Health insurer Cigna buying Express Scripts for $52 billion

Health insurer Cigna is buying the nation’s biggest pharmacy benefit manager, Express Scripts, the latest in a string of proposed tie-ups 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. No one knows what that means yet, but it sent a shudder through the industry.

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.