National Pharmaceutical Council (NPC) Survey Spotlights PBM Credibility, Trust Deficit

Just One-Third of Employers Rate Their PBM as “Very Trustworthy”

Washington, DC – Commenting on a new National Pharmaceutical Council (NPC) survey of employers finding just one-third rate their pharmacy benefit manager (PBM) as “very trustworthy,” the Senior Care Pharmacy Coalition (SCPC) said the findings spotlight PBMs’ ongoing credibility and trust deficit with customers, lawmakers and the regulatory community. In addition, the survey, entitled “Toward Better Value,” found half of employers do not believe that PBMs provide transparency into formularies and exclusion lists.

“As 2017 draws to a close, PBMs rightly find themselves buried by an avalanche of negative publicity and research findings, which spotlight their escalating credibility and trust deficit with stakeholders,” said Alan G. Rosenbloom, President and CEO of SCPC, the only federal advocacy organization devoted exclusively to the interests of the nation’s LTC pharmacies and the patients they serve. “Overall this new NPC survey showcases the extent to which employers simply do not trust their PBM.”

The NPC survey also reported the following:

  • 63% strongly agree that PBMs lack transparency about how they make their money;
  • 58% strongly agree contracts are overly-complicated and often harbor clauses that benefit the PBM at the expense of the employer or patient;
  • 49% strongly agree rebates contribute to misaligned incentives that put PBM interests before those of their customers or patients; and
  • 41% strongly agree PBM demand for large rebates is a key factor in driving manufacturers to raise drug prices.

Rosenbloom pointed out the nation’s three major PBMs — CVS Caremark, Express Scripts and Optum Rx — control more than 80 percent of prescriptions dispensed in America, “and thrive in what can be accurately characterized as an oligopolistic swamp.” For elderly patients living in the nation’s long term care (LTC) facilities, this percentage jumps to more than 90 percent. “This degree of market control, by so few companies, facilitates PBMs’ ability to manipulate prices, gouge consumers and side-step accountability,” he continued.

The SCPC President and CEO said that at a time when transparency in the marketplace, in government and within society at-large is a driving force for positive change, the PBM industry has for too long been content to operate out of sight, avoiding scrutiny. “Any 21st Century business model premised upon hiding facts and claiming it a right to do so should be a target for federal reform – reform that will finally begin to drain a drug pricing swamp filled by PBMs’ own shadowy, unaccountable activities.”


The SCPC is the national association for independent LTC pharmacies. Our member pharmacies provide care and services to patients in LTC facilities across the country occupying approximately 675,000 beds. Visit us at to learn more.