Healthcare and pharma procurement teams enter 2026 with rising spend, volatile supply markets, and higher expectations for performance.
For many leaders, the starting point for a new year is a clear procurement benchmarking report that shows how their KPIs compare with peers and where procurement best-practice benchmarks are actually being met.
The State of Spend Report, based entirely on real purchase orders, invoices, and supplier transactions, gives a unique view of how the industry actually operates. What's changing, where leaders outperform, and where risk is rising?
This article summarizes the trends, benchmarks, and KPIs procurement leaders most frequently look for as they plan 2026.
Full details, including category-level KPIs and distributions for top, average, and bottom performers, are available in the complete State of Spend procurement benchmarking report.
Total healthcare spend has risen steadily since 2022 and remains above the 2022 Q1 baseline on an inflation-adjusted basis for both direct and indirect categories.
Key structural drivers are visible in the data and in the wider market:
Even small categories are strategic priorities. Fleet spend, for example, accounts for roughly 0.6% of revenue, but about 52% of that spend goes to fleet management services, signaling fleet modernization rather than simple operating cost (State of Spend, 2025).
Takeaway for 2026: Treat cost pressure as structural. Plans for 2026 should assume sustained spend growth rather than a return to pre-2022 levels.
AI adoption accelerated through 2025, but the State of Spend data shows that results depend on digital maturity. Organizations that meet or exceed procurement best practices benchmarks in process design capture more AI value.
Common traits of higher-performing, AI-ready procurement functions:
Higher spend per invoice, indicating consolidated and well-designed purchasing.
Invoice volume is a strong differentiator. Top performers process well below 100,000 indirect invoices per 1B USD, while lower performers can exceed 250,000 (State of Spend, 2025).
In other words, AI performs best where processes are already standardized, data is structured, and channels are consolidated. Where spend is fragmented, and PO discipline is weak, the same tools deliver much less impact.
Takeaway for 2026: AI amplifies well-structured procurement processes, but it does not fix fragmentation. Strengthen PO discipline, master data, and category governance before scaling AI.
Payment-term discipline is one of the fastest, most scalable levers for working-capital gains.
According to the State of Spend 2025 dataset, moving from bottom-performing payment behavior to best-in-class execution can unlock around 65k USD in working capital per 1M USD of spend.
This improvement comes from:
Small shifts in average days to pay, applied consistently across large spend bases, convert into meaningful cash benefits.
Takeaway for 2026: Payment terms will likely play a larger role in cash-flow management than in prior years. Treat payment terms as an integral part of the healthcare and pharma procurement strategy, not just a finance concern.
Invoice load remains unusually high across the sector. A median of ~85,000 invoices per 1B USD of spend is observed across the dataset, though the range varies sharply by performance tier.
Process materially fewer invoices for the same spend
Achieve higher spend per invoice
Demonstrate more stable cycle times and cleaner matching between POs, invoices, and payments
Manage two to three times the invoice volume
Struggle with fragmented spend and inconsistent channels
Experience slower processing and weaker category insight due to high transactional noise
The State of Spend report breaks this out by direct vs. indirect categories, but the pattern is consistent: fewer, better-structured transactions drive better efficiency and insight.
Takeaway for 2026: To move toward procurement best practices in invoicing:
The 2025 State of Spend dataset highlights a group of procurement KPIs that consistently separate top-performing teams from the rest.
These metrics have the strongest impact on cost, cash flow, process efficiency, and resilience.
PO coverage is one of the clearest indicators of procurement process control.
Higher PO coverage is strongly associated with:
Better spend data quality
Fewer exceptions and off-PO purchases
More predictable financial and budgeting outcomes
This KPI is a practical proxy for transaction and invoice processing efficiency.
In the 2025 dataset, the median is around 85,000 invoices per $1B, but the spread between performance tiers is wide enough to influence working capital and payment execution costs
Spend per invoice captures how well categories and buying channels are designed and governed.
Higher spend per invoice usually indicates:
More structured and consolidated purchasing models
Better catalog and contract utilization
Lower transactional workload for the same level of spend
The number of active suppliers per $1B of spend directly affects risk and leverage. The median remains high, especially compared with more consolidated industries.
This KPI influences:
Supplier risk exposure
Negotiating power and price consistency
Supplier management and onboarding overhead
Invoice-to-due timing links operational speed with cash discipline. It is particularly important in categories where payment terms are strategic.
This KPI helps you understand:
Category spend as a share of revenue highlights differences in cost structure and demand patterns, especially in indirect spend such as:
HR
Professional services
Marketing and media
IT and SaaS
These procurement KPIs are a practical starting point for 2026 planning. They help teams:
Prioritize improvement initiatives
Quantify the impact of procurement and automation
Make mid-year course corrections as business conditions change
The full State of Spend report includes benchmark ranges for top, median, and bottom performers, plus category-level comparisons that show where the biggest performance gaps — and opportunities — sit.