The Centers for Medicare & Medicaid Services proposed two mandatory demonstration models intended to lower Medicare drug prices by aligning U.S. payments with international benchmarks and most‑favored‑nation concepts. The program design targets both Part B (physician‑administered) and Part D (retail) channels and is framed as a means to reduce federal spending on branded medicines. CMS described the pilots as building on prior pricing initiatives but acknowledged industry pushback is likely. The proposals could reshape manufacturer negotiations, Part B reimbursement pathways and device/biologic contracting if finalized. Stakeholders including drugmakers, PBMs and insurers will evaluate operational impacts, legal risks and potential downstream effects on access and commercial strategies.