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The health insurance deal went public Thursday morning. Photo: James Leynse / Corbis via Getty Images

Health insurer Cigna has agreed to buy pharmacy benefit giant Express Scripts for $52 billion in cash and stock. Including debt, the deal is valued at $67 billion. The Wall Street Journal first reported about the deal Wednesday night.

The big picture: The health care industry continues to consolidate at a breakneck pace. CVS Health and Aetna are attempting to combine in a similar tie-up of health insurance and pharmacy benefit management. Numerous hospital systems and other health care companies also are rushing to merge in what has become an all-out turf war.

Driving the news: Anthem split ways with Express Scripts after Anthem said Express Scripts pocketed "obscene" profits from their prescription drug contract.

  • Because Express Scripts lost a highly profitable drug plan client, which drove a lot of negativity on Wall Street, Express Scripts became a takeover target.
  • We previously reported that Cigna had a lot of cash to spend and made it clear it would be on the prowl for some kind of deal after its merger with Anthem flopped. But it appears Medicare rival Humana is not on the table for now.
  • Health insurers and pharmacy benefit managers have been aligning more, like CVS and Aetna, in an attempt to save costs on drugs.
  • Yes, but: What's old is new again.

Go deeper

Biden's Day 1 challenges: Systemic racism

Photo illustration: Sarah Grillo/Axios. Photo: Kirsty O'Connor (PA Images)/Getty Images

Advocates are pushing President-elect Biden to tackle systemic racism with a Day 1 agenda that includes ending the detention of migrant children and expanding DACA, announcing a Justice Department investigation of rogue police departments and returning some public lands to Indigenous tribes.

Why it matters: Biden has said the fight against systemic racism will be one of the top goals of his presidency — but the expectations may be so high that he won't be able to meet them.

Caitlin Owens, author of Vitals
1 hour ago - Health

Most Americans are still vulnerable to the coronavirus

Adapted from Bajema, et al., 2020, "Estimated SARS-CoV-2 Seroprevalence in the US as of September 2020"; Cartogram: Andrew Witherspoon/Axios

As of September, the vast majority of Americans did not have coronavirus antibodies, according to a new study published in JAMA Internal Medicine.

Why it matters: As the coronavirus spreads rapidly throughout most of the country, most people remain vulnerable to it.

Trump set to appear at Pennsylvania GOP hearing on voter fraud claims

President Trumpat the White House on Tuesday. Photo: Chip Somodevilla/Getty Images

President Trump is due to join his personal lawyer Rudy Giuliani in Gettysburg, Pennsylvania, Wednesday at a Republican-led state Senate Majority Policy Committee hearing to discuss alleged election irregularities.

Why it matters: This would be his first trip outside of the DMV since Election Day and comes shortly after GSA ascertained the results, formally signing off on a transition to President-elect Biden.