The cost of inefficiency: overcoming Medtech's contract renewal and expansion challenges

In the world of Medtech sales, contract renewal and expansion isn’t a mundane administrative task—it’s a critical strategic opportunity that can drive growth and shape the future of a business. The consequences of neglecting contract renewal and expansion can be grave. Revenue loss and leakage, strained stakeholder relationships, and compliance headaches are just a few of the potential downsides.  

Ineffective handling of contract renewals and expansions can also create opportunities for competitors to step in and win over your customers. Remember, it is usually easier to keep existing customers than to win over a competitor’s customers.  

In this fourth article in our blog series, industry-leading specialists from PwC and Conga explore how advancements in configure, price, quote (CPQ) and contract lifecycle management (CLM) technology and AI are helping Medtech companies retain high-value customers, identify timely upselling opportunities, and maintain a predictable revenue stream—all are often prerequisites for long-term success.

Why Medtech contract renewal and expansion matters

Successfully renewing Medtech contracts translates into a more consistent and predictable revenue stream. This stability also helps businesses weather economic uncertainties more effectively, easing the pressure to continually acquire new customers to sustain growth.

Renewal discussions are also an ideal juncture to explore upsell and cross-sell opportunities. By assessing a customer’s evolving needs and aligning them with complementary services or products, including new or upgraded products, you not only increase revenue but also can deliver more value to your customer.

Moreover, becoming more proficient at contract renewals helps reduce your customer acquisition costs. When you succeed in retaining your existing customer base, you save valuable time and energy that can be redirected toward strategic priorities—such as market expansion or diversification.

Medtech contract renewal and expansion: challenges and common pitfalls

Let’s take a moment to consider some of the challenges and complexities that typically plague Medtech customer success teams responsible for contract renewal and expansion.

A complex and dynamic customer ecosystem.

In Medtech sales, a large share of revenue flows through enterprise-level agreements with integrated delivery networks (IDNs), group purchasing organizations (GPOs), and other regional purchasing coalitions. IDNs continue to consolidate through M&A, while hospitals often join—or maintain concurrent memberships in—multiple GPOs to secure the more competitive price tiers and commitment terms. Because each affiliation determines who qualifies for a given discount, rebate, or volume obligation, every change in membership instantly reshapes the contract footprint. Staying ahead of those shifts is imperative; otherwise, manufacturers can face mispricing, rebate over-payments and avoidable revenue leakage.

Under-leveraged contracts

Medtech manufacturers frequently leave negotiated value on the table because vital contract insights are scattered across disconnected systems. Lacking an intelligence-driven, unified view of clauses—volume tiers, price-protection periods, rebate triggers—teams overlook renewal deadlines, let advantageous pricing lapse, or apply rebates incorrectly. These gaps create revenue leakage that erodes margins and gives better-informed competitors an opening to win business.

Reliance on stale, siloed data

Many Medtech companies lack centralized digital systems to track healthcare providers and facilities with whom they have contracts throughout the sales cycle. This means customer success teams often don’t have accurate and current information about individual customers to determine opportunities and inform sales pitches. Reliance on incomplete or stale data translates into missed upsell and-cross-sell opportunities, extended sales cycles, and compliance and pricing gaps—all of which can lead to significant revenue leakage.  

Miscommunication and confusion

Inefficient renewal management can leave teams and departments uninformed about pricing, renewals, and revenue. This can quickly lead to confusion and miscommunication, particularly in complex agreements. Beyond internal challenges, inadequate contract management and a lack of transparency can frustrate customers and damage relationships.

Complex renewal schedules

Managing contracts with intricate renewal schedules can be challenging and time-intensive, especially when using outdated systems that lack advanced features. For example, if you sell a $1 million MRI machine financed over three years, you may also need to bill the customer annually for software renewals, maintenance, and additional service fees, such as charges per image. These recurring revenue streams are at the heart of medical device renewals.  

