RxBenefits Releases Pharmacy Benefits Market Report to Help Benefits Advisors Evaluate Transparent PBMs

New Report Provides Five Ways to Assess Vendors on Savings, Clinical Depth, and Service

BIRMINGHAM, Ala., Aug. 10, 2026 /PRNewswire/ -- RxBenefits, Inc., the nation's only pharmacy benefits optimizer, has released its Market Report "How to Evaluate Transparent PBMs with Confidence: A Practical Guide for Benefits Advisors." This new report is designed to help benefits advisors and HR leaders assess pharmacy benefits managers (PBM) with greater confidence, identifying vendors that deliver real value, meaningful savings, and strong service. The report arrives as evolving federal and state transparency legislation and a growing number of transparent PBM models reshape how self-funded employers evaluate their pharmacy benefits options.

The report's central finding challenges a common assumption: transparency isn't a savings strategy on its own. A pass-through contract provides greater visibility into plan economics, but it doesn't automatically lower a client's costs. What separates strong vendors from disappointing ones is solid execution, a strong utilization management approach, and the ability to sustain high-quality service after go-live.

The report gives benefits advisors five areas to evaluate against every PBM vendor:

• Savings execution
• Clinical depth
• Channel optimization
• Implementation quality
• Service durability

Of these, clinical management depth stands out as the single most important differentiator. Human-led clinical reviews of high-cost claims can produce better results than automated systems that only check claims against preset rules.

The stakes are concentrated in a small share of claims. Fewer than 2% of prescription claims account for more than 50% of total pharmacy spend, and a single specialty drug can add more than $250,000 per year to plan costs. GLP-1 medications illustrate the pressure: national spending on these drugs rose more than 500% between 2018 and 2023.

"Transparency is the price of entry now, not the finish line," said Nathan White, Chief Client Officer at RxBenefits. "The advisors who consistently deliver lower net cost look past pricing structure to clinical depth, channel execution, and ongoing engagement, because that's where the savings are actually won or lost."

The full Market Report is available here.

RxBenefits will explore these themes further in an upcoming webinar, "The Transparent PBM Shift: What It Means for Your Clients," on Tuesday, August 11 at 11 a.m. CT/12 p.m. ET. The moderated panel, built for benefits advisors representing self-insured plans, will feature Nathan White and Mark Campbell, PharmD, Chief Pharmacy Officer at RxBenefits. 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 
[email protected]

SOURCE RxBenefits