “The GLOBE Model geographic areas will be determined through a random selection of ZIP Code Tabulation Areas (ZCTAs).”
For a person in Original Medicare, the useful question is whether their own ZIP code lands in the drawn areas. Someone inside them may pay less for certain Part B drugs. Someone outside them sees no change from this model. The people most likely to notice are those who get drugs through a clinic or a doctor’s office, since those are the drugs Part B pays for.
A drug-price model is about Part B drugs in some ZIP codes, while the Medicare costs most households carry sit elsewhere: premiums and the drugs filled at the pharmacy. The Medicare Cost & Coverage Protection Kit includes 51 state Medicare cost-help packs and the new Part D out-of-pocket cap.
Get the state cost-help packs and Part D cap guide beside the GLOBE change →
Mandatory for drugmakers, not for patients
The word “mandatory” in this model describes the drug companies. The rule says GLOBE “will require mandatory participation for all manufacturers” of Part B rebatable drugs that are GLOBE Model drugs. A drugmaker with a covered product cannot decline to take part.
The model works through rebates. According to a law firm summary of the final rule, manufacturers pay rebates when a drug’s U.S. price exceeds an international benchmark. The same summary lists exclusions: orphan-only drugs, cellular and gene therapy products, and plasma-derived products.
What patients see, and when
The Nov. 30 date is when the rule takes effect, not when prices change at the clinic. The rule sets the model’s performance years as running “from April 1, 2027 through March 31, 2032.” Trade coverage in the American Journal of Managed Care says the reduced coinsurance for GLOBE drugs in participating areas applies over those same April 2027 to March 2032 dates.
That article describes the drugs as single-source drugs and sole-source biologicals in oncology, rheumatology, immunology, ophthalmology and endocrinology, with Original Medicare spending above $100 million a year. People who get infusions or injections in those fields are the ones to watch. Coinsurance is the share a patient pays after the deductible, so a lower benchmark-based price can mean a lower bill for the patient.
Trade reports differ on labels for the early dates. Both the law firm summary and the AJMC story give Jan. 1, 2027 as the model’s launch, while the rule itself counts performance years from April 1, 2027. For a patient, the April date is the one tied to coinsurance. AJMC reported the CMS announcement on Sept. 30, two days before the rule went on public inspection.
The savings estimates
CMS puts a dollar figure on the patient side. The rule says “the GLOBE Model is expected to generate $177 million in total out-of-pocket savings.”
The law firm summary reports a different type of number, $80 million in annual Medicare Part B net spending savings and about $440 million over the model’s full period. That figure is about what Medicare spends, not about what patients pay.
The law firm’s write-up describes the final model as scaled down by CMS, and it reaches about a quarter of Part B enrollees, not all of them.
Finding out whether a ZIP code is drawn
The agency running the model is CMS, and its site at cms.gov is the no-cost route for the list of areas and for notices about the model. The rule text says areas are chosen by random draw of ZIP Code Tabulation Areas, which are census-based areas that roughly follow ZIP codes, so a home address may need to be matched to its area.
Until that match is made, the practical step is to know which Part B drugs are in the household’s treatment. Someone on a regular infusion or injection can ask the clinic’s billing office what coinsurance was charged on the last visit, and then ask again once the April 2027 start approaches. Keep the explanation of benefits from each visit, since it shows the drug, the allowed amount and the patient share.
The final rule, available as a public inspection copy at the Federal Register, is the document that sets the Nov. 30 effective date, the 25 percent share and the random selection of areas.
For costs outside the drugs GLOBE touches, The Medicare Cost & Coverage Protection Kit pairs the new Part D out-of-pocket cap with a medication and cost tracker, so each drug’s cost can be followed through the year.
Get the Part D cap guide and tracker for Medicare drug costs →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
