Published
February 23, 2026
The U.S. Chamber of Commerce recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) opposing the proposed GLOBE and GUARD rules. These proposals, which aim to impose foreign price controls on medicines, risk undermining American medical innovation and patient access to life-saving therapies.
What’s happening:
CMS’s approach would impose payment “models” in Medicare that would tie the price of life-saving medicines to foreign government price controls, a move that fundamentally threatens the U.S. biopharmaceutical ecosystem. Foreign governments’ price-control regimes rely on non-market mechanisms that undervalue innovation and discriminate against vulnerable populations, including the elderly and disabled.
Why it matters:
The U.S. leads the world in life sciences innovation, driven by strong intellectual property protections and robust investment in research and development. The GLOBE and GUARD rules would dismantle this leadership by importing policies that have stifled innovation abroad.
Countries with price controls see fewer new medicines. While 85% of new drugs are available in the U.S., only 24% are accessible in Australia and 21% in Canada. Even when medicines are eventually available in price-controlled markets, patients face delays of 12–18 months, delays that in some cases can mean the difference between life and death.
The big picture:
The Chamber’s comments highlight how these proposals would harm patients, stifle innovation, and weaken U.S. economic competitiveness. By tying U.S. prices to artificially low foreign benchmarks, the proposed rules would:
- Reduce investment: Small biotech companies, which drive rare disease innovation, would face significant financial uncertainty, jeopardizing their ability to develop new therapies.
- Threaten rare disease treatments: With 95% of rare diseases lacking FDA-approved treatments, these proposals would further discourage investment in orphan medicines, leaving patients without options.
- Undermine U.S. leadership: At a time when global competitors are vying for dominance in life sciences, these policies would erode America’s competitive edge.
In addition, the proposed rules are deeply defective as a legal matter. The law requires payment models to address “a defined population for which there are deficits in care leading to poor clinical outcomes or potentially avoidable expenditures.” The proposed rules don’t meet these, and other, statutory requirements, so they aren’t legally authorized. The rules would also violate constitutional protections against arbitrary and confiscatory government action.
The Bottom Line:
The Chamber is urging CMS to withdraw these proposals and work with stakeholders to develop market-based solutions that ensure affordability without sacrificing innovation. The U.S. cannot afford to adopt policies that stifle the very innovation that saves lives.
About the authors
Brad Watts
Brad Watts is the Senior Vice President at the U.S. Chamber of Commerce's Global Innovation Policy Center (GIPC). He works with U.S. Chamber members to foster a political, legal, and economic environment where innovators and creators can invest in the next big thing for the benefit of Americans and the world.
Lexi Branson
Lexi Branson serves as Vice President of Health Policy at the U.S. Chamber of Commerce, where she leads the Chamber’s Health Policy Division.
