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.

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