Shareholders from both companies back the deal, which remains the subject of a DOJ antitrust review.
Shareholders at Cigna Corp. and Express Scripts overwhelmingly approved the $52 billion merger agreement on Friday morning, the two companies announced.
Early results show that 90% of Cigna shareholders favored the deal, as did 78% of Express Scripts shareholders.
"By approving our proposed combination, Cigna and Express Scripts stockholders recognize and validate the highly attractive value this transaction delivers to all stakeholders," Express Scripts CEO Tim Wentworth said in a media release.
"Together, we will transform healthcare by combining two innovative healthcare services companies that will have the capabilities, financial flexibility, reach and expansion opportunities to create significant and immediate value for clients and stockholders," Wentworth said.
Cigna CEO David M. Cordani called the strong endorsement by shareholders a "recognition of the combination's significant value creation potential."
The deal recently was endorsed by two independent analysts, prompting Cigna investor Carl Icahn to drop his previous opposition. Before the favorable analyses, Icahn had urged Cigna stockholders to vote against what he called a "$60 billion folly."
Cordani has been an unabashed cheerleader for the deal.
"Our combined company will enhance Cigna's differentiated service-based model, fueled by actionable insights and analytics, to drive innovation and meaningful growth in a highly dynamic market environment," Cordani said. "As a result, we will build more effective partnerships, further improve health outcomes and deliver a superior customer experience."
The final voting results will be filed with the Securities and Exchange Commission.
The merger is the subject of a Department of Justice antitrust review. If the deal clears those regulatory hurdles, it is expected to close by the end of this year.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
Cigna, Express Scripts leaders vow merger will 'transform healthcare.'
If the deal clears antitrust hurdles, it could be finalized by year's end.