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Health insurer Cigna Corp. plans to buy Express Scripts Holding Co. in a cash-and-stock deal worth $52 billion, excluding debt, that the companies say will expand their health care offerings and help them control costs. ... The deal has a total transaction value of $67 billion, which includes Cigna’s assumption of $15 billion of Express Scripts’ debt. (Mattioli and Cimilluca, 3/8)

Express Scripts is the largest remaining independent drug middleman. Its biggest competitors are the pharmacy-benefits management companies run by CVS Health Corp. and UnitedHealth Group Inc. Pharmacy-benefits managers have come under increasing political pressure in recent weeks as the Trump administration looks for ways to lower medical costs. The president’s Council of Economic Advisers, in a recent report, criticized the companies’ market power and the opacity of their drug-price contracts. (Langreth and Vercoe, 3/7)

Express Scripts is the largest pharmacy benefit manager in the United States, responsible for the drug plans of more than 80 million Americans, including on behalf of large employers like the Department of Defense. (Bray and Thomas, 3/8)

The companies said the combination will save $600 million due to administrative efficiencies. They can cut costs as they better coordinate pharmacy and medical claims. It could also increase their leverage in price negotiations with drugmakers. (Banerjee, 3/8)

The nation's largest health insurer, UnitedHealth Group, is following rival Anthem's footsteps with a new payment policy aimed at reducing its emergency department claims costs. Under the policy, rolled out nationwide March 1, UnitedHealth is reviewing and adjusting facility claims for the most severe and costly ED visits for patients enrolled in the company's commercial and Medicare Advantage plans. (Livingston, 3/7)