Cigna’s $52bn acquisition of Express Scripts is approved by the Department of Justice
Health insurer Cigna’s proposed $52bn acquisition of Pharmacy Benefit Manager (PBM) Express Scripts has recently been approved by federal officials, where it has been stated that a merger will provide a number of advantages to consumers in both insurance and PBM markets.
The news follows on from previous horizontal deals, such as Anthem’s acquisition of Cigna and Aetna’s of Humana being blocked due to this threat.
Traditional healthcare players are having to transform outdated business models in order to attract and retain customers, who want increased control over their healthcare, at competitive prices and can ensure high quality.
The emergence of players such as Amazon, Berkshire Hathaway and JP Morgan, amongst others, as well as the Trump Administration placing increased pressure on the industry, has led healthcare companies to look at further ways to reduce escalating healthcare costs and remain competitive.
“We are pleased that the Department of Justice has cleared our transaction and that we are another step closer to completing our merger and delivering greater affordability, choice and predictability to our customers and clients as a combined company,” said David Cordani, President and Chief Executive Officer of Cigna.
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“The value that we deliver together will help put our society on a far more sustainable path – one that helps health care professionals’ close gaps in care and supports our customers along their health journey.”
“Together, we believe we will be able to do even more to reduce health care costs, expand choice, and improve patient outcomes,” added Tim Wentworth, chief executive of Express Scripts.
"The Cigna-Scripts and CVS-Aetna deals are doing what everyone else in the healthcare space is doing right now, just on a grander scale – reacting to continued cost pressures from market forces like the Affordable Care Act, consumerism, and other industry players building scale against each other," commented Brad Haller, director of West Monroe Partners.
"The vertical integration we are seeing with retailers buying payers and health plans buying prescription benefit plan providers is the way the industry is going. Now that the DOJ has approved and provided certainty, one would expect others to follow suit."
As the combined company, led by Cordani will gain the ability to share patient data and negotiate lower prices, providing great transparency. The deal will also enable the business to gain greater traction within the Medicare programme.
The deal is expected to be completed by the end of 2018.
NHSX releases new data plans, experts call for transparency
Patients in England will get "greater control" over their health and care data according to new proposals set out by the government.
In a new draft strategy called "Data saves lives: reshaping health and social care with data", Health and Social Care Secretary Matt Hancock says that more effective use of data will deliver better patient-focused care. "This strategy seeks to put people in control of their own data, while supporting the NHS in creating a modernised system fit for the 21st century which puts patients and staff in pole position."
Under the new plans people will be able to access their medical records from different parts of the health system through different applications, to access test results, medication lists, procedures and care plans.
The strategy, published by NHSX, the government department that sets policies for the use of technology within the NHS, follows delays to the creation of a central database of patient records amid concerns over data sharing and a lack of transparency, with critics saying that only a small proportion of the public were made aware of the plans and the choice to opt out.
Kevin Curran, senior member of The Institute of Electrical and Electronics Engineers (IEEE) and Professor of Cybersecurity at the University of Ulster, says that moving health records online raises concerns. "The move to an online app does seem like a natural progression, however there is a difference between having computerised records within our healthcare IT infrastructure and having those records reside on a public facing server.
"Having records inhouse limits the range and type of access – it's far more difficult for remote hackers" Curran said. "There are techniques that healthcare organisations can use to reduce the risk of future data breaches. One way is to make it ‘opt in’, so patients have the choice to decide whether their medical information is moved to a public facing service so that they can access it.
"However, those who do not opt in or download the app instead should have their records hosted in a non-public-facing cloud service. This way, if a data breach does occur, those who never used the app, or not wanted to, will not have had their details released."
The new strategy has been welcomed by some, with an emphasis on the need for transparency. Adam Steventon, Director of Data Analytics at the Health Foundation, said: "Health data has played a critical role in the last year – from tracking COVID-19 outbreaks and developing treatments, to getting people booked in for their vaccines. It is critical that the use of data is accelerated if the NHS is to tackle the backlog of care and address the massive health challenges facing the country.
"It is particularly positive that the government has committed to building analytical and data science capability in the NHS and to improving data on social care. To ensure the full potential of data can be realised, the government must ensure transparency on how it will be used and the rights and options people have, as well as engaging with the public and health care professionals to build trust and show people how their data can improve the NHS and save lives."