Cigna shareholders have approved a $52 billion acquisition of Express Scripts, putting one of the year's largest mergers in the health-care industry one step closer to reality.
The deal, which still needs approval from the Department of Justice, would merge Cigna, a health insurance giant, with Express Scripts, a company that manages prescription drug benefits for insurers and employers.
Express Scripts is one of the last of the pharmacy benefit managers (PBMs) not yet merged with insurance companies.
Cigna agreed to buy Express Scripts in March and hopes to close the deal by the end of the year.
The two companies say they could save money if they coordinated care with prescriptions.
PBMs like Express Scripts have faced harsh criticism from the Trump administration and members of Congress as drug prices soar.
Health and Human Services Secretary Alex Azar says PBMs purposely keep prices high to rake in more profits.
The Justice Department is also reviewing a merger between health insurer Aetna and CVS Health, a PBM.