CVS Health, an American drug store chain that also operates walk-in health clinics and a pharmacy benefit business, in October 2017 was reported to be in talks to purchase Aetna Insurance in a deal that could be worth more than $60 billion based on Aetna’s current market value. This would make the purchase one of the largest in the history of the health industry.

CVS, with the addition of its walk-in clinics, has been positioning itself as more of a healthcare provider than a pharmacy for a long time. The talks also appear to be an attempt to fend off a move by e-retailer Amazon into the drug-selling business, as the retail giant is reported to have gained licenses to become a wholesale prescription drug distributor in 12 U.S. states.

CVS is best known for its chain of storefront pharmacies and reported revenue of $177.5 billion for 2016. It is also the third-ranked U.S. pharmacy benefit manager and operates a large specialty pharmacy, which sells high-priced drugs that often require special handling. Its walk-in MinuteClinic, where people can speak to a licensed physician or nurse practitioner, can be found in CVS pharmacies as well as Target retail stores throughout the U.S.

The acquisition of Aetna would mark an industry shift toward a more seamless approach to managing health care costs. According to industry observers, CVS’s goal may be to acquire the ability to manage both medical and pharmacy costs for large employers. Many are self-insured or have plans that are reinsured to a captive, and simplifying the structure of their healthcare providers may be appealing to them. Aetna already has partnerships with numerous large health systems and a sophisticated technology operation.

The resulting company could end up resembling UnitedHealth Group, which has a large insurance operation but also runs a leading pharmacy benefit manager, OptumRx, and a related health service business. The deal would end Aetna’s ambitions to be a much bigger insurance company, especially after its proposed $37 billion merger with Humana in 2016-17 was blocked by the U.S. Department of Justice.