Such risks and uncertainties include, but are not limited to: our ability to achieve our financial, strategic and operational plans or initiatives; our ability to predict and manage medical costs and price effectively and develop and maintain good relationships with physicians, hospitals and other health care providers; the impact
of modifications to our operations and processes; our ability to identify potential strategic acquisitions or transactions and realize the expected benefits
of such transactions, including with respect to the Merger; the substantial level
of government regulation over our business and the potential effects
of new laws or regulations or changes in existing laws or regulations; the outcome
of litigation, regulatory audits,
investigations, actions and / or guaranty
fund assessments; uncertainties surrounding participation in government - sponsored programs such
as Medicare; the effectiveness and security
of our information technology and other business systems; unfavorable industry, economic or political conditions, including foreign currency movements; acts
of war, terrorism, natural disasters or pandemics; our ability to obtain shareholder or regulatory approvals required for the Merger or the requirement to accept conditions that could reduce the anticipated benefits
of the Merger
as a condition to obtaining regulatory approvals; a longer time than anticipated to consummate the proposed Merger; problems regarding the successful integration
of the businesses
of Express Scripts and Cigna; unexpected costs regarding the proposed Merger; diversion
of management's attention from ongoing business operations and opportunities during the pendency
of the Merger; potential litigation associated with the proposed Merger; the ability to retain key personnel; the availability
of financing, including relating to the proposed Merger; effects on the businesses
as a
result of uncertainty surrounding the proposed Merger;
as well
as more specific risks and uncertainties discussed in our most recent report on Form 10 - K and subsequent reports on Forms 10 - Q and 8 - K available on the Investor Relations section
of www.cigna.com
as well
as on Express Scripts» most recent report on Form 10 - K and subsequent reports on Forms 10 - Q and 8 - K available on the Investor Relations section
of www.express-scripts.com.
The meta - analysis, published online Jan. 20, 2013, in Annals
of Internal Medicine, pools
results from 15
investigations, slightly more than half
of which were done after a 1996 federal law prohibited the U.S. Department
of Health and Human Services from
funding research that could be seen
as promoting gun control.