"The question that employers will have is whether this new entity can execute, given that health care is local, with a very fragmented delivery system. The track record from the mergers within health care haven’t been great, so skepticism will be around execution – but the opportunity is there.

"The other question is whether this new entity can disrupt an overly complex pharmacy supply chain, or will it otherwise continue to entrench an already entrenched business model? There are possibilities around the management of both pharmacy and medical collectively. When managed separately, that sometimes creates the wrong incentives, but integrating pharmacy and medical management can impact the total costs of care."

Jim Winkler, global chief innovation officer
of Health at Aon, Norwalk, Connecticut

"We’re all working off fairly limited amount of information at this point, but to us, this is a transaction that has the potential to be transformative as it relates to how health care is accessed and paid for – and not just pharmaceuticals.

"There is lots of coverage around pharmaceuticals, given this is CVS, but we look at this as one of many things that is happening in health care that seeks to transform the way we seek care from traditional players in this ecosystem – potentially creating space for new entrants to come in.

"While this is a very big transaction between two very big companies, this is really going to be one where innovation has to have as big as a seat at the table as integration when the two companies come together. In a typical merger-of-equals by competitors in the same space, it’s really about integration – taking out costs. But since this transaction is by adjacent players in different parts of the health ecosystem, it’s really important for the leaders to think about how to build a combined company that’s driven by innovation and transformation in the marketplace.

"It’s not just about nuts and bolts about how to integrate the two – innovation will be the most impactful part of the success story."

Dinesh Sheth, chief executive of Green Circle Health
Pensacola Beach, Florida

"For Aetna, this deal makes perfect sense, to realize their investment value for their stockholders. It’s a great transaction for Aetna on the business side. For CVS, it remains to be seen. They are branching out into unchartered territory. They already own a PBM, Caremark, but to buy an insurance company – it’s a very interesting expansion of their own business.

"It’s intriguing how they are going to monetize [the acquisition] when they are projecting only $750 million in post-merger synergies. That’s not a huge consideration for the price they are paying. I think the success of the merger is going to depend on how much additional business will be derived from the insurance business.

"Now from the consumers’ point of view, if an individual is already an Aetna customer, then there’s not much change, as Aetna is already using CVS Caremark as their PBM. CVS has other clients that buy from the PBM, and for those clients, the question will be what synergies Aetna brings to the table.

"If you are a large corporate client and are using CVS Caremark, but your insurance is provided by Anthem or UnitedHealthcare, do you now go to Aetna? Then you will be helping grow that side of the business for CVS."