As drug prices fall under increased scrutiny, payers and regulators are targeting some key initiatives that could change the dynamic of pharmacy benefit management over the next 12 months. These emerging trends point to potentially rougher terrain for drugmakers looking to increase market share as payers take a more active role in enforcing formularies.

The U.S. Justice Department will not challenge the $69 million merger of CVS Health and health insurer Aetna.

U.S. Food and Drug Administration chief Scott Gottlieb criticized pharmacy benefit managers, health insurers and drugmakers for “Kabuki drug-pricing constructs” that profit the industry at the expense of consumers.

Amazon.com Inc., Berkshire Hathaway and JPMorgan Chase & Co. will form a healthcare company aimed at cutting costs for their U.S. employees, they said on Tuesday, sending shares in the broad healthcare sector sharply lower.

CVS Health’s proposed purchase of Aetna will change the way many major U.S. corporations buy health coverage for employees, according to benefit consultants.

U.S. pharmacy operator CVS Health Corp. made an offer to acquire No. 3 U.S. health insurer Aetna Inc. for more than $200 per share, or over $66 billion, sources said.

Shares of drug retailers Walgreens Boots Alliance Inc., CVS Health Corp. and Rite Aid Corp. tumbled after reports that Amazon.com Inc. was looking to make a move into selling drugs online.

The largest U.S. retail pharmacies – including Wal-Mart Stores Inc. and Walgreens Boots Alliance Inc. – are wielding more leverage when buying generic drugs, accelerating a decline in prices likely to affect drug companies for some time, industry experts said.

CVS Health and Cleveland Clinic expanded their eight-year clinical affiliation to enhance access to care for patients throughout Northeast Ohio and Florida, and improve quality, coordinated delivery of care, and health outcomes for patients.