PBM satisfaction among health plans and employers has dropped to a three-year low, study finds

Satisfaction with pharmacy benefit managers (PBMs) reached a three-year low in 2022, a trend analysts say may be tied to rising drug prices. The new report, from Pharmaceutical Strategies Group, finds a decline in satisfaction across several categories.

The report, which measures satisfaction as reported by employers and health plans, finds that 2022 saw the lowest mark in overall satisfaction (7.8 out of 10) for the past three years, compared with an 8.2 score for 2021 and an 8.0 score for 2020.

“This decline is not surprising. One of the drivers of a customer’s perception of their PBM is drug trend, which is on the rise for many plan sponsors,” the report says. “Furthermore, while PBMs received some positive public attention during the COVID-19 pandemic, most of their public visibility has been negative of late.”

Overall satisfaction may not be the most important measure

The report notes that although high levels of satisfaction can increase customer retention, there are complexities to the PBM market that make overall satisfaction perhaps less important than crucial factors such as cost and customer service. The report’s authors say that because of that complexity, they explored dozens of PBM functions and services beyond overall satisfaction.

Among the measurements the study examines were respondents’ likelihood to recommend their PBM to a colleague. The analysis also uses the Net Promoter Score (NPS) measurement, which is commonly used to gauge general customer satisfaction and loyalty.

For the likelihood to recommend a PBM to a colleague, 2022 was also a down year; on a scale from 1 to 10, it ranked 7.6, down from 8.1 in 2021, and from 7.9 in 2020. The NPS score also shows some fluctuation; on the NPS scale of 0 to 50, satisfaction with an organization’s PBM earned an overall score of 29 in 2020, 38 in 2021, and 18 in 2022. PBMs also received mixed reviews when it came to transparency. Although a majority of respondents say they are either somewhat (36%) or very (23%) satisfied with PBM transparency, almost a quarter of respondents say they are somewhat (8%) or very (16%) dissatisfied. An additional 17% say they are neither satisfied nor dissatisfied with their PBM’s transparency.

Measuring essential PBM functions

The report takes a close look at essential PBM functions. The higher-scoring categories include “retail network options that meet the needs of members,” with 83% of respondents saying they are satisfied with that function of their PBM. Also scoring highly in satisfaction among respondents are eligibility data management (81%), account management (79%), and regulatory and IT security compliance (77%).

Two measures the see drops in satisfaction are member services at 70% and actionable reporting at 57%, both scores lower than in their 2021 measurements.

“The lower satisfaction with actionable reporting speaks to an unmet need in the marketplace — plan sponsors are looking for complete and transparent reporting of data accompanied by actionable insights, and their responses indicate they don’t see this happening to the full extent possible,” the report says. “The lower satisfaction and decline in satisfaction with member services may be in part due to effects of the Great Resignation, as staff who excelled at customer service may have departed, leaving PBMs either understaffed or using less qualified staff to provide member services.”

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The analysis also looked at satisfaction by size of PBM — comparing PBMs with more than 20 million members and those with 10 million or fewer members, which are considered mid-sized PBMs. Although mid-size PBMs had slightly higher satisfaction scores, the report says the differences were not statistically significant.

The study also asked questions about social determinants of health (SDOH); the authors note that SDOH have been a major topic of discussion in the past few years. Respondents were asked questions to determine how much of a priority addressing these issues have become for organizations. The study shows that for health plans, addressing SDOH was rated higher in importance than for employers.