PBM Satisfaction Among Health Plans Drops to Three-year Low
In 2022, customer satisfaction with pharmacy benefit managers (PBMs) reached a three-year low, according to a recent report from the Pharmaceutical Strategies Group (PSG). This year’s PBM customer satisfaction score was 7.8 out of 10, compared with 8.2 in 2021 and 8 in 2020. Analysts believe this drop may be linked to rising drug prices and negative public sentiment since the COVID-19 pandemic.
PSG’s report revealed that satisfaction with specific PBM services and functions was similar to previous years, but overall customer satisfaction decreased in 2022. PBMs received low satisfaction marks for member services and actionable reporting, indicating that health plan sponsors are likely looking for complete and transparent data reporting as well as actionable insights. However, this isn’t happening to the extent customers want.
PBMs also received mixed reviews regarding transparency, with almost a quarter of respondents being “somewhat” or “very” dissatisfied with their PBM’s transparency. Additionally, most customers were not satisfied with their PBM’s medical benefit management. The likelihood of a customer recommending their PBM to a colleague decreased from 8.1 in 2021 to 7.6 in 2022.
Despite the drop in overall customer satisfaction, PBMs received high scores in essential functions, including the following categories:
Retail network options that meet member needs
Eligible data management
Account management
Regulatory and IT security compliance
Additionally, PSG’s report indicated that health plans’ customer satisfaction with PBMs differed from employers. Health plans reported a significantly lower PBM satisfaction in nearly every service and function than employers.
PBMs Linked to Higher Drug Prices
During the COVID-19 pandemic, PBMs benefited from positive public attention. However, public perception seems to have soured recently due to certain PBMs’ business practices being linked to higher drug prices. For example, a practice called spread pricing allows PBMs to charge plan sponsors one rate for a drug while simultaneously reimbursing network pharmacies a substantially lower rate for the same drug. PBMs collect the difference as profit. Spread pricing harms plan sponsors, who routinely contract with PBMs to obtain wider prescription drug coverage for their plan’s enrollees, and is linked to rising drug prices.
What This Means
These findings highlight the importance of evaluating PBMs based on a wide variety of services and functions. The report also reveals that while high satisfaction levels can increase customer retention, overall PBM satisfaction may be less important than other considerations, such as cost and customer service, due to the complexities of the market. However, PSG’s report indicates that PBMs may be experiencing similar challenges as health plans to meet customer demands and rising market pressure.
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