Seven Data Trends Reveal the Most Unsettled Pharmacy Benefits Market in Years

BIRMINGHAM, Ala., Oct. 12, 2026 /PRNewswire/ -- RxBenefits, Inc., the nation's only pharmacy benefits optimizer, has today released its new market report, "2026 State of Pharmacy Benefits Decisions: The Churn Trap." The report draws on proprietary survey data fielded by FTI Consulting on behalf of RxBenefits, capturing responses from 601 employers and 300 employee benefits consultants and advisors, all with decision-making authority over pharmacy benefits.

The findings paint a telling picture. Three out of four employers have changed their pharmacy benefits advisor in the past 12 months or plan to within the next 12 months, and 87% say they're likely to switch their pharmacy benefits manager (PBM) at contract renewal. The advisor relationships and vendor arrangements that once anchored pharmacy decisions are losing their hold, leaving a market that feels much less stable.

The drivers are well-documented. Rising costs show no sign of leveling off, transparency has shifted from competitive advantage to table stakes, and new federal disclosure requirements have put advisor compensation and fiduciary obligations under a level of scrutiny the market hasn't seen before. Taken together, these pressures have pushed clinical management to the center of every provider evaluation, raising the bar for what advisors and PBMs must prove, not just promise.

The report maps those pressures across seven data trends, each one grounded in new survey data, and together paint a clear picture of where the market is breaking down and what it takes to hold ground in it.

Among the report's key findings:

• Advisor trust has a shorter shelf life. Employers still rely on benefits advisors to guide pharmacy decisions, but scrutiny of compensation arrangements and fiduciary obligations has raised the bar for what earns and keeps that trust.
• Transparency is no longer a differentiator. When nearly every provider claims it, the label stops doing any work. Employers have moved on to harder questions about guarantees, rebates, and clinical results.
• The line between transparent and traditional PBMs is blurring. Employers aren't buying the label anymore — they're asking harder questions about plan economics including guarantees, rebates, and clinical results.
• Clinical management is now the primary lens for provider evaluation. With net drug spend exceeding $600 billion, employers want proof a partner can move the trend, not just measure it.
• GLP-1 strategy is a standalone test of provider readiness. Employers now treat GLP-1 trend management as its own evaluation criterion, expecting a defined approach to coverage controls, step therapy, and program design.

The report's bottom line: optimization beats replacement. In a market defined by switching, another vendor swap rarely solves the underlying problem. What employers and advisors need is active management backed by measurable proof.

"Employers are stuck in a churn trap, and another vendor swap won't break it," said Kyra Hagan, senior vice president, marketing and communications, at RxBenefits. "What ends the cycle is proof, not promises. Advisors and employers who can point to documented savings, performance guarantees, and real clinical results give their clients a credible reason to stop switching and start optimizing."

The full Market Report is available here.

RxBenefits experts will discuss these themes in an upcoming webinar, "The Loyalty Gap: What 601 Employers and 300 Advisors Told Us About Pharmacy Benefits in 2026," taking place Oct. 13 at 11 a.m. CT / 12 p.m. ET. The moderated panel, built for benefits advisors representing self-insured plans, will feature Jasmine Aral, senior vice president of PBM strategy and partnerships, and Bradley Nelson, vice president of clinical services. Registration is available here.

More information about RxBenefits is available at www.rxbenefits.com.  

About RxBenefits  

RxBenefits is the nation's first and only Pharmacy Benefits Optimizer (PBO), partnering with benefits advisors and self-funded plan leaders to deliver high-value, client-aligned pharmacy solutions. By combining deep marketplace expertise, aggressive PBM pricing negotiations, independent clinical oversight, and award-winning service, RxBenefits helps organizations control pharmacy costs while ensuring members receive seamless, high-quality care and best-in-class support. Headquartered in Birmingham, Alabama, RxBenefits serves more than 3 million members nationwide. For more information, visit www.rxbenefits.com.   

For media inquiries, please contact: 

Jill Kipnis 
205-208-8323 
jkipnis@rxbenefits.com

View original content to download multimedia:https://www.prnewswire.com/news-releases/rxbenefits-report-finds-3-in-4-employers-have-changed-or-plan-to-change-pharmacy-benefits-advisors-in-next-12-months-302903751.html

SOURCE RxBenefits