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Satisfaction with pharmacy benefit managers declined in 2022, report shows

Employers are less satisfied with their PBMs, likely a result of cost and poor public opinion.

Healthcare Dive


Dive Brief:

  • Customers’ satisfaction with their pharmacy benefit managers declined in 2022, according to a report from pharmacy research and tech company Pharmaceutical Strategies Group. While respondents averaged an 8.2 out of 10 in satisfaction in 2021, their satisfaction dropped to 7.8 in 2022.

  • In addition, respondents this year said they were less likely to recommend their PBM to a colleague and expressed slightly less likelihood to renew their contracts without a competitive request for proposal process. Health plan respondents reported significantly less satisfaction than employers, PSG found.

  • “This decline is not surprising,” PSG noted in the report. “One of the drivers of a customer’s perception of their PBM is drug trend” — the percentage change in drug costs from one year to the next — “which is on the rise for many plan sponsors.” The company also blamed the decline on increasingly negative public sentiment.

Dive Insight:

Pharmacy benefit managers are companies that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers and other payers, according to healthcare research firm The Commonwealth Fund. PBMs negotiate with drug manufacturers and pharmacies to help determine drug costs for insurers.


As PSG noted, the price of drugs is on the rise; in addition, recent Kaiser Family Foundation research found that 83% of U.S. adults said the cost of prescription drugs was “unreasonable,” although 69% of those needing drugs said they did not have an issue affording them.


Transparency tends to be an issue with PBMs. Only 23% of respondents to PSG’s survey said they were “very satisfied” with PBM transparency, while 24% were either “somewhat” or “very” dissatisfied. HR Dive’s sister publication, Healthcare Dive, has reported on concerns that PBMs hide behind opaque, complex contracts to inflate drug prices and reduce competition.


The Commonwealth Fund noted some regulations policymakers have considered to smooth out problems with PBMs, including requiring more data on rebates PBMs negotiate; eliminating spread pricing, which occurs when PBMs charge more for a drug than they reimburse; and requiring PBMs to pass rebates on to payers or patients.


About the Author: Emilie Shumway, Editor