Most-Favoured-Nation Pricing for Prescription Drugs in US Medicare: A Cohort Study

Across 195 brand-name drugs, the most-favored-nation payment models for Medicare Part B (GLOBE) and Part D (GUARD) were estimated to yield net savings of $5.2 billion (16.1%) and $6.4 billion (17.6%), respectively, though savings would fall by more than 70% if manufacturers with separate agreements with HHS were exempted. For about three-quarters of drugs, projected Medicare savings exceeded the drug’s total annual sales in the lowest-priced reference country, suggesting manufacturers may be incentivized to delay launches or take other steps to avoid setting low reference prices abroad.