5 Strategic Priorities for PBM CIOs and CTOs in 2025

Many of these lists of priorities for technology leaders can be a little idealistic with a list full of bleeding-edge technology innovations. Recognizing that most technology leaders in pharmacy benefits management are dealing with a different but equally complex set of challenges, here are the five priorities our team of technology modernization strategists are actually seeing PBM IT leaders tackling in the upcoming year.

1. Microservices Complexity

Some PBM platforms that have begun a move to microservices are failing to realize the expected benefits. A look under the hood often reveals improper domain boundaries and a partial decoupling of application architecture. This leads to increased complexity, higher costs, lock-step deployments, and technical debt. A key focus for 2025 will be on improving service decoupling through techniques like asynchronous communication and independent data stores. Strong senior technical leadership with experience in distributed systems will be crucial for success.

2. Data Maturity

Modernization often leads to an explosion of data from various sources but can raise issues with data siloes, data quality, and unclear lineage. All of which can disrupt the already difficult process of extracting clear requirements from business stakeholders to help them actually utilize the data. The long-term goal is a structured data strategy that covers requirements gathering, data governance, and integrity constraints, breaks down data siloes, and introduces tools to meet those requirements. In 2025, we’re seeing PBMs make incremental progress by systematically automating manual reports. Being able to automate the ingestion, cataloging, and analysis of that data requires a lightweight data governance strategy and the implementation of a data architecture.

3. AI-Assisted Automation

AI adoption in the industry is accelerating. In 2025, expect to see increased use of AI for tasks like document processing, information summarization, and initial decision-making in areas like claims. Leveraging pre-trained AI models to build applications within their own cloud infrastructure can offer a safe and efficient way to get started. For longer-term strategies, a robust data strategy is the first step for AI readiness.

4. Developer Experience

Modernization initiatives, while beneficial, can introduce increased complexity into core systems (especially if the legacy system and new system are running concurrently). This, combined with limited leadership capacity, can result in new forms of technical debt being accrued. To mitigate this, in 2025, technology leaders are focusing on scaling their leadership through reusable architecture assets, CI/CD pipelines, robust documentation practices, observability, infrastructure-as-code, standardized tooling, and well-defined design systems. All of these are introduced as part of an intentional developer experience focused on accelerating engineers and making it easier to follow the best practices set out by the organization.

5. Hybrid Cloud POCs

As with many blanket-approach strategies, migrating everything to the cloud is just not feasible or even warranted for many PBMs. In 2025, we’re seeing cloud proof of concepts as a common theme to meet in the middle and make progress. Partnering with Infosec teams to establish a DevSecOps approach is the key to realizing a seamless Hybrid Cloud architecture. Success requires identifying incremental efforts that bring together software development, operations, and cybersecurity to collaborate on resilient architecture built on scalable and compliant infrastructure. Common solutions may be accelerated using cloud provider technology, such as Landing Zone accelerators (pre-configured compliant environments for SOC, HIPAA, etc.), portable containers, and seamless storage gateways.

2025: The Year of Evolution

2025 is set to be an exciting year where more PBM companies continue to take giant leaps forward toward a modern technology ecosystem. The key will be ensuring they reinvest the right way so that their systems are evolutionary and enable them the flexibility to change and adopt new technology now and in the future.

Want to take a more evolutionary approach to PBM modernization? Download our latest guide here: The Future-Proof PBM Platform: 7 must-haves for an unbeatable platform.

Want to learn more about how Praxent can help you accelerate and derisk your initiatives this year? Click here: https://info.praxent.com/pharmacy-benefits-management