PBM Satisfaction
Still Important After 24 Years

Sharon Phares, PhD, MPH
June 19, 2019

Customer satisfaction in the business-to-business (B2B) world is essential to company success. The stakes are particularly high in areas like pharmacy benefit managers (PBMs). PBMs are responsible for helping to manage tens of thousands or even tens of millions of dollars in plan sponsor spend in any given year. They are also part of the equation for employee engagement and satisfaction with their employer.

Drug benefits are important to employees. A survey published by the Harvard Business Review in 2017 found that better health, dental, and vision insurance would be given either heavy consideration (54%) or some consideration (34%) when deciding between a high paying job and a lower-paying job with more benefits and perks.[1] This makes sense considering that nearly half of all Americans have used at least one prescription drug in the last 30 days.[2] Drug benefits are one of the most frequently used benefits offered, so for employers, ensuring they provide a valuable benefit that can attract, retain, and keep employees healthy is critical.

Because of this importance, this is the 24th year that PSG’s Pharmacy Benefit Management Institute (PBMI) has surveyed and reported on satisfaction that plan sponsors have with their PBM.  Given the number of years that we at PBMI have been studying this topic, it might be interesting to see what has changed and what hasn’t over the years.

What has changed in the PBMI PBM Customer Satisfaction Report (CSR)?

  • When we first started publishing the CSR, the survey was distributed by fax; today an electronic invitation is sent via email and the survey is conducted entirely online.
  • Overall satisfaction has improved. The average rating in 1997 was 7.0 which slowly increased over the years to the 8.0 seen in 2018 and 2019.
  • The services and functions offered by PBMs have expanded.
  • Specialty drug management, which was not even mentioned in the CSR until 2004, is now a key area of focus.
  • Many of the PBMs in existence has changed. For example, in 1998 the PBMs included were:
    • Advance Paradigm
    • Aetna Pharmacy Management
    • Caremark Prescription Services
    • Diversified Pharmaceutical Services
    • Eckerd Health Services
    • Express Scripts/Value Rx
    • Merck-Medco Managed Care
    • National Prescription Administrators
    • PCS Health Systems
  • Today, only Aetna and Express Scripts (now owned by Cigna) still operate as separate companies. The others have been acquired, merged with other companies, or shuttered completely. The 2019 CSR includes detailed information on:
    • Aetna
    • Benecard BPF
    • Cigna
    • CVS Health
    • Express Scripts
    • Magellan Rx
    • MaxorPlus
    • MedImpact
    • Navitus
    • OptumRx
    • Prime Therapeutics

What hasn’t changed over the years?

  • The pharmacy network is still important. In 1998 it was the highest rated PBM function with a score of 8.8. Today it is still the highest rated PBM function with an average score of 8.5.
  • Commitment to good customer service is still of extreme importance – while the questions focusing on member services and account management service have evolved over the years, the importance has not wavered. Employers and other plan sponsors expect best-in-class customer service and their members deserve compassionate, timely, and accurate PBM services.
  • PBMI is still committed to bringing unbiased, accurate, and actionable information to the marketplace to help all stakeholders maximize the value of drug benefit services.

However, customer satisfaction is not only the responsibility of the PBM. Employers and health plans are responsible for clearly defining and communicating their expectations and requirements but PBMs, as the providers of services, are ultimately accountable for delivering on promises made. We are happy to report that they generally perform quite well.

Would you like to learn more? The 2019 PBM Customer Satisfaction Report is available for purchase online.



[1] Jones K. The Most Desirable Employee Benefits. Harvard Business Review. February 15, 2017. Available online at https://hbr.org/2017/02/the-most-desirable-employee-benefits. Accessed June 14, 2019’.
2]Centers for Disease Control and Prevention. Therapeutic Drug Use. Last updated January 19, 2017. https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm. Accessed June 14, 2019.

Sharon Phares, PhD, MPH, is the Senior Vice President of Research for PSG and an Assistant Adjunct Professor of Clinical Pediatrics and Assistant Adjunct Professor of Internal Medicine with Washington University in St. Louis. Prior to joining the PSG, Sharon was Vice President of Research and Analytics at Express Scripts where she led research strategy and execution for one of the largest PBMs in the nation. She has also held leadership roles in health and economic outcomes research, survey design, pilot and program design and evaluation, analytics and research consulting, advanced analytics, and the development of predictive models at Walgreens, LabCorp, and Landacorp. She was an instructor at North Carolina State University and provided evaluation research for various state and local government agencies before joining the private sector.