After weathering a rocky 2018 and facing public pressure from a hedge fund, Magellan Health Inc. appears more and more likely to end up on the selling block. Some say that if the company does opt for a sale, its PBM could be one of the most attractive assets to potential buyers, AIS Health reported.

On Feb. 22, the hedge fund Starboard Value — which owns approximately 9.8% of Magellan shares — sent an open letter to the company’s shareholders suggesting new candidates for its board of directors and urging Magellan management to explore selling all or part of the company.

Leerink analyst Ana Gupte suggested that Anthem and UnitedHealth are the most likely strategic buyers, “in light of their synergies with Medicaid in [Magellan’s] Complete Care [segment], and the PBM across IngenioRx and Optum Rx.”

To Jefferies analyst David Styblo, Magellan’s PBM Magellan Rx “doesn’t seem as integrated” as its other business segments and thus could be sold as standalone asset. That “could be interesting for companies wanting to enhance their medical pharmacy and clinical management capabilities,” Styblo wrote in a research note.

In general, “there’s always an opportunity for good-quality PBM assets” to be purchased in the managed care space, says Ashraf Shehata, a principal in KPMG’s health care life sciences advisory practice and Global Healthcare Center of Excellence.

He also argues that in the PBM industry, there is an opportunity for an organization that wants to act as an “aggregator” of smaller PBMs by buying up several of them, putting them on a common platform and making improvements to their rebating and pricing tools. “If somebody were willing to do that, there could be kind of a bigger back-end valuation,” Shehata says.

The PBM, though, has had its issues. The company said in its fourth-quarter and full-year 2018 earnings report that Magellan Rx’s profits decreased from $139.9 million in 2017 to $104.4 million in 2018.