Gilead Sciences Inc. plans to launch generic versions of the company’s hepatitis C drugs in the United States, at a time when regulators are looking to lower healthcare costs.

Health insurer Cigna Corp.’s $52 billion acquisition of pharmacy benefits manager Express Scripts Holding Co. passed U.S. antitrust scrutiny, the companies said.

Cigna Corp. shareholders voted in favor of the health insurer’s proposed $52 billion acquisition of pharmacy benefit manager Express Scripts Holding Co.

Express Scripts Holding Co. built a multi-billion enterprise pressuring drug companies to lower their prices for U.S. patients. Now the pharmacy benefit manager is quietly building a side business: getting paid to help drug companies dispense a new generation of high-priced drugs.

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 largest U.S. manager of prescription benefits is telling drugmakers that the current pricing model is broken, and is taking aim at Amgen Inc. and other makers of new migraine medicines to try and fix it.

U.S. health insurer Cigna Corp. will buy pharmacy benefits manager Express Scripts Holding Co., a tie-up that reflects pressure on healthcare companies to grow bigger to cut costs.

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.