7 Critical Pressures Reshaping PBM Procurement

Organizations do not change procurement processes because they enjoy changing them. They change because external pressures gradually make the existing approach more difficult to justify.

That is exactly where Pharmacy Benefit Manager (PBM) procurement finds itself today.

Over the past decade, the PBM industry has become significantly more sophisticated. Pricing models have diversified, specialty pharmacy spending has grown rapidly, employers and health plans expect greater transparency, and procurement teams are evaluating more information than ever before. At the same time, policymakers, industry stakeholders, and the public have placed increasing attention on how pharmacy benefits are managed and purchased.

None of these developments, by themselves, require organizations to rethink procurement. Together, however, they are creating meaningful pressure to modernize how PBM services are evaluated and selected.

This is not because legacy procurement has failed. On the contrary, experienced procurement professionals, consultants, clinicians, legal teams, and financial leaders continue guiding successful PBM procurements every year. The opportunity is to build upon that expertise by reducing unnecessary administrative effort, improving transparency, and creating stronger foundations for decision-making.

Markets naturally evolve. Procurement should evolve with them.

The following seven pressures are reshaping PBM procurement. Individually, each one influences how organizations purchase pharmacy benefit services. Collectively, they illustrate why procurement itself is becoming an increasingly strategic advantage.

Executive Perspective
Procurement should evolve as markets evolve. The more complex an industry becomes, the more valuable transparency and comparability become.

1. The PBM Landscape Has Become Significantly More Complex

The PBM landscape today looks very different than it did even ten years ago.

Specialty medications account for a growing share of pharmacy spending. Employers are evaluating multiple pricing models, including pass-through arrangements and increasingly customized contract structures. Clinical management programs continue expanding, while reporting expectations have grown substantially as organizations seek deeper insight into pharmacy performance.

Each of these developments increases the amount of information requestors must evaluate before selecting a PBM.

Legacy procurement processes have adapted in predictable ways. Organizations ask more questions, require increasingly detailed responses, expand evaluation committees, extend procurement timelines, and devote additional resources to comparing proposals. Those adjustments have helped procurement keep pace with industry complexity, but they have also increased the administrative burden placed on everyone involved.

The challenge is no longer collecting information.

The challenge is transforming that information into meaningful comparisons that support confident executive decisions.

2. Transparency Is Becoming an Organizational Expectation

Transparency has moved beyond being a desirable characteristic of procurement. Increasingly, it is becoming an organizational expectation.

Executive leadership, governing boards, procurement teams, and consultants all benefit when vendor information is easier to understand and compare. Clearer information supports better governance, more informed discussions, and greater confidence that procurement decisions can be explained long after a contract has been awarded.

The expectation for transparency extends beyond procurement itself. Employers, health plans, coalitions, and other healthcare organizations continue seeking greater visibility into how healthcare dollars are spent and how vendor relationships are structured. While policy discussions continue evolving, the broader direction is clear: organizations increasingly value procurement processes that make vendor capabilities easier to evaluate.

Transparency benefits vendors as well. When evaluation criteria and vendor information are presented more consistently, organizations can focus less on interpreting documentation and more on understanding meaningful differences between competing approaches.

Transparency does not eliminate difficult procurement decisions. It simply makes those decisions easier to defend.

Executive Perspective
Better information does not guarantee better decisions. It creates the conditions that allow better decisions to be made.

3. Competition Depends on Visibility

Competition is often discussed as though it begins when proposals are submitted.

In reality, competition begins much earlier.

Before proposals can be compared, vendors must first become candidates for consideration. That initial step often receives far less attention than the evaluation process itself, yet it significantly influences the competitive landscape.

Organizations naturally develop bid lists that balance broad market participation with practical procurement management. Consultants provide valuable guidance, procurement teams establish qualification criteria, and requestors determine which vendors are most appropriate for their organization’s objectives. Those decisions are both necessary and appropriate.

At the same time, competition can only occur among vendors that have an opportunity to participate.

Established PBMs often benefit from greater market visibility because of their size, experience, and existing relationships. Regional PBMs and emerging organizations may offer compelling capabilities for certain requestors but receive fewer opportunities simply because they are less visible during the earliest stages of procurement planning.

