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GUARD program proposes to offer lower drug prices for consumers
Dec. 22, 2025
Under a proposed mandatory model from the U.S. Centers for Medicare and Medicaid services, enrollees in the program could save on out-of-pocket medication costs. Called Guarding U.S. Medicare Against Rising Drug Costs (GUARD), the program is proposed to start for a five-year period on Jan. 1, 2027. Under GUARD, CMS would require manufacturer rebates when the price of the drug exceeds that of an international benchmark based on what other comparable countries pay. Thus, the net cost to Medicare for certain Part D drugs would be similar to what other comparable countries pay.
SKYROCKETING DRUG PRICES
According to the CMS, Medicare prescription drug costs continue to skyrocket, with total Part D gross drug spending jumping from $121 billion in 2014 to $276 billion in 2023, an increase of nearly 10% annually. In 2024, Part D drug spending made up about 30% of overall gross drug spending in the U.S.
“The intent of the proposed GUARD Model is to test an innovative payment model that modifies the inflation rebate for GUARD Model drugs using international drug pricing information to identify a benchmark that reflects prices paid in a set of economically comparable countries, which CMS expects would reduce program expenditures for Medicare Part D while preserving or enhancing beneficiaries’ quality of care,” a Dec. 21, 2025, press release from CMS states.
AIM TO MAKE COSTS MORE AFFORDABLE
Mehmet Oz, MD, says, “Seniors who rely on Medicare Part D drugs should never have to choose between filling their prescriptions and filling their grocery carts or gas tanks. That’s why we’re proposing the GUARD Model to reduce costs and improve quality of care by addressing the broken pricing system that forces Americans to pay top dollar for drugs foreigners get at a fraction of the cost.”
Additionally, ophthalmic agents are listed as a category of drug that would be covered.
Public comments on the Notice of Proposed Rulemaking may be submitted by Feb. 23, 2026. Read the full press release here.
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