Why did alternative PBM customer satisfaction decline in 2026 survey results?

Pharmaceutical Strategies Group’s 2026 survey found non-Big Three PBM satisfaction fell to 7.3 from 7.9, shrinking their lead over CVS Caremark, Express Scripts, and Optum Rx. Drug Channels said weaker Net Promoter Score, lower service-versus-expectations ratings, and softer renewal intent suggest retention is becoming harder for alternative PBMs.