A 2025 National Alliance of Healthcare Purchaser Coalitions survey reveals that 61% of health plan purchasers replaced their pharmacy benefit manager (PBM) or planned to do so within three years. While this movement suggests a desire for change, Paul Pruitt, Chief Growth Officer at SHARx, argues that the standard request-for-proposal process remains flawed. Comparing traditional metrics like rebate guarantees and discounts often obscures the reality that high costs are baked into the starting price.
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Why Switching PBMs Often Fails to Lower Employer Drug Costs
Employers are increasingly cycling through pharmacy benefit managers in search of savings, yet many find that shifting vendors does little to address systemic overspending. Experts warn that unless companies fundamentally overhaul how they evaluate these contracts, they will continue to trade one inefficient model for another identical one.
Business Group on Health data shows pharmacy spending as a share of total employer healthcare costs climbed from 21% in 2021 to 27% in 2023. Simply selecting a new bidder does not resolve these pressures if the core financial incentives remain misaligned. Employers must look past contractual promises to scrutinize how vendors earn revenue, specifically regarding affiliated specialty pharmacies and rebate aggregators. True transparency requires verifying performance in real-time rather than waiting for annual audits. To achieve actual savings, organizations must shift their focus toward models where vendor success is directly tied to lower net costs and improved member access rather than increased prescription volume.
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