With PBM satisfaction on the decline, Centene switches to Express Scripts

Shortly after a new survey revealed that health plans’ satisfaction with pharmacy benefit managers (PBMs) is down, Centene announced this week that it is switching to Express Scripts from CVS Caremark.

St. Louis-based Express Scripts is the PBM of Cigna’s health services unit Evernorth. Express Scripts and Centene stated in a Tuesday news release that the two entities formed the strategic partnership “to make prescription medications more accessible and affordable for customers.”

Starting January 2024, Express Scripts will serve about 20 million Centene members, who will be able to reach the PBM’s network of retail pharmacies, as well as receive 24/7 access to its pharmacists, said Amy Bricker, president of Express Scripts.

“We are proud to be selected by Centene to deliver greater prescription drug savings and access for their members,” Bricker wrote in an email. “Express Scripts has a long track record of delivering value for people that use government-sponsored health plans and this is an important opportunity to further extend our best-in-class services to more Americans.”

An October 19 survey by Pharmaceutical Strategies Group showed that overall satisfaction of PBMs reached 7.8 points out of 10 in 2022, down from 8.2 points in 2021. The likelihood to recommend a PBM was 7.6 points out of 10 in 2022, compared to 8.1 in 2021. The survey received responses from 236 respondents, mostly from employers and health plans. 

“This decline is not surprising,” the report stated. “One of the drivers of a customer’s perception of their PBM is drug trend, which is on the rise for many plan sponsors. Furthermore, while PBMs received some positive public attention during the Covid-19 pandemic, most of their public visibility has been negative of late.”

Centene declined MedCity’s request for comment on why it was abandoning CVS Caremark for Express Scripts. But the report may hold some clues.

Express Scripts performed better than CVS Caremark on overall satisfaction, with 7.9 points out of 10 compared to CVS Caremark’s 7.7 points. Express Scripts was rated the highest out of the individual PBMs listed, tied with OptumRx. Individual PBM ratings were only provided for PBMs with at least 10 survey responses. Express scripts received 74 responses, while CVS Caremark received 46 and OptumRx received 54.

In addition to overall satisfaction, the survey also looked at over 40 PBM functions, in which it found that the areas with the lowest satisfaction included “willingness to integrate with other pharmacy solutions” and “customizable options.” The areas with the highest satisfaction included “retail network options” and “competitive traditional drug discounts.”

Overall satisfaction was different based on respondent type. Health plans’ satisfaction in PBMs averaged 6.9 points out of 10 in 2022, compared to 7.5 in 2021. Employers’ satisfaction, meanwhile, was 8.1 points in 2022, compared to 8.5 in 2021.

When asked for reasons for leaving a current PBM, several respondents mentioned cost. One anonymous respondent stated, “Cost savings with other PBMs and more flexibility in managing cost of specialty drugs.” Another said, “Cost savings provided service levels were the same.”

Cost savings are just what Express Scripts aims to bring to Centene’s members, Bricker said.

“We look forward to working with Centene to create innovative health services that help people live healthier lives and unlock meaningful savings for those we serve,” Bricker said.

Photo: bong hyunjung, Getty Images

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