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Expand chart
Data: Company filings and FactSet; Chart: Naema Ahmed/Axios

The 5 largest conglomerates combining health insurance and pharmacy benefits are on track this year to be bigger than the 5 preeminent tech companies.

The big picture: Anthem, Cigna, CVS Health, Humana and UnitedHealth Group cumulatively expect to collect almost $787 billion in 2019, compared with $783 billion of projected revenue for Facebook, Amazon, Apple, Netflix and Google.

Yes, but: The tech companies cumulatively were 5 times more profitable than the health care companies in 2018 and are projected to be 3.5 times more profitable this year.

  • There's more money to be made selling smartphones and online ads than acting as a health care middleman.
  • Health insurers and pharmacy benefit managers pay out a vast majority of their revenues to hospitals, doctors and drug companies.
  • But insurers and PBMs are still turning large overall profits. And a delay in an Affordable Care Act tax is expected to create a big windfall for the insurance industry this year. Companies are working behind the scenes to get that tax delayed again for 2020 or permanently repealed.

It's also worth remembering that health insurance giants today do a lot more than just pay out claims for medical care and prescriptions.

  • UnitedHealth owns surgery centers, doctors' offices, consulting shops and data-analyzing services.
  • CVS, which just bought Aetna, brings in a lot of money through its retail pharmacies and in-store clinics.

Go deeper: The consolidation of health insurance and drug benefits is back

Go deeper

2 mins ago - Politics & Policy

Biden's tax-the-rich plans

Photo: Doug Mills/Pool/Getty Images

President Biden in the next few days will unveil eye-popping new tax rates for the wealthiest Americans —a top marginal income tax rate of 39.6% and a capital gains rate of 43.4%.

Why it matters: The proposal, to be announced ahead of Biden's address to Congress next Wednesday, is an opening bid for Hill negotiations.

Caitlin Owens, author of Vitals
23 mins ago - Health

The next generation of coronavirus vaccines won't come as quickly

Illustration: Aïda Amer/Axios

A flood of cash from Operation Warp Speed helped coax a slew of biotech companies into the race for a coronavirus vaccine, but the incentives to keep working on new competitors won't be nearly as strong.

Why it matters: That initial flood of cash worked — it delivered multiple, highly effective vaccines in record time. In other disease areas, though, second- and third-generation vaccines usually become the dominant products. And the first COVID-19 vaccines aren't necessarily a great fit for the whole world.

The Biden climate doctrine emerges at summit

Illustration: Annelise Capossela/Axios

President Biden's climate summit is highlighting a White House approach that blends diplomacy, executive power, salesmanship and a few threats too.

  • Here are a few pillars of the emerging Biden doctrine.

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