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FILE - In this July 25, 2017, file photo, Express Scripts prescription medication bottles are arranged for a photo in Surfside, Fla. Health insurer Cigna will spend about $52 billion to acquire the pharmacy benefits manager Express Scripts, announced Thursday, March 8, 2018, the latest in a string of proposed buyouts and tie-ups in a rapidly shifting landscape for the health services industry. (AP Photo/Wilfredo Lee, File)

FILE - In this July 25, 2017, file photo, Express Scripts prescription medication bottles are arranged for a photo in Surfside, Fla. Health insurer Cigna will spend about $52 billion to acquire the pharmacy benefits manager Express Scripts, announced Thursday, March 8, 2018, the latest in a string of proposed buyouts and tie-ups in a rapidly shifting landscape for the health services industry. (AP Photo/Wilfredo Lee, File)

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