At Some Point, Results Matter More Than Relationships
One of the hardest leadership decisions isn’t identifying a failing partnership.
It’s admitting the partnership no longer deserves the benefit of the doubt.
I was talking with a colleague recently—let’s call her Elly—who was wrestling with exactly that.
Years ago, a vendor partner (“Jay”) had been exceptional. Her team loved him. The relationship was strong. The value was obvious. Problems got solved. Innovation happened. The partnership moved the business forward.
But over time, something changed.
Performance flattened. Meetings became repetitive. The same stale solutions kept reappearing in new PowerPoints. Response times slowed. Friction increased.
The relationship still felt familiar. It just no longer felt valuable.
Normally, this would be a straightforward business decision.
But Jay wasn’t just a vendor anymore. He was a trusted colleague. Someone Elly respected deeply. Someone who had earned goodwill over years of partnership.
And that was the problem.
Because once relationships become personal, leaders often stop measuring outcomes objectively. We start protecting history instead of evaluating performance.
That dynamic shows up quit a bit in workers’ comp pharmacy.
A PBM that “has always handled the account.”
A partner everyone is comfortable with.
A solution that once felt innovative… but hasn’t meaningfully evolved in years.
Meanwhile, the market keeps moving.
Specialty spend accelerates.
Transparency expectations rise.
Regulatory scrutiny increases.
Clinical complexity deepens.
But many buyers are still getting the same:
stale reporting
recycled clinical programs
opaque pricing logic
overcomplicated workflows
and innovation theater disguised as strategy
That’s the danger of trusting relationships more than results. Because familiarity has a way of masking decline.
Especially in PBM, where complexity can make mediocre performance look sophisticated.
And over time, the relationship itself becomes the justification.
Not the outcomes.
That’s the moment leaders need to pause. Because strong partners don’t ask you to ignore the scoreboard.
They want accountability.
They want transparency.
They want the results to speak for themselves.
The partnerships that struggle most with scrutiny are often the ones benefiting most from inertia.And inertia is expensive. Especially now.
The PBM market is entering a different era—one where buyers are starting to care less about legacy relationships and more about alignment, innovation, transparency, and measurable outcomes.
That shift matters. Because the question is no longer: “How long have we worked together?”
It’s becoming: “What are you doing today that meaningfully improves my program tomorrow?”
That’s a much harder question for stale partner to answer. Elly already knew what needed to happen.
That wasn’t the hard part.
The hard part was accepting that respect for someone’s past contribution does not obligate you to tolerate current underperformance.
That’s uncomfortable.
But it’s also leadership.
Because in the end, trust should reinforce results—not replace them.
And the moment trust starts asking you to ignore the outcomes…it may be time to trust the results instead.
And if you do, let’s connect.
About P4P
A Strategic Dose of Clarity in a Noisy PBM Market
Written by Prodigy CEO, Del Doherty, P4P delivers sharp, consultative insights for decision-makers who are tired of legacy models, hidden costs, and passive vendors. Each piece is a prescription—cutting through the noise to reveal what actually drives performance in pharmacy benefit management. No fluff. No spin. Just insight that pays off.