Competition benefits requestors because it encourages innovation and creates opportunities to evaluate different approaches to solving similar challenges. Strengthening vendor visibility before procurement formally begins helps ensure organizations are comparing the strongest available options rather than only the most familiar ones.

Executive Perspective
Vendor evaluation determines who wins a procurement. Vendor visibility determines who has the opportunity to compete.

4. Procurement Expertise Is Increasingly Consumed by Administrative Work

Organizations invest in experienced procurement professionals because they bring judgment, not because they can manage spreadsheets more efficiently.

The same is true for consultants, clinicians, finance leaders, legal counsel, and subject matter experts. Each contributes a different perspective that helps organizations select a PBM capable of supporting both financial objectives and member outcomes. Their expertise becomes most valuable when they are evaluating tradeoffs, asking better questions, negotiating contracts, and planning successful implementations.

Yet much of a modern PBM procurement is devoted to work that, while necessary, creates little strategic value on its own.

Questions must be drafted and reviewed. Responses must be collected and validated. Pricing formats must be normalized. Spreadsheets require manual reconciliation. Internal stakeholders review overlapping information from different perspectives, often because vendors present similar concepts in completely different formats. Before meaningful evaluation can begin, procurement teams spend considerable effort transforming information into something that can actually be compared.

None of these activities are inherently inefficient. They are the natural consequence of evaluating highly customized proposals that were never designed to be analyzed side by side.

The opportunity is not to eliminate this work entirely. Procurement requires diligence, documentation, and consistency to ensure vendors are evaluated fairly. Instead, the opportunity is to reduce the repetitive administrative effort that surrounds procurement so experienced professionals can devote a greater share of their time to the work that organizations actually hired them to perform.

Imagine two procurement processes that consume the same total number of hours. In one, most of the effort is spent organizing information before meaningful analysis begins. In the other, structured vendor information allows procurement teams to spend that time discussing strategy, comparing solutions, evaluating financial models, and negotiating stronger agreements.

Both organizations invested the same amount of time.

Only one invested that time where expertise creates the greatest value.

Executive Perspective
Organizations hire experts for their judgment. Procurement should maximize the time available to apply it.

5. Growing Public Attention Raises the Importance of Procurement

Few areas of healthcare have received as much public attention in recent years as pharmacy benefits.

Employers continue looking for ways to manage rising prescription drug costs. Health plans are balancing affordability with access to innovative therapies. Policymakers at both the federal and state levels continue examining different aspects of the PBM industry, while patients increasingly want to understand how prescription benefit decisions affect their out-of-pocket costs.

These conversations extend far beyond procurement, but they have an important implication for organizations purchasing PBM services.

As industries receive greater public attention, purchasing decisions naturally receive greater scrutiny as well. Executive leadership, governing boards, and procurement teams increasingly benefit from procurement processes that are well documented, transparent, and capable of demonstrating why one vendor was selected over another.

History offers an important lesson across many industries. Markets that continuously improve transparency, encourage healthy competition, and adopt better standards are often better positioned to respond to changing expectations than markets that resist change until external pressures force adaptation.

That observation should not be interpreted as a prediction about future regulation. The future policy landscape will continue evolving, and procurement alone cannot resolve every challenge facing healthcare.

It does suggest something much simpler. Organizations that continuously improve how they evaluate vendors place themselves in a stronger position regardless of how the broader industry evolves.

Procurement has always been about selecting the right partner. Increasingly, it is also about demonstrating confidence in the process used to reach that decision.

6. Technology Is Changing What Good Procurement Looks Like

Technology has influenced procurement for decades, but recent advances are changing expectations about what procurement systems should actually accomplish.

Historically, technology focused on documentation. It stored proposals, tracked deadlines, managed communications, and created repositories for procurement records. Those capabilities remain important, but they primarily support the procurement process rather than improving procurement decisions.

Today, organizations increasingly expect technology to help them interpret information rather than simply organize it.

