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Cigna Corp.’s $54 billion deal for Express Scripts Holding Co. is the latest sign that health care’s biggest players believe they can no longer go it alone, and they must branch into other businesses to forge integrated products aimed at curbing costs. The acquisition sets up the combined company, which would bring together Cigna’s insurance assets with Express Scripts’ pharmacy-benefit management, to better compete with peers such as UnitedHealth Group Inc. and CVS Health Corp. that already moved toward vertical combination, analysts said. (Wilde Mathews and Walker, 3/8)

Cigna Corp.’s $54-billion purchase of Express Scripts Holding Co. is being called the “best case scenario” for the pharmacy-benefits manager’s beleaguered investors. The deal is “clearly a positive turn of events” for Express Scripts, Evercore ISI’s Ross Muken wrote. The company’s role as a middleman hired by insurers and employers to negotiate discounts from drugmakers has been under fire from everyone from the head of the Food and Drug Administration to short-sellers. Other analysts noted uncertainties on how the interconnected agreements between insurers and benefits managers would play out once the deal is completed. (Flanagan, 3/8)

Major deals in the health-care supply chain may be better news for sellers than for buyers. Health-insurance giant Cigna announced Thursday morning that it plans to buy the pharmacy-benefit manager Express Scripts Holding for about $54 billion in cash and stock. Cigna shares dove sharply Thursday morning, and for good reason. (Grant, 3/8)

Cigna’s $52 billion bid to buy Express Scripts, rolled out Thursday, is another example of the nation’s largest carriers angling to match UnitedHealth Group’s model of combining insurance with the management of pharmacy benefits. On one level, the deal could pull business from Minnetonka-based UnitedHealth, since Connecticut-based Cigna currently hires United’s OptumRx division as its pharmaceutical benefits manager (PBM). (Snowbeck, 3/8)

Cigna Corp.’s proposed deal for Express Scripts Holding Co. faces a drawn-out merger review as the Trump administration’s antitrust enforcers weigh the competitive effects of a wave of consolidation sweeping the health-care industry. The tie-up of the insurer and pharmacy benefit manager comes on the heels of CVS Health Corp.’s agreement to buy insurer Aetna Inc. In both combinations, the companies say they’ll become more efficient firms and help lower health-care costs. Whether customers are actually poised to benefit is the key question for antitrust enforcers. (McLaughlin, 3/9)

Big mergers in U.S. health care have rotated on their axis, with the nation’s biggest insurers and the companies that preside over customers’ access to high-priced drugs eyeing one another after deals to combine insurers were struck down. Cigna Corp. has agreed to acquire drug benefits manager Express Scripts Holding Co. in a deal valued at $67 billion, including $54 billion in cash and stock. That follows an offer by CVS Health Corp. -- a company created by the merger of a drugstore chain with a pharmacy benefit manager -- to buy insurer Aetna Inc. (Lauerman, 3/8)