It may be one of the most tortured corporate relationships in the health-care industry right now.

A 15-month fight between Anthem Inc. and Express Scripts Holding Co. spilled into public view again this week as the companies traded volleys over whether or not the insurer will renew its pharmacy benefit management contract with Express Scripts at the end of 2019.

On Monday afternoon, Express Scripts shares plunged after the company said that it had been told by Anthem, its biggest customer, not to bother making an offer for the contract. Then, Wednesday morning, Anthem's CEO said not so fast — the insurer had made no decisions yet. Observers were left scratching their heads about what is going on.

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