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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
sy.mukherjee@fortune.com
@the_sy_guy

DIGITAL HEALTH

FDA greenlights new digital health tool for autism disorders. The Food and Drug Administration (FDA) has granted clearance for Cognoa's autism diagnosis aid for children. The technology, called Canvas Dx, combines hospital data with other behavioral biometrics that can be collected at home via an app in order to help primary care doctors identify the specific contours of a child's autism diagnosis and help plot a medical care plan to address it early on. It also incorporates information, with the help of artificial intelligence, that can guide physicians to tailor their treatment plans based on a patient's socioeconomic conditions, age, and race. (MedPage Today)

INDICATIONS

The world's largest cancer conference begins. It's that time of year again. The American Society of Clinical Oncology (ASCO) is holding its 2021 meeting starting tomorrow, and one early win comes for Swiss drug giant Novartis. The firm has a major footprint in the cancer space and a late-breaking clinical presentation announced Thursday suggests that its $2.1 billion bet on 177Lu-PSMA-617 could eventually (if slowly) pay off as an effective treatment for late-stage prostate cancer. Clinical studies suggest a nearly 40% reduction in risk of death (over the course of nearly three years) with this treatment compared to the usual standard of care. But the key indicator to watch from a financial standpoint is whether or not this treatment can be used at earlier stages of the disease or before the use of other drugs, which could vastly expand its reach. (Evaluate)

THE BIG PICTURE

President Biden's vaccine-sharing plan. The United States has faced criticism from developing nations for not being aggressive in COVID vaccine-sharing efforts. In an effort to combat the narrative of vaccine nationalism, and to boost a global immunization campaign in a critical moment, the Biden administration announced that it will donate 75% of unused COVID vaccines in the U.S. to COVAX, the worldwide vaccine sharing program. That includes plans to share 80 million COVID vaccine doses by the end of the month. “As long as this pandemic is raging anywhere in the world, the American people will still be vulnerable,” Biden said in a statement. “And the United States is committed to bringing the same urgency to international vaccination efforts that we have demonstrated at home.” (Fortune)

Fauci emails unleash another round of coronavirus lab leak speculation. Dr. Anthony Fauci pushed back on claims that he had been too lenient with Chinese health authorities at the start of the COVID pandemic in an interview with CNN following the release of thousands of his emails over the course of the outbreak. But he didn't quite deny outright that a lab leak in Wuhan may have fueled the rise of coronavirus. "I have always said, and will say today to you... that I still believe the most likely origin is from an animal species to a human, but I keep an absolutely open mind that if there may be other origins of that, there may be another reason, it could have been a lab leak," said Fauci in the interview. The famed physician still urged caution over jumping to conclusions, however. "The idea I think is quite farfetched that the Chinese deliberately engineered something so that they could kill themselves as well as other people. I think that's a bit far out," he said. (CNN)

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