Cigna announced it will buy Express Scripts for $52 Billion, setting off a frenzy of speculation and analysis. Including $15 billion in debt, the proposed $67 billion acquisition is largely seen as a response to the formation of a healthcare company by Amazon, Berkshire Hathaway and Morgan Chase. If this and the similar acquisition by CVS of Aetna succeed without Department of Justice interference, then pharma may need to review its strategy as it faces an evermore unified stakeholder to contract with. One reaction could be a wave of M&A activity within pharma to counteract the consolidation of its opponents.

Manufacturer Sanofi and Regeneron announced they will bring the price down to ensure access to the expensive but promising PCSK9 inhibitor PRALUENT. The manufacturers recent press release states that the drug met its primary endpoint of significantly reducing the risk of major adverse cardiovascular events (MACE) in patients who had suffered a recent acute coronary syndrome (ACS) event such as a heart attack.

On the policy front: It’s a good time to be healthy and employed in a Republican state or otherwise be in a Democratic state as the ACA is getting state by state makeovers. Republican states are loosening restrictions on the types of plans that can be sold and increasing work requirements for those on Medicaid. Meanwhile Democratic states are working to preserve the individual mandate and the ACA’s essential benefits of plans.

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