NEW YORK (AP) -- Express Scripts Inc. said Monday that it completed its $29.1 billion acquisition of Medco Health Solutions Inc., creating the largest pharmacy benefits manager in the country by far.
The closing came after the Federal Trade Commission voted to close its investigation into the deal, clearing the last hurdle in its path. Express Scripts shares rose $2.29, or 4.3 percent, to $56.47 in premarket trading.
The deal creates a pharmacy benefits manager, or PBM, so large that it will handle the prescriptions of about 135 million people, or more than one in three Americans.
Both companies touted the savings and efficiency that the combination would create, while others in the industry have voiced concerns about competition.
Last week, an alliance of drugstores and community pharmacists filed a federal lawsuit to stop the deal from going through, saying it would create a giant pharmacy benefits manager with too much leverage and market share.
Express Scripts Chairman and CEO George Paz said the combination of the two companies will both lower costs and improve patient care.
Pharmacy benefits managers, or PBMs, run prescription drug plans for employers, government agencies and other clients, using their large purchasing power to negotiate lower drug prices. They make money by reducing costs for health plan sponsors and members.
In July, St. Louis-based Express Scripts said it would pay $28.80 in cash and a portion of an Express Scripts share valued at $42.56 for each share of Franklin Lakes, N.J.-based Medco.
Express Scripts said Monday that it still expects the acquisition to result in cost savings of $1 billion once the two companies are fully integrated. The company also still expects its earnings per share to increase slightly in the first year after closing and then moderately increase once the companies are fully combined.
Both companies become subsidiaries of Express Scripts Holding Co., which will trade on the Nasdaq stock exchange under the symbol "ESRX."
Express Scripts has also made news with its public split with Walgreen Co., the nation's largest drugstore chain. After a contract expired, Walgreen stopped filling prescriptions for Express Scripts, saying it would rather give up the revenue than continue filling unprofitable prescriptions.