Fewer employers are relying on a traditional pharmacy benefit manager (PBM) model to run their entire Rx program. Use of transparent PBMs among employers increased to 31% in 2025 last year from 12% in 2024, according to the National Alliance of Healthcare Purchaser Coalitions.
For brokers and consultants, this shift shows up across the book of business as a move toward disintermediation. In practice, plan sponsors are unbundling the traditional PBM model and moving to a multi-vendor configuration, whether that means changing PBM contracting structures, carving out specialty management, or layering clinical navigation and other partners alongside the PBM.
