Structural changes and increasing market dynamics in the health care sector intensify the hospitals’ needs for cost-savings and process optimization. The adoption of new information and communication technology (ICT) is thereby seen as opportunity to improve not only efficiency and effectiveness but also the quality of health services. As costs for drugs continuously increase, especially hospital pharmacies will be in need of acquiring expertise and technology in order to enhance the sourcing processes. The diffusion of e-procurement is however slow in this area. To investigate why hospital pharmacies only have a modest adoption rate of e-procurement, case studies of three distinct Swiss hospitals with differing organizational structure and automation degrees are presented. It will be shown that technological as well as organizational change is needed in order to efficiently use e-procurement in future.