The Justice Department announced on September 18 that they’ve approved the acquisition of Express Scripts by CIGNA. Additional state and other regulatory approvals are still required, but the deal is expected to close late this year.
There is very little overlap between CIGNA’s business as a national insurer and Express Script’s business as a pharmacy benefits manager and provider of stand-alone Part D prescription drug plans.
The CVS-Aetna acquisition is also expected to receive antitrust approval, but as a condition of receiving that approval (which as of this writing has not yet occurred) Aetna announced on September 27 that the're selling their stand-alone Part D busines to Wellcare. They're not selling any Medicare Advantage Part D (MAPD) drug plans.
The reason for the sale is that CVS owns Silverscript, the largest provider of stand-alone Part D plans, while Aetna also has a significant stand-alone Part D business, and the government thought this would be anti-competitive.
This will have no impact on Aetna's 2019 stand-alone drug plans. Benefits for those plans have already been approved by CMS (Medicare), and the agreement stipulates that Aetna will continue to administer those plans next year.
We had expected that divestiture of some drug plans would be a condition of government approval of the acquisition. Now that an agreement has been reached to sell the Aetna and Aetna Coventry (formerly called First Health) Part D plans, we expect that an announcement approving the deal will be made shortly. Additional state and regulatory approvals will still be required. CVS and Aetna have said that they expect the deal to be closed by the end of the year.