Artificial intelligence represents one example of this shift. When applied appropriately, AI can help procurement teams summarize responses, identify meaningful differences between vendors, organize supporting documentation, and accelerate comparisons that would otherwise require significant manual effort. These capabilities allow experienced professionals to spend less time locating information and more time evaluating it.

The effectiveness of these tools, however, depends heavily on the quality of the underlying data.

Information that is inconsistent, highly customized, or presented in different formats across vendors remains difficult to compare, regardless of how sophisticated the software becomes. AI can assist with analysis, but it cannot fully compensate for procurement processes that begin with information designed primarily for human interpretation rather than structured comparison.

That observation reinforces an important principle. Technology should enhance procurement expertise, not replace it.

Executive judgment remains essential when balancing financial objectives, clinical priorities, implementation risk, organizational culture, and long-term partnership considerations. Those decisions involve context that cannot be reduced to a score or ranking.

The greatest opportunity lies in allowing technology to perform the repetitive analytical work that precedes those decisions. When information is structured consistently, procurement teams gain the freedom to focus their attention where experience creates the greatest value.

Executive Perspective
Technology creates the greatest value when it reduces administrative effort without reducing human judgment.

7. Modern Procurement Needs a Better Foundation

Every procurement process begins long before an RFP is issued.

Organizations first determine their objectives, identify stakeholders, establish evaluation criteria, and develop a strategy for identifying potential vendors. By the time a formal procurement begins, many of the most important decisions about the process have already been made.

That early planning stage presents one of the greatest opportunities for modernization.

Rather than relying exclusively on organization-specific RFPs to gather comparable information, organizations can begin procurement with better visibility into the market itself. Structured vendor information allows requestors to understand capabilities earlier, identify meaningful differences more quickly, and begin formal procurement from a stronger position.

This is where Proposal for Requestors (PfRs) introduce a different model.

Instead of requiring vendors to recreate much of the same information for every procurement, PfRs allow qualified vendors to develop structured, standardized, reusable proposals that can be published within a secure marketplace accessible only to qualified requestors. Rather than replacing procurement, they improve the information available before procurement formally begins.

That distinction is important.

PfRs do not replace:

• Request for Proposals (RFPs)
• Consultant expertise
• Contract negotiations
• Legal review
• Executive decision-making

Instead, they strengthen the foundation those activities depend upon.

Consultants continue advising clients on procurement strategy, evaluating vendor capabilities, negotiating agreements, and supporting implementation. Procurement professionals continue defining qualification criteria and coordinating complex evaluations. Executive leadership continues making the final purchasing decision.

The difference is that each of those activities begins with information that is already more structured, more consistent, and easier to compare.

Improving the starting point improves everything that follows.

The Future of PBM Procurement

Every industry eventually reaches a point where the process surrounding the work becomes nearly as important as the work itself.

PBM procurement appears to be approaching that point.

The increasing complexity of pharmacy benefits, rising expectations for transparency, stronger competition, growing public attention, and advances in technology are all applying pressure to procurement processes that were designed for a different era. None of these pressures suggests that legacy procurement has failed. Instead, they illustrate why organizations are beginning to rethink how procurement can better support the decisions that matter most.

The strongest procurement processes of the future are unlikely to be those that collect the most information. They will be the ones that transform information into insight with the least amount of unnecessary administrative effort. They will allow consultants to spend more time advising clients, procurement professionals to spend more time evaluating vendors, and executive leadership to spend more time making informed strategic decisions.

Proposal for Requestors (PfRs) represent one approach to that evolution. By creating structured, standardized vendor information before formal procurement begins, they improve market visibility, simplify comparisons, and reduce repetitive work without replacing the expertise that successful procurement depends upon.

Organizations have always measured procurement by the quality of the vendors they select. Increasingly, they may also measure it by the quality of the process that helped them reach that decision.

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PBM procurement continues to evolve as organizations seek greater transparency, stronger competition, and more efficient ways to evaluate vendors.

Rapid Request is building a procurement platform centered on Proposal for Requestors (PfRs), helping qualified requestors discover structured, standardized vendor information earlier in the procurement process while supporting better-informed procurement decisions.