Inflated cost-to-serve

Poor renewal management can also inflate the internal costs associated with renewing smaller contracts and subscriptions. While individually, these smaller contracts may seem insignificant, collectively, they can contribute substantially to overall revenue. The challenge for Medtech companies is confirming they nurture these customers and grow them into larger contracts and subscriptions without overburdening the sales team.

How technology helps speed and simplify contract renewal and expansion  

Modern technology—like the Conga Advantage Platform—features embedded renew and expand capabilities and automated cross-sell/upsell suggestions to prevent much of the manual effort involved in building and sustaining new and existing customer relationships.  

The benefits of these systems can include:

Centralized data for clear renewal insights

With an integrated platform, every stage of the customer commitment—quotes, pricing, contract clauses, billing schedules, rebate triggers, and renewal dates—lives in a single system. Role-based dashboards give customer-success, sales, finance, and legal teams a unified, real-time view of obligations and consumption trends, while automated alerts surface upcoming expirations or volume-tier milestones well in advance.  

For sales reps, these early warnings create the runway to craft personalized, value-led renewal offers instead of last-minute, defensive quotes—raising win rates and average contract value. By keeping pricing, contract, and billing data out of disconnected silos, teams can curb revenue leakage and help prevent the swivel-chair effort that once slowed Medtech growth.

Effortless communication and collaboration

Integrated CLM and CPQ solutions help facilitate teamwork among sales, legal, and customer success teams involved in the contract renewal and expansion process by providing a collaborative platform where stakeholders can work together seamlessly and in real time. As a result, renewals are managed efficiently, and contracts are executed on time.

Additionally, by proactively and automatically sharing information with customers, you can align contract terms with expectations—so potential issues can be identified and addressed early on. All this contributes to building trust and transparency, leading to more favorable contract terms and long-term partnerships.

Iterative enhancements and improvement

Embedded data analytics capabilities work behind the scenes, synthesizing large datasets and identifying trends in contracts and pricing models. Medtech companies can use these insights to enhance future agreements and increase their revenue potential.  

And with granular insight into how contracts perform over time, Medtech organizations can take steps to simplify their contracts, develop new product bundles, update pricing models, and tailor contract terms to better meet customers’ needs.  

AI-powered market and customer intelligence

Modern solutions draw on the power of AI to streamline renewal, uncover revenue opportunities within existing customer relationships, and act on them effectively. For example, AI can give MedTech companies insights on:

• Spend-to-commit gap: How does actual purchase volume compare with contracted tiers, and what true-up or upsell opportunity does that create?
• Utilization patterns: Which products, SKUs, or service lines a customer consumes most (or not at all) by site and modality, spotlighting cross-sell targets.
• Market and competitor benchmarks: External price and share-of-wallet data that shows where rivals are discounting or gaining traction, guiding defensive or value-based pricing.
• Next-best offer recommendations: AI-generated bundles, pricing, and contract amendments tailored to the customer’s usage and margin profile, ready for instant quote creation.

By ingesting this information, AI can suggest what different customers’ contract renewals or amendments should look like and auto-generate a new quote. This helps reduce the need for a new round of calls, meetings, quote development, and contract drafting. What used to take weeks or months can now be accomplished in days or even hours.  

The takeaway

Contract renewal and expansion in Medtech shouldn’t be fraught with risk and complexity. Advancements in AI-powered CLM and CPQ technology are transforming longstanding challenges into opportunities.  

These platforms make the process more effective and proactive by centralizing data, facilitating effortless collaboration, and surfacing real-time insights and up-and-cross-selling opportunities.  

By adopting these modern solutions, Medtech companies can enable a stable revenue stream, reduce customer acquisition costs, and build stronger, more transparent relationships.

© 2025 PwC US. All rights reserved. PwC US refers to the US group of member firms, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. This content is for general purposes only, and should not be used as a substitute for consultation with professional advisors.