Cigna purchasing Express Scripts in $52 billion deal

Health insurer Cigna is buying the nation’s biggest pharmacy benefit manager, Express Scripts, the latest in a string of proposed mergers as health care’s bill-payers attempt to get a grip on rising costs.

The $52 billion deal announced Thursday follows the drugstore chain CVS Health Corp.’s roughly

$69 billion bid to buy the insurer Aetna Inc., an acquisition the companies detailed in December.

Insurers and pharmacy benefit managers — which run drug plans for insurers and employer-based plans — have struggled to keep costs under control for clients like big companies that provide coverage to their workers. They are pushing to shift health care from a system that treats the sick to one that essentially tries to prevent you from getting sick in the first place or keeps you out of an expensive hospital.

They’re not the only ones hunting for solutions. Amazon said earlier this year that it will collaborate with billionaire Warren Buffett and Jpmorgan Chase to create a company that provides their employees with high-quality, affordable care.

Insurers and others say they want to get more involved in patient care, to supplement what a regular doctor provides and keep people healthy and on their medications. They are especially focused on those with chronic conditions, like a diabetic who needs regular blood sugar monitoring and care to stave off heart attacks or other serious illnesses.

“They want to be the consumer’s partner in managing their health through data and services that help them take charge of their own health,” health economist Paul Keckley said.

Aetna and CVS have said they hope to create “front doors” to care through CVS drugstores. That deal could turn many of the chain’s more than 9,800 locations into one-stop shopping for health care needs like blood work and eye or hearing care, in addition to their traditional role of filling prescriptions.

Unitedhealth Group Inc., which runs the nation’s largest insurer, is spending almost $5 billion to buy nearly 300 primary and specialty care clinics and some urgent care and surgery centers. That push will help the company steer patients away from hospitals and cut down on unnecessary emergency room visits.