Breaking Down The 2008 PBM Customer Satisfaction Report

PBMI (Pharmacy Benefit Management Institute) put out its 14^th report on employer satisfaction with their PBMs. Here are some of the highlights from the report:

• 275 employers representing 11.3M members responded.
• The overall rating was an 8.0 out of 10.0. (up from 7.9 in 2007)
• 6.7% of respondents perceived that their benefit costs were increasing more than others and ranked their PBMs lower. (perhaps a validation that trend management matters…hence the “battle” to show the lowest year-over-year trend to the street in the individual trend reports)
• PBMs were ranked on three factors – overall service and performance, delivering promised savings, and delivering promised services.
• For the overall score:
  • Envision 9.7
  • Express Scripts 8.4
  • Catalyst 8.3
  • Caremark 8.0
  • Cigna 7.9
  • Medco 7.8
  • Walgreens 7.7
  • Wellpoint 6.4
• Aetna (6.6), Argus (4.8), Innoviant (8.7), MedImpact (8.0), NMHC (7.5), and Prime Therapeutics (9.0) also were part of the report but had limited profiles due to a lower number of surveys being received.
  • As far as I know, Prime doesn’t contract directly with employers but just through their BCBS owners. That would seem to disadvantage them in this survey.
    
• Employers can contract directly with PBMs or thru a managed care entity or buying group. Those that contracted directly ranked their PBMs higher (8.2 versus 7.6) which makes sense since they are more involved and more likely to be actively managing trend and having lower costs.
• This is validated by the fact that those with very aggressive intervention in benefit management rated their PBMs much higher (8.6 versus 7.1). About 33% considered themselves to be very aggressive.
• PBMs were rated the worst (7.2) for their disease management programs.
• When looking at factors that were correlated with satisfaction there were a few surprises and a few no-kidding variables:
  • I was surprised the member website, specialty pharmacy, and mail service pharmacy ranked low on the list of variables (i.e., less correlation).
  • I was not surprised that account management ranked high and retail pharmacy network was low. In many cases, the networks are pretty similar. I would be interested to see how large employers ranked PBMs versus smaller employers since they probably get different levels of service.
• Looking at the overall scores from 2004-2008:
  • Caremark, Catalyst, Cigna, Express Scripts, and Medco all went up.
  • Walgreens and Wellpoint went down.

Looking at the ranking of key factors:

So…my overall assessment is that it is a good report. It is limited by response and limited by the fact that there aren’t major differences between PBM scores (with a few exceptions). But, it certainly would give me some clues on what to expect, where to push, and how I should evaluate my PBM.