PSG Survey: Payer Satisfaction with PBMs Declines


One of the drivers of a lowered payer satisfaction is the public perception of PBMs, said Morgan Lee, Ph.D., of PSG.

Overall satisfaction with PBMs among both health plans and employers has declined, while at the same time, some specific measures of satisfaction stayed steady, according to Pharmaceutical Strategies Group’s (PSG) annual Pharmacy Benefit Manager Customer Satisfaction Report. Payers had the highest overall satisfaction with pharmacy trend guarantees but the lowest satisfaction with medical benefit management.

Morgan Lee, Ph.D.

Morgan Lee, Ph.D.

People’s feelings about their PBMs are changing, but it’s not mirrored in the specific services and functions that the PBMs offer, said Morgan Lee, Ph.D., PSG senior director - research & strategy. “Overall, there has been a lot of negative publicity. And we’ve found in our recent spending trends report that the spending trend is going up,” she said in an interview.

PSG surveyed 236 payers in May and June. Respondents were pharmacy benefit decision makers within employers, health plans, health systems, and unions. In broad measures of satisfaction with PBMs, there were declines compared with last year. On more specific satisfaction items, PSG found a more nuanced story of strengths and weaknesses, but there were decreases in some core measures of general satisfaction such as likelihood to recommend.

Net promoter score, a widely used measure to assess customer experience, went down significantly from last year. Specifically, net promoter scores for CVS Health, MedImpact and Prime Therapeutics decreased.

The areas with the highest satisfaction include retail network options, competitive drug discounts, eligibility data management, IT and security compliances, and pharmacy network management. The areas with the lowest satisfaction include the willingness to integrate with other pharmacy solutions, products differentiated in the marketplace, customizable solutions, contract and service flexibility, management of trend, and clinical outcomes reporting.

“There was also a gap in how scores between how important peopled felt a particular service is and how the PBM was doing with that services,” Lee said. “For example, the strategy for biosimilars is a topics are really important to people. But what their PBMs are offering is not quite keeping up with the level of importance just yet.”

Health plans reported lower satisfaction with their PBM than did employers on nearly every service and function. “Health firms are very sophisticated in this space. I think they demand more and they’re expecting more from their PBMs,” Lee said.

The survey also assessed whether sponsors were satisfied with the level of transparency offered by their PBM. A little over half were somewhat or very satisfied, but nearly a quarter were somewhat or very dissatisfied. Lee said payers overall are looking for more openness about financial components, including rebates.

“There’s definitely a hunger for more transparency,” she said. “In the open-ended comments, respondents questioned whether they’re really getting transparency from their PBM. Our consultants have seen that PBMs are making some attempts to be more transparent, but among plan sponsors, there isn’t a lot of trust in that transparency.”

Payers also want more flexibility from their PBMs to integrate with other pharmacy solutions and to offer more customizable solutions, especially among health plans. “Technology is a source of frustration,” Lee said. “There is a feeling that things aren’t working as well as they could.”

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