Being in the middle isn’t always easy. The spread can be nice, but the squeeze can be rough. And pharmacy benefit managers are being judged harshly these days. Preliminary results of a new survey finds that just 63 percent of their customers ranked their middlemen as a 7 or higher on a scale of 1 to 10, and just 41 percent rated the entire PBM industry a 7 or more.

Arxcel, the PBM consulting firm that queried executives at 100 large companies, speculates the poor showing may be due to increased media attention about regulation and transparency. That seems odd, though. A satisfied PBM customer, who is the one signing the contract, would likely be motivated to offer a better ranking, no?

After all, other responses also show signs of discontent. Only half of the respondents had a positive opinion of PBMs. And just 52 percent marked 7 or higher on the matter of trust, while 40 percent displayed a lukewarm level of trust.

There are other findings to mull over. Nearly three-quarters say negotiating discounts makes a PBM valuable. About 45 percent believe DTC ads play the biggest role in rising drug costs; only 25 percent fingered drug-development costs. And the three most popular solutions to high costs: patient education, providing incentives to use mail-order meds and educating docs.

Unlike past surveys, this year’s research indicates the level of co-pays is decreasing. This may be a function of companies not passing on as much of the premium increases in the past. This also reinforces past surveys, where higher co-pays were seen as a way to blunt rising costs. Now, 78 percent say a member’s co-pay should be 30 percent or less of a prescription. But most lean toward a slightly higher co-pay as being the ideal.

You can visit the Arxcel site here, but the survey isn’t yet available because these are preliminary results.

[tags]Arxcel, PBM[/tags]