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The health care companies leading 2021’s Fortune 500 list

June 3, 2021, 10:32 PM UTC

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Good afternoon, readers.

It’s that time of year again. We’ve released 2021’s Fortune 500 list, our annual ranking of public U.S. companies ranked by their revenues over the past fiscal year. And guess what? During a global pandemic, the health care industry made a big splash.

Where to begin? CVS Health, now completely consolidated with insurer Aetna, took the number four spot. It’s followed immediately by UnitedHealth Group, the country’s largest private insurer. And then drug distributors McKesson and AmerisourceBergen make up numbers seven and eight in the rankings. That’s four legacy health care firms in the top 10 alone and other firms such as Apple, Alphabet, and Amazon in that top tier are at least attempting to become more medicine-focused themselves (with varying degrees of success).

All told, six of the top 20 and 10 of the top 50 companies on this year’s Fortune 500 are health care firms, and they run the gamut from pharmacies to drug distributors to insurers to pharmaceutical companies.

Insurers in particular had a year of windfall growth as the COVID pandemic shut down many elective medical procedures at hospitals, curbing massive payouts. For instance, UnitedHealthcare’s profits jumped 11.3% this past year even though the insurer had to cover health care services for coronavirus patients due to a drop-off in other payouts.

It’s a bit more complicated with pharmaceutical companies such as Pfizer which are manufacturing COVID vaccines. Since these vaccines were only granted emergency authorization at the end of 2020 and not initially meant to generate massive profits, they weren’t big money-makers for the vaccine pioneers. But that could change in the coming year. In fact, Pfizer has projected tens of billions of dollars in 2021 revenues from its jab. Sociopolitical questions such as responsible pricing could certainly influence that bullish projection.

As for CVS Health? CEO Karen Lynch, the highest-ranking female chief executive on the list, has overseen a transformation that emphasizes community access to basic health services such as testing, chronic disease management, and pharmacy sales over retail products. That was always the game plan for CVS following its Aetna integration, but the pandemic hastened its arrival. I encourage you to read my colleague Emma Hinchliffe’s coverage of her ascension and CVS’ evolution. And be sure to peruse all of our coverage of the biggest money makers in business this past year.

Read on for the day’s news, and see you again next Thursday.

Sy Mukherjee


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