The board of US health insurer Aetna has signed off a $69bn (£51bn) takeover approach from pharmacy operator CVS Health, according to reports.
The deal would be this year's biggest corporate transaction.
Multiple sources told Reuters that Aetna execs gave the sale the thumbs up on Sunday. Aetna shareholders will receive $207 per share through a combination of cash and CVS Health shares.
Aetna shares closed at $181 each on Friday.
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The transaction brings together two of the US' biggest and best-known brands. Aetna offers a broad range of policies from employer policies to government plans.
The pharmaceutical and healthcare sector across the Atlantic has come under pressure from Obamacare, rising drug prices and competition from online retailers such as Amazon. The combination of insurer and pharmacy is likely to put the combined firm in a better place to negotiate lower prices.
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