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Data: Company filings; Chart: Naema Ahmed/Axios

A majority of the health care industry's profits in the first three months of 2019 went to the top 10 companies, and 9 of those 10 companies were pharmaceutical manufacturers, according to Axios' quarterly analysis of industry financial reports.

The bottom line: Quarter after quarter after quarter shows drugmakers continue to wield the highest profit margins in the industry even though the political and public uproar over drug prices has somewhat dampened their stocks.

Between the lines: Nothing has fundamentally changed for drug companies even though the Trump administration is tinkering with ideas on how to lower what people pay for their prescriptions.

  • Drug companies are charging more for their patent-protected medicines at prices that are well above what it costs to make them, and/or they are selling more of their drugs overall.
  • The insulin made by Eli Lilly and Novo Nordisk, Merck's cancer drug Keytruda, and Pfizer's breast cancer pill Ibrance epitomize this growth of sales and prices.

By the numbers: Investors have soured a bit on health care, including pharma, but the numbers don't lie.

  • 12 of the most profitable drug companies in Q1 collectively reported more than $29 billion in profits.
  • A dozen companies had net profit margins above 30% in the first quarter, 9 of which were pharma firms. Alexion Pharmaceuticals' margin was 52%, one of the highest margins in the industry after accounting for odd, one-time items.

Yes, but: Our analysis does not include financial statements of not-for-profit hospitals, due to their protracted reporting patterns, and there are a lot more hospitals in the country than drug companies.

  • Hospitals represent the largest share of health care spending, and an initial look at the not-for-profit systems' first-quarter reports shows net income has been increasing.
  • Negotiating power over private health insurers has allowed the dominant hospital systems to maintain or grow their wealth.

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