A new Yale University study raises questions about how the Trump Administration’s proposed Medicare international reference pricing (IRP) models, GLOBE and GUARD, could affect access to innovative therapies. The models would require manufacturers to pay rebates when U.S. drug prices exceed benchmark prices in certain peer countries.
Researchers analyzed 211 novel therapies approved between 2015 and 2019 and found that 79 would have qualified for the models. While about 60% launched in more than one of the 19 reference countries within a year of U.S. approval, only 40% launched in countries with combined populations comparable to Medicare’s beneficiary base, and just 1% launched in countries with similar combined drug spending. Because many newly approved therapies are not broadly launched across the countries used to establish IRP, the researchers found that future pricing benchmarks may rely on a relatively small number of countries and markets. As a result, determining benchmark prices for new therapies may be challenging. These findings underscore concerns about whether IRP models can reduce costs without creating unintended consequences for patient access to innovative medicines. Learn more about the Yale study.
To learn more about Most Favored Nations pricing and it’s potential impact on patients, read Aimed Alliance’s 2026 Report.
