Why the Digital Patient Experience in Pharmacy Benefits Is a Decade Behind: And Patients Are Paying the Price

From telehealth to advanced analytics. From gene editing to AI-powered diagnostics. From wearable devices to non-invasive surgery. Technology is transforming health care in remarkable ways.  

Despite these advances, the health care industry still lags others in delivering the seamless, user-friendly experiences people have come to expect as digital consumers.  

The rise of e-commerce, mobile banking, and on-demand services has changed consumer expectations. People now anticipate speed, personalization, and ease-of-use in nearly every aspect of life, including their health care. Yet when it comes to navigating their health benefits, many often face confusing websites, clunky portals, generic information, and long call center wait times. The consumer experience gap is real. According to the 2024 U.S. Healthcare Digital Experience Study from J.D. Power, 42% of insured adults say they have experienced a problem using their health insurance website and/or app over the past year. 

There are valid reasons for this lag: the inherent complexity of health care, a patchwork of outdated and incompatible platforms, the critical need to protect sensitive patient data, and constantly evolving regulatory requirements, to name a few. 

Still, the expectation remains: consumers now expect—and deserve—better. 

The Rise of Patient-First Digital Strategies

Some PBMs, particularly forward-thinking ones, are rising to meet that challenge. Drawing inspiration from customer experience leaders in other industries, nimble, independent PBMs are crafting patient-first digital strategies that bridge the gap between traditional pharmacy tools and personalized health navigation.  

“We should take the lead in the health care sector. Pharmacy is often the most utilized piece of an employee’s health benefits package,” said Nithya Shankar, Vice President of Innovation at True Rx. “As PBM leaders, we’re challenging ourselves to go above and beyond the status quo to deliver best-in-class patient care and experience.” 

So, what does a best-in-class digital pharmacy experience look like? 

Mobile-first access: People manage most of their lives via their smartphones, and they expect the same from their health care tools. A pharmacy app should enable on-the-go benefit management, whether that means checking coverage, refilling a prescription, or chatting with support.  

Personalized dashboard: The challenge, and advantage, of mobile apps is that they have very limited real estate. When members open a pharmacy benefits app, they should immediately see a personalized dashboard tailored to their coverage and medications with easy and intuitive navigation, not generic menus that force them to dig. 

Savings opportunities: Cost remains a top barrier to adherence. According to a recent KFF survey, one in five U.S. adults have skipped filling a prescription due to price. PBMs that offer real-time cost comparisons based on their specific benefit plan can make an immediate difference in health outcomes and member satisfaction. 

Live chat with a real person: For all the benefits digital tools can offer, health care remains deeply personal. Chatbots have their place. But when someone faces a time-sensitive decision or a question that affects their health and well-being, live human support is essential to customer experience and health outcomes. 

Turning Strategy into Action 

Meeting rising consumer expectations requires more than incremental upgrades, it demands a reimagining of the pharmacy benefit experience from the ground up.  

True Rx developed True Rx+™, a mobile app designed to deliver the best possible pharmacy benefits experience directly in the palm of patients’ hands. Featuring real-time cost transparency, intuitive navigation, and integrated live support, True Rx+ puts control back into patients’ hands, making health benefits management simpler, more personalized, and more convenient than ever. 

From the Savings Center to the GPS-enabled Pharmacy Locator, every feature helps members make informed, confident decisions about their health, wherever they are. 

Although healthcare has traditionally lagged behind other industries in digital consumer experience, True Rx is actively closing that gap. 

“Consumers are demanding, and they should be, especially when it comes to their health care,” said Shankar. “With True Rx+, we’re proud to be among the leaders offering digital tools that help people stay informed, save money, and get expert support exactly when they need it.”