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National CooperativeRx regularly evaluates its PBM partnerships and explores the broader marketplace to ensure members have access to competitive pharmacy benefit solutions. Every three years, National CooperativeRx conducts a comprehensive request for proposal (RFP), inviting PBMs to submit proposals and demonstrate the value they can deliver to the Cooperative and our members.
On October 19, 2026, National CooperativeRx officially launched an RFP for pharmacy benefit services, with the support of an independent consultant. This RFP comes at an opportune time as the PBM industry continues to undergo significant change. The process will provide insight into how PBMs are responding to market pressures, adapting their business models, and evolving their service offerings. The approaches of the industry’s three largest PBMs will be an important part of this review, given their significant influence on the broader pharmacy benefits landscape. We have also engaged certain mid-market PBMs who we believe could support the needs of our membership at viable price points.
Member-Focused Evaluation
As a member-owned and governed Cooperative, National CooperativeRx has a responsibility to ensure its PBM partnerships serve members’ best interests. This responsibility guides how we evaluate proposals, looking beyond pricing alone to consider the contractual protections, service capabilities, and overall value they can deliver to our diverse membership.
National CooperativeRx is working with an independent consultant to guide the RFP process and support an objective, thorough review of submitted proposals. The evaluation will examine pricing and contractual terms, including contract definitions and guarantees, alongside the clinical programs, member support, and data reporting capabilities that shape the pharmacy benefit experience.
Recent RFPs and market checks have also reinforced the importance of understanding how PBMs are responding to industry shifts. National CooperativeRx will consider how well each PBM is positioned to respond to future developments. This includes assessing the flexibility of their approaches, their capacity to address emerging challenges, and their ability to continue delivering value as member needs and the pharmacy benefits landscape evolve.
National CooperativeRx has already met with three potential PBM partners to learn more about their approaches to pharmacy benefit services. Ultimately, our goal is to identify PBM partners that deliver the strongest overall value while providing the capabilities and flexibility to support our members’ current and future needs. Our focus will continue to be on PBMs who recognize the value of our collective purchasing power.
Marketplace Change & Controlling Spend
Historically, PBM pricing has focused on discounts and rebates. While National CooperativeRx has long championed contract language and proper management to achieve lower costs, the rest of the marketplace has not always followed. There is often a correlation between higher spending and higher rebates. Some modeling does not show the impact on costs when higher rebates are guaranteed.
Our hope for this changing marketplace is that PBMs will focus more on the bottom-line cost of pharmacy benefits. PBMs have shared with us their vision for this, and we are excited to work with a PBM consultant ready to analyze all the data points necessary to determine who can best control costs.
An Ambitious Timeline
National CooperativeRx is targeting March 2027 to release the RFP results. This aggressive timeline is intended to give current and prospective members sufficient time to understand their options, evaluate a potential PBM change, and prepare for the 2028 plan year.
The RFP does not necessarily signal a change in National CooperativeRx’s current PBM partnerships. The process could reaffirm the value of current relationships while providing market insights to inform negotiations and identify opportunities to strengthen our existing master PBM contracts.
Whether the process leads to a new PBM partnership or stronger agreements with current partners, we are confident our members will be well positioned for the 2028 plan year and beyond.
Expertise and Oversight Beyond the RFP
National CooperativeRx’s role extends well beyond selecting PBM partners and negotiating master contracts. Our in-house pharmacy benefit experts provide ongoing oversight by monitoring industry developments, evaluating plan performance, and holding PBM partners accountable to the terms of our agreements. This ongoing involvement gives members an added layer of expertise and oversight beyond the standard plan sponsor–PBM relationship—and is a key differentiator of our Cooperative.
To Be Continued
National CooperativeRx will keep members informed as the RFP process progresses and key milestones are reached. We look forward to sharing additional updates as they become available.
To learn more about the RFP or National CooperativeRx’s approach to pharmacy benefits, contact your National CooperativeRx account representative or use our online contact form.
