I'm not sure what Aetna brings to the table in regard to a future where nurses fill CVSes, either. That seems like it would be a far bigger operation than buying Aetna, and the two would be only tangentially related.
Buying Aetna makes it easier to expand the new Minute Clinic business model. CVS no longer has to worry about getting paid less than a hospital for treating a cough or fever. Aetna could even charge zero copay for nurse visits. It's more competition in the "basic healthcare" space (if it happens).
Amazon is going to buy drugs in major bulk (Walmart, or Mail-order-pharmacy style), and likely will charge low "dispensing fees" (because robots will do most thigs). CVS is looking to be the "other other Walmart" of pharmacies. I have worked (as an intern) in many pharmacies, and I've seen several buyouts. At this point in time, I'm very happy that I made the leap from PharmD to SRE/DevOps about 11 years ago. Pharmacists will be robots in <5 years IMHO.
All pharmacies, electronic and brick-and-mortar, go through one of 3 wholesalers: Cardinal, AmerisourceBergen, or Mckesson. It's, "which retailer can drive distribution?"
We both agreed it would never have been so easy in the states.
Hospitals do this too. In some cases 2-3 pharmacists can cover 10-12 hospitals for off shift dispensing needs.
With the black horse cavalry running the country, we’re going to see lots of M&A activity like this.
The problem with these mergers is they allow health plans that further disadvantage other pharmacies or providers. Once those other options are eliminated we’ll see prices rise. Do people actually want the Home Depot’s of healthcare rather than the equivalent of the local hardware store? We’ll see I guess.
Evidence suggests that they've used their monopoly to artificially inflate prices quite dramatically.
A brick and mortar pharmacy must have a pharmacist on-site to dispense drugs. Not only are they supposed to do a final check on prescriptions filled, but they must be available for patient question and sometimes medicine requires advice from a pharmacist before it can be dispensed. In addition, there are some stricter laws for certain controlled medications and these checks must be done by a pharmacist. If the pharmacist gets sick or in a car accident on the way to work, the pharmacy can't legally open (they can section the pharmacy off with its own locks to keep the convenience store open).