Pharmacy Benefit Manager Satisfaction Fell to Historic Low
Benefits leaders now report a negative outlook on PBM services, forcing employers to re-evaluate their pharmacy contracts.
Updated on Sept. 29, 2026 in Healthcare
Live Poll
Do you trust the pharmacy benefit managers that administer your health plan's prescription drug coverage?
The Net Promoter Score for pharmacy benefit managers dropped to -13 in 2026, marking a significant decline from the +18 recorded in 2022. This shift reflects a plateau in satisfaction among employers and health plans using these services.
Why it matters
The deterioration in sentiment suggests a growing disconnect between PBM service offerings and the expectations of plan sponsors. Operators should monitor how this dissatisfaction influences contract negotiations and the potential adoption of alternative pharmacy benefit models.
The Pharmacy Benefit Manager Customer Satisfaction Report surveyed 250 benefits leaders to produce a score that fell to -13 in 2026 compared to a +18 score in 2022. The index measures willingness to recommend services on a scale ranging from -100 to +100.
The players
Pharmacy Benefit Manager Customer Satisfaction Report
An industry survey assessing the service experience of 250 benefits leaders regarding their PBM partners.
The details
The report used the Net Promoter Score as a proxy to gauge how willing benefits managers were to endorse their current PBM services to others. This downward trend places PBM satisfaction at a ten-year low, indicating that the value proposition of these pharmacy intermediaries is increasingly strained. Employers are now facing a market where their primary partners in managing drug costs are viewed with mounting skepticism by their own peers.
Timeline
The PBM Net Promoter Score measured +18 in 2022.
The PBM Net Promoter Score fell to -13 by 2026.
Market Landscape
The 2026 data updates the ten-year trend established by the Pharmacy Benefit Manager Customer Satisfaction Report, confirming a shift toward record-low sentiment. This decline follows years of industry friction regarding transparency and contract value.
Employers should review their current PBM contract renewal terms and evaluate whether performance metrics align with these broader industry dissatisfaction trends. Given the decline in service sentiment, auditing pharmacy spend and contract transparency is a necessary step for financial oversight.
The takeaway
Operators must recognize that the declining sentiment toward PBMs indicates a shift in the standard for administrative and financial transparency in pharmacy benefits. Businesses should use this industry signal to push for more rigorous performance reporting in their next contract cycle.
Further reading
For broader trends impacting how companies manage coverage, visit Healthcare.
Source note: This article includes information reported by Ajmc.
Live Poll
Do you trust the pharmacy benefit managers that administer your health plan's prescription drug coverage?
