(Compares with estimates, adds background)
Feb 6 (Reuters) - Cigna Corp reported a better-than-expected quarterly profit on Thursday, as the health insurer kept a tight lid on medical costs and benefited from its $52 billion acquisition of Express Scripts.
The acquisition of the pharmacy benefits manager has put it in direct race with CVS Health Corp, which bought health insurer Aetna Inc, and UnitedHealth Group Inc's Optum pharmacy benefits unit.
Cigna's medical care ratio, which represents the amount it spent on medical claims compared to income from premiums, was 82.3% in the fourth quarter, in line with estimates.
The company said its expects adjusted revenue between $154 billion and $156 billion in 2020.
Cigna said net income attributable to shareholders rose to $977 million, or $2.60 per share, in the fourth quarter ended Dec. 31, from $144 million, or 55 cents per share, a year earlier.
Excluding items, it earned $4.31 per share, beating the average analysts' estimate of $4.20, according to IBES data from Refinitiv.
The company said its adjusted revenue rose to $36.54 billion, beating estimates of $35.07 billion.
Reporting by Tamara Mathias and Manojna Maddipatla in Bengaluru; Editing by Arun Koyyur