Alliance: GLOBE and GUARD’s Reliance on International Reference Pricing Risks Restricting Patient Access

Today, the Alliance for Aging Research submitted comments on the Centers for Medicare & Medicaid Innovation’s (CMMI) proposed Global Benchmark for Efficient Drug Pricing (GLOBE) and Guarding U.S. Medicare Against Rising Drug Costs (GUARD) drug pricing models, warning that both demonstrations rely on international reference pricing approaches that would tie Medicare drug payments to prices set by foreign governments.

In separate coalition letters, the Alliance and more than 35 partner organizations explain that although these models are framed as demonstrations, they function as Most-Favored Nation–style price control policies that risk restricting patient access, importing discriminatory value assessments such as QALYs into Medicare, and undermining the innovation ecosystem older adults rely on for future treatments.

The letters also highlight that neither model is likely to meaningfully reduce beneficiaries’ out-of-pocket costs and urge the Center for Medicare & Medicaid Services (CMS) to withdraw the proposals and instead pursue patient-centered reforms that lower costs while preserving access, protecting equity, and sustaining medical innovation.