Cigna logo on building The latest megadeal come as the Justice Department is rethinking how to approach transactions that combine firms operating at different points in an industry supply chain. (Photo: AP)

Cigna Corp.'s proposed deal for Express Scripts Holding Co. faces a drawn-out merger review as the Trump administration's antitrust enforcers weigh the competitive effects of a wave of consolidation sweeping the health-care industry.

The tie-up of the insurer and pharmacy benefit manager comes on the heels of CVS Health Corp.'s agreement to buy insurer Aetna Inc. In both combinations, the companies say they'll become more efficient firms and help lower health-care costs. Whether customers are actually poised to benefit is the key question for antitrust enforcers.

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