A federal judge will hold a hearing Tuesday afternoon on a request to immediately stop Express Scripts Inc.'s $29.1 billion acquisition of fellow pharmacy benefits manger Medco Health Solutions Inc.

St. Louis-based Express Scripts said April 2 it had completed the acquisition, which it first announced last summer. The closing came after the Federal Trade Commission voted to close its investigation into the deal, clearing the last hurdle in its path.

The deal creates a combined PBM that will handle the prescriptions of more than one in three Americans.

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.

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