PBM Satisfaction Survey

It should be out soon, and it will be interesting to see the data. The WilsonRx PBM Satisfaction Survey is the only (I think) independent survey done of the industry. [Although I never remember paying attention to it at Express Scripts.] From what I know, they seem to get a good sample of more than 25,000 responses rating 18 PBMs (Pharmacy Benefit Managers).

Some of the new factors they are including:

• Overall Medicare costs and availability
• Annual increases in premiums or costs
• Overall delivery of pharmacy benefit services
• Courteousness and helpfulness of PBM plan representatives
• Ease and timeliness regarding conversations with a PBM representative
• Ease and ability to access prescription records and order refills
• Resolution of denied drug claims or appeals
• Overall quality of care
• Adequate coverage of treatment medication needs
• Personalized care for Rx needs

They seem like logical factors, but some of them aren’t controlled by the PBM but by either the self-insured employer or the managed care company (1, 2, 9). Depending on the service model, several others may be done by the managed care company (4, 5, 6, 7). And, I have no idea of how they are going to gauge things like overall delivery (3); quality of care (8); or personalized care (10). I hope they at least look at how responses vary by high utilizers versus low utilizers (of drugs) along with the type of coverage (which I doubt the individual knows whether their pharmacy coverage is through Aetna’s PBM or Medco (for example)).

Walgreens Health Initiatives (WHI) won the award last year and is certainly building a very competitive offering:

• A goal of 10,000 retail locations
• Mail pharmacy
• Specialty pharmacy
• 90-day at retail
• On-site (or worksite) pharmacy
• PBM

“While we already knew from our own surveys that members are highly satisfied with the wide selection of innovative products and services we offer, it was gratifying to have it confirmed by an independent third-party,” according to Richard Ashworth, Pharm.D., MBA, executive vice president for WHI, a wholly owned subsidiary of drugstore giant Walgreen Co.

He believes member satisfaction ultimately boils down to choice and convenience, noting how a 90-day medication option at the retail level serves as an important mail-order alternative for those who prefer face-to-face consultations with a pharmacy team they know and trust. Of WHI’s national retail network of more than 62,000 pharmacies, more than 39,000 offer this option and the number continues to grow.

Walgreens also offers worksite pharmacies on many corporate campuses across the U.S., which encourages employees to be more proactive about their health and, in turn, helps reduce absenteeism and the overall health care spend. Serving just one employer allows pharmacists to focus solely on that particular patient population, maximizing plan design and wellness strategies as part of a tailor-made approach to comprehensive care.

Pharmacists can help engage, educate and empower employees, as well as provide informed feedback on clinical prior authorizations, therapy-specific programs or the impact of formulary changes on medication options. There’s also room for leveraging a company’s core cost-containment strategies by promoting generic utilization, formulary efficiency and other key clinical programs whether or not WHI is the plan’s PBM. (Text from article by Employee Benefit News)