Anthem wants IngenioRX to be less focused on rebates and more intent on keeping drug costs as low as possible. (Photo: Diego M. Radzinschi/THE NATIONAL LAW JOURNAL)

CVS Health Corp. and Cigna Inc. spent a combined $122 billion on Aetna Inc. and Express Scripts Holding Co. in deals that linked health insurers with pharmacy benefit managers, the health-care middlemen that negotiate drug costs. Their rival Anthem Inc. thinks it can do the same thing while saving money instead of spending it.

Along with fourth-quarter profit that beat analyst expectations Wednesday, Anthem said it is accelerating the launch of its in-house PBM IngenioRX to March from a previously planned start time in 2020. The company also announced higher 2019 profit guidance than analysts were expecting because it anticipates significant drug-cost savings. Investors seemed enthused, sending Anthem's shares higher by a meaty 10 percent.

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