Satisfaction With PBM Industry Dips to Record Low in 2024

Overall satisfaction with PBMs is at a decade-long low this year, according to the 2024 Pharmacy Benefit Manager Customer Satisfaction Report, published by Pharmaceutical Strategies Group, an EPIC company. The report also showed that payers were seeking improvements in the PBM industry and were willing to be part of the disruptive change.

The report is based on responses from 248 benefits leaders at employers, unions/Taft-Hartley plans, health plans, and health systems, and it was conducted from May 10, 2024, through June 7, 2024.

For both employers and health plans, overall satisfaction with their PBMs declined to a five-year low, while employers were substantially more satisfied compared to health plans. Overall satisfaction with the “Big Three” PBMs — CVS Health Corp.’s Caremark, The Cigna Group’s Express Scripts and UnitedHealth Group’s Optum Rx — was 7.4 on a 10-point scale in 2024, compared to a rating of 7.9 for all other PBMs. High-level satisfaction varied by type of respondent: For example, sponsors that worked with one of the Big Three rated the likelihood of renewing with them 6.7 out of 10 points, while sponsors using other PBMs rated that likelihood 7.6.

Respondents were asked to rate their satisfaction with PBMs’ essential services on a 5-point scale. Satisfaction was highest for meeting financial guarantees and lowest for delivering products that are differentiated in the marketplace. In terms of PBMs’ essential functions, satisfaction was highest for retail network options that meet the needs of members, regulatory compliance, and eligibility data management, and satisfaction was lowest for actionable reporting.

For nearly all services and functions, employers had higher levels of satisfaction than health plans in 2024. The ratings differ significantly in delivery of promised services, contract and service flexibility, and responsiveness and issue resolution.

Many respondents said their PBMs have strategies for new and upcoming biosimilars in 2024 and acknowledged the importance of having such strategies. Yet they expressed mixed feelings about their PBMs’ Humira biosimilar strategy, with 10% indicating they were dissatisfied and just 16% saying they were very satisfied.

When selecting their PBMs, respondents said pricing or cost ranked as the top priority in 2024. Member experience or customer service and honoring guarantees and commitments rounded out the top three. PBMs were given the lowest marks regarding their track record serving similar organizations, willingness to integrate with other solutions, and innovation.

Looking ahead, four out of five respondents expressed at least moderate interest in including PBMs beyond the Big Three if they were to engage in a PBM procurement today. Over half of the respondents rated their desire for change in the PBM industry at or above a 7 on the 10-point scale.

This article was reprinted from AIS Health’s biweekly publication Radar on Drug Benefits.