CVS is buying Aetna in massive deal that could transform health care

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The pharmacy chain agreed to buy Aetna for about $207 per share, or $69 billion.

The company explained this with an example of how diabetics could get quicker, easier treatment.

The FTC has typically handled mergers of retail businesses like CVS.

Bloss worries Aetna patients could be forced to get services from CVS. "Our combined company will be more competitive in the marketplace and accelerate progress toward achieving this mission", Bertolini said. "If this sets off a wave of consolidation, it's not clear what that's going to do to consumers." he said. Customers could see benefits down the road, however, if CVS turns some storefronts into clinics or primary care centers.

"We believe the acquisition represents the next evolution in healthcare services following the commingling of retail pharmacy, PBM and drug distribution business creating further, necessary economies of scale and an overall ecosystem that will be impossible for non-healthcare entities to compete with", Macquarie wrote.

Bertolini said during the conference call that many Medicare/Medicaid patients are "confused" and "wandering through the system" seeing numerous doctors and taking many different medications. PBMs like Optum and CVS's Caremark help manage prescription drug plans for commercial health insurers.

The prospects for the deal are uncertain, since mergers involving health insurance companies have recentlyrun into regulatory roadblocks.

So how close to reality is this vision, one where a trip to the drug store makes visits to the doctor's office or hospital less necessary?

The clinics started off as a place to treat basic health care needs like sinus infections or strep throat. Both deals were called off in February after they were blocked by federal judges citing antitrust concerns.

But the fact that CVS and Aetna are not really competitors could make it more likely that Washington will approve the combination. The latter two were deals in which one major health insurer sought to buy another.

The CVS-Aetna deal could attract similar scrutiny if regulators feared it could block Aetna customers from frequenting other pharmacies or contracting with other PBMs, several investors said, asking not to be named because they were not authorized to talk to the press.

The deal comes as healthcare payers and pharmacies are responding to a shifting landscape, including changes in the Affordable Care Act, rising drug prices and the threat of competition from online retailers such as Amazon.com (amzn).

Nationally, the CVS-Aetna deal, if completed, would rank somewhere between the 13th and 15th priciest deal of all time, depending on whether two other recently announced deals are ultimately finalized.

A combined CVS-Aetna will reorder those options, leaving Express Scripts as the only standalone company big enough to easily provide pharmacy benefits to top employers.

The ultimate goal, after all, is a land grab. "In fact, it's more than just a step to go from where they are to becoming a health care hub".

The deal "would definitely be scrutinized, but ultimately we still see a path for it to get through", Newshel said in an email.

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