A Closer Look at the Complexities of PBM Satisfaction
Posted on November 2, 2022
Choosing, negotiating a contract, and navigating a relationship with a pharmacy benefit manager (PBM) isn’t one size fits all. No single PBM is “best” across the board, and needs and priorities vary based on many factors — organization type, plan size, member demographics, etc. PSG’s latest market research report, the 2022 PBM Customer Satisfaction Report (CSR), highlights the intricacy of plan sponsors’ relationships with their PBMs. The report contains not only high-level satisfaction ratings, but also ratings on over 30 services and functions, a dozen clinical and cost management programs, and several special topics (e.g., PBM involvement in addressing social determinants of health, biosimilars strategy, and gene therapy affordability).
When looking at a report like our PBM CSR, it’s tempting to focus on high-level metrics like overall satisfaction and net promoter score (NPS), which vary across PBMs and are lower in 2022 compared to 2021. This information is valuable, but stopping here misses a more nuanced story that can provide insights to plan sponsors, the consultants and brokers who work with them, and PBMs alike. Here are additional key areas to consider.
1. Service and function satisfaction
Satisfaction varies widely across the PBM services and functions included in the survey. For example, while plan sponsors — which include health plans, employers, labor unions, and health systems — express high satisfaction on the item retail network options that meet the needs of members (mean: 4.5/5, 83% somewhat or very satisfied), they are notably less satisfied with their PBM’s willingness to integrate with other pharmacy solutions (mean: 3.7/5, 52% somewhat or very satisfied). It’s also interesting to note areas where plan sponsors show some ambivalence — e.g., 27% of plan sponsors are neither satisfied nor dissatisfied with their PBM’s delivery of products that are differentiated in the marketplace.
For plan sponsors and the consultants and brokers who work with them, these data on service and function satisfaction can be used to help pinpoint areas of particular focus for the organization and then benchmark based on overall findings or use to evaluate individual PBMs. PBMs each have their own strengths and weaknesses. Focusing on the specific services and functions your organization values most can help with PBM selection and ongoing relationship management. For PBMs, these data highlight areas for improvement and allow for benchmarking versus competitors and the market overall.
2. Awareness of and satisfaction with clinical and cost management programs
Clinical and cost management programs are offered in various forms by most PBMs. Recognizing the importance of these programs in a plan sponsor’s experience with their PBM, the survey asked about their awareness of, use of, and satisfaction with a dozen programs their PBM might offer. Although every PBM does not offer every program on the list, our results suggest that some plan sponsors may be unaware of some of the programs available to them. For plan sponsors, this presents a reminder to keep up to date with their PBM’s offerings, and for PBMs it points to programs about which they might want to provide additional messaging to customers.
Use of clinical and cost management programs varies widely by program as does satisfaction with the programs used. For example, 90% of plan sponsors who use pharmacy trend guarantees are somewhat or very satisfied overall with them, versus just 66% for medical benefit management programs. These data may indicate to plan sponsors some programs to consider using. They also shed light on which programs are performing well and which programs are producing below average satisfaction in the industry.
3. Differences by segment
Organizations vary in their needs, priorities, and expectations for their PBM, and this leads variation in customer satisfaction. Factors about the PBM and the customer’s length of relationship with that PBM also produce differences in satisfaction. We evaluated differences in satisfaction across 3 breakouts: plan sponsor type, size of PBM, and length of relationship with the PBM. The most striking differences appeared in our comparisons of employer and health plan satisfaction with their PBM. On nearly every item, the difference was statistically significant, with lower satisfaction among health plans.
For plan sponsors, these breakouts can provide more context and tailored data for benchmarking purposes. For PBMs, the breakouts indicate customer segments that are at risk for dissatisfaction and potential non-renewal.
No PBM is perfect, and each has its own strengths and weaknesses. Furthermore, each plan has a unique set of needs and preferences. Benefit leaders evaluating PBMs should account for the attributes that matter most to their individual group and seek to find the best aligned match.
