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Plan sponsors renew PBM contracts at lowest rate in 10 years
A 2026 survey found PBM satisfaction held at 7.2 out of 10, while the share willing to renew without a competitive RFP fell to 6.4.
Plan sponsors are more willing to shop for a new pharmacy benefit manager, with a 2026 industry survey showing renewal intent is at the lowest level in the past decade. Insurance Business reports that most plan sponsors still do not fully understand what their current PBM contract allows them to do.
The 2026 Pharmacy Benefit Manager Customer Satisfaction Report, published by Pharmaceutical Strategies Group, surveyed 250 benefits leaders representing employers, health plans, and health systems in May and June. The report says overall PBM satisfaction stabilized at 7.2 out of 10, nearly unchanged from 2025 but down from 8.2 in 2021.
While satisfaction was relatively steady, the survey points to a sharper divide when it comes to renewal behavior. According to Insurance Business, plan sponsors' likelihood of renewing their PBM contract without issuing a competitive RFP fell to 6.4 in 2026, the lowest point in the survey's 10-year history, and stayed above 8.0 from 2017 through 2020.
Insurance Business also notes that the report received no financial support and was stated to be solely responsible by PSG, which positioned the findings as a sign that transparency and contract clarity remain key concerns for plan sponsors.