Nov 12, 2018

Pharma's grip on the health care economy

Expand chart
Source: Axios analysis of company financial documents; Chart: Chris Canipe/Axios

Ten companies controlled half of the health care industry's $50 billion of global profit in the third quarter of this year, according to an analysis of financial documents for 112 publicly traded health care corporations. Nine of those 10 companies at the top are pharmaceutical firms.

The bottom line: Americans spend a lot more money on hospital and physician care than prescription drugs, but pharmaceutical companies pocket a lot more than other parts of the industry.

By the numbers: The health care industry's $50 billion of profit came from $636 billion of revenue, equating to a cumulative profit margin of almost 8%. Those are the highest figures of the past four quarters.

  • Approximately 63% of the profit total went to drug companies, even though they collected 23% of the revenue — numbers that mirror our past analyses.
  • Pfizer had the highest profit total ($4.1 billion) of any publicly traded health care company in the third quarter. Pfizer also said it will go back to its "normal" routine of raising drug prices after a public skirmish with President Trump.
  • Of the 19 companies that tallied at least $1 billion of third-quarter profit, 14 were drug companies. The others were either health insurers (UnitedHealth Group and Aetna) or involved in the drug supply chain (Walgreens, CVS Health, Express Scripts).
  • The analysis does not include not-for-profit hospital systems, but early returns still show the biggest systems have a lot of money.

Between the lines: The Republican tax law, which slashed the corporate tax rate, also continues to bolster the industry.

  • Drug firm AbbVie paid $14 million of income taxes on $2.76 billion of pre-tax earnings in the third quarter — an effective tax rate of just 0.5%. Pfizer's effective tax rate in Q3 was 1.6%.

The big picture: The health care industry arguably has more financial power now than at any point in its history, and a split Congress likely won't change that in the short term — even though patients are fed up with the system.

Go deeper

The health care debate we ought to be having

Photo Illustration: Sarah Grillo/Axios. Photos: Scott Eisen/Getty Images and Erik McGregor/LightRocket via Getty Images

Americans worry a lot about how to get and pay for good health care, but the 2020 presidential candidates are barely talking about what's at the root of these problems: Almost every incentive in the U.S. health care system is broken.

Why it matters: President Trump and most of the Democratic field are minimizing the hard conversations with voters about why health care eats up so much of each paycheck and what it would really take to change things.

Drugmakers opt to mine medical data in lieu of lengthy clinical trials

Big drugmakers Pfizer, Johnson & Johnson and Amgen have submitted data-mining analyses of electronic medical records to the Food and Drug Administration to help expedite the approval of new or improved medicines, the Wall Street Journal reports.

Why it matters: So far, parsing patient data instead of carrying out long clinical trials has cut costs and shortened drug-development times for breast cancer, bladder cancer and leukemia drugs.

Go deeperArrowDec 23, 2019

Hospitals' dueling financial realities

Illustration: Sarah Grillo/Axios

As hospital prices rise and much of the sector continues to rake in cash, rural hospitals continue to shutter.

Why it matters: There's no way to address U.S. health care spending without cutting hospital costs. But blanket cuts could hurt hospitals that are already struggling to keep their doors open, leaving vulnerable patients without access to care.

Go deeperArrowJan 13, 2020