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   제목: Cigna to Buy Express Scripts in $52 Billion Health Care Deal


Cigna to Buy Express Scripts in $52 Billion Health Care Deal


By KATIE THOMAS, REED ABELSON and CHAD BRAY
MARCH 8, 2018


The health insurance giant Cigna said on Thursday that it had agreed to buy Express Scripts, the nation’s largest pharmacy benefit manager, in a $52 billion deal that could further reshape the roiling health care landscape.

The deal is the latest in a wave of consolidations that is sweeping through the health care industry. Companies are reacting to concerns over rising health care costs and the possibility of powerful new rivals entering the fray. In particular, Amazon’s move into the health care business has forced established companies to rethink how they can compete.

Cigna and Express Scripts said the acquisition would benefit consumers by allowing the two companies to bring together patients’ medical and pharmacy histories to improve treatments and lower costs.

“This step furthers our strategy to improve the affordability and value to the consumer in a more personalized way,” said Cigna’s chief executive, David Cordani, who will serve as chief executive for the combined company.





The completion of the deal would mark the end of Express Scripts as the last major independent pharmacy benefit manager, one that has focused on striking deals with drug companies to lower costs for insurers and employers. The company is responsible for the prescription plans of more than 80 million Americans.
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“This is the future of the stand-alone” pharmacy benefit manager, said Tim Wentworth, the chief executive of Express Scripts, who would serve as president of the Express Scripts business under the deal. The two companies said that they would continue to offer pharmacy services to other insurers and to employers that do not use Cigna.

The deal would ensure that all of the major pharmacy benefit managers would have ties to big insurers. CVS Health, which also owns pharmacies, recently announced a merger agreement with the health insurer Aetna. OptumRx is owned by the insurance giant UnitedHealth Group. Anthem, which operates for-profit Blue Cross plans in several states, said it had plans to create its own pharmacy business.

With no other large independent pharmacy managers left for smaller insurers, federal and state officials could be reluctant to approve the Cigna-Express Scripts deal, said David A. Balto, an antitrust lawyer who worked at the Federal Trade Commission and the Justice Department who is a fierce critic of mergers of insurers and pharmacy mangers. The CVS-Aetna deal could face the same problem, he said.

“History has shown where there are multiple mergers going on in a single industry, the Justice Department goes on high alert,” Mr. Balto said.

Other antitrust experts said it was unclear how the combination of Cigna and Express Scripts would reshape the market. “It’s not nearly as obvious an antitrust risk as other deals,” said Leemore S. Dafny, a business professor at Harvard. The deal could make the insurance industry more competitive by giving Cigna, which is not a major player in some markets, a way to challenge the dominant companies, she said.

Selected articles from The New York Times
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