News | March 2021

Major Pharmacies Failing to Meet the Needs of People With Diabetes, According to National dQ&A® Survey

A large national survey demonstrates that people with diabetes believe that there is a wide variation in pharmacy quality, whether they use a major chain, an independent, mail order, online or other channels. The diabetes Net Promoter Score (NPS)® – the willingness to recommend a pharmacy to another person with diabetes – ranged from +74 for the best pharmacy to -13 for the worst. The bottom quartile had a maximum NPS score of only +13, indicating significant dissatisfaction. Respondents’ pharmacy channel varied by their type of insurance, but generally, supermarkets and independent pharmacies had a higher willingness to recommend than the other channels. The pharmacies with the highest net promoter score were Sam’s Club, Publix, Costco and United States Medical Supply.

SAN FRANCISCO, California, March 16, 2021 — dQ&A, the leader in diabetes research, released selected results from its Q4 2020 United States Diabetes Connections survey related to pharmacy use. Over five thousand respondents (n=5,017) with diabetes disclosed their primary pharmacy and rated their willingness to recommend that store to another person with diabetes.

The most common source for people with diabetes was a major chain pharmacy, particularly for those people with Medicaid. Mail order was next in popularity, followed by supermarkets/discount stores – which were especially popular for those with no insurance. Online is an important sector, but only represented about 5% of respondents (figure 1).

The diabetes Net Promoter Score (NPS) is obtained by subtracting ‘detractors’ (people who would not recommend their pharmacy to others with diabetes) from ‘promoters’ (those who would). NPS is a commonly used measure of customer loyalty and higher NPS implies growth.

Figure 1: Source of diabetes supplies by insurance type. (Excludes pump and CGM, but includes test strips, meters, oral drugs, insulin etc.). Source: dQ&A United States Diabetes Connections patient survey Q4 2020 (n=5,017)

dQ&A uncovered great variation in diabetes NPS across the various channels (figure 2). Independent pharmacies and supermarket pharmacies were rated significantly better.

Figure 2: Category Net Promoter Score (weighted average). Source: dQ&A United States Diabetes Connections patient survey Q4 2020 (n=4,969)

Online pharmacies trailed in last place, although there was a wide spread across the mail order channel.

Within these channels, there was significant variation in willingness to recommend a store. dQ&A used a ranking system (A to F) to grade top pharmacies into statistically distinct groups (Figure 3). The overall winners were Sam’s Club, Publix, Costco and US Medical Supply. The best of the major pharmacies was Rite Aid, which placed in the second rank, above Walgreens (third rank) and CVS (fourth rank).

Figure 3: Chart showing Net Promoter score ranking for leading pharmacies according to people with diabetes. The six NPS ranks (A to F) are statistically distinguishable at a 90% confidence level. Source: dQ&A United States Diabetes Connections patient survey Q4 2020; for pharmacies with sample sizes ≥30 (n=4,042)

In the mail order channel, there was a distinct spread in popularity, with some companies having a more even balance between promoters and detractors. This is not an ideal position, since detractors are much more likely to voice their opinions publicly.

“People living with diabetes deserve more from their pharmacies,” said Richard Wood, dQ&A’s CEO. “Because of their large numbers and the many medications and supplies they need, people with diabetes represent a significant source of revenue for these companies, yet many are not being kept satisfied.”

In the course of this study, dQ&A received over 3,000 write-in responses from promoters and detractors of individual pharmacies, explaining their perspective. Analysis showed that patients valued timeliness, helpfulness, knowledge and the ability to work with insurance companies. Common frustrations included mistakes on the part of the pharmacies, poor customer service, higher prices and being treated impersonally.

Please contact Richard Wood at for more information on this research, to obtain data, or for other inquiries into dQ&A’s industry-leading services.

dQ&A would like to express its sincere gratitude to all of the community members who participated in these research studies.

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About dQ&A – The Diabetes Research Company

dQ&A is a social enterprise that’s committed to making life better for people with diabetes. We harness patient voices to help develop better tools and policies for people with diabetes and improve health outcomes. For over ten years, we have been tracking the experiences and opinions of people with diabetes in the United States, Canada and Europe. We are trusted by patients because of our independence and commitment to them. Our team has decades of experience in quantitative and qualitative research and a deep knowledge of diabetes. Many of our own lives have been touched by diabetes, so we have a personal stake in our work. To learn more and to see research highlights, you can follow us on LinkedIn (dQ&A – The Diabetes Research Company), Facebook (@dQandA) and Twitter (@dQAresearch).