Biggest Healthcare Companies by Revenue

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UnitedHealth Group is the biggest healthcare company by revenue in this ranking, followed by CVS Health and McKesson. The order is based on trailing 12-month (TTM) revenue, meaning sales over the most recent four reported quarters, as compiled by companiesmarketcap.com in the snapshot dated Nov 9, 2026. The top eight places all go to U.S. companies that insure patients, manage pharmacy benefits or distribute drugs. Household-name drugmakers such as Johnson & Johnson and Eli Lilly appear only after them.

What the Ranking Measures

Ranking by TTM revenue has three practical effects.

• It captures scale of activity, not profit. A company that resells $100 of medicine for $102 records $102 of revenue, even though it keeps only a sliver of it. A drugmaker selling a patented medicine may record less revenue but keep far more of each dollar.
• It smooths over different fiscal years. Many healthcare firms do not use the calendar year. McKesson’s fiscal year, for example, ends March 31. Using the latest four quarters puts companies with different reporting calendars on a comparable footing.
• It converts foreign companies into dollars. Roche, Novartis, Sanofi, Bayer, Novo Nordisk, Takeda and the German groups report in their home currencies. Their dollar revenue, and therefore their rank, can shift when exchange rates move even if their local-currency sales do not.

Revenue is also counted for the whole company. Where a group runs businesses outside healthcare, those sales are included in the figure that places it on the list.

Why Insurers and Distributors Dominate the Top

The ranking mixes companies that produce medical goods (drugs, devices, diagnostics, supplies) with companies that provide or pay for medical services (insurers, hospital operators, pharmacies). The business model largely decides how high a company can climb on revenue.

Health Insurers and Managed Care

Insurers record the premiums they collect from employers, individuals and government programs as revenue, then pay out most of it in medical claims. Because premiums cover the full cost of members’ care, the revenue figures are enormous.

• UnitedHealth Group combines the UnitedHealthcare insurance business with its Optum units: Optum Health (care delivery), Optum Insight (data analytics and consulting for providers) and Optum Rx (pharmacy services).
• Elevance Health operates through affiliates including Anthem and Wellpoint, offering commercial, Medicare and Medicaid plans along with pharmacy, behavioral and complex-care services.
• Centene focuses on government-sponsored coverage, administering Medicaid, Medicare Advantage and Medicare prescription drug plans across all 50 states.
• Molina Healthcare is also built around Medicaid and Medicare, plus plans sold on state insurance marketplaces.
• The Cigna Group pairs its health services business, which serves customers in more than 30 countries, with the Express Scripts pharmacy benefit manager it acquired in 2018.

CVS Health, through its Aetna arm, is the other major insurer in the list. Centene and Molina are the most concentrated on Medicaid and Medicare, which ties their results closely to government program funding and reimbursement rates.

Drug and Medical-Supply Distributors

McKesson, Cencora (known as AmerisourceBergen until 2023) and Cardinal Health buy medicines from manufacturers and deliver them to pharmacies, hospitals and clinics. The full wholesale value of every product they move counts as revenue, so they rank near insurers despite operating on thin margins.

• McKesson distributes pharmaceuticals and medical products in the U.S., Canada and Europe, working with drugmakers, care providers, pharmacies and governments.
• Cencora distributes medications and supplies and works with manufacturers to bring products to market.
• Cardinal Health both manufactures and distributes medical and laboratory products, and states that it serves about 90% of U.S. hospitals.
• Medline, near the bottom of the 30, is a medical-supply maker and distributor whose revenue is far smaller than the big three drug wholesalers.

Pharmacy Benefit Managers and Pharmacies

CVS Health owns a national drugstore chain, the Caremark pharmacy benefit manager (PBM), the Aetna insurer and MinuteClinic walk-in clinics. A PBM negotiates drug prices with manufacturers and processes prescription claims for health plans and employers, and the drug spending flowing through those arrangements adds substantially to revenue. Cigna (Express Scripts) and UnitedHealth (Optum Rx) own the other large PBMs, which is one reason those three sit so high in the ranking.

Hospital Operators

HCA Healthcare is the only pure hospital operator in the list. It reports running about 190 hospitals and roughly 2,400 ambulatory sites across 20 U.S. states and the United Kingdom, earning revenue from inpatient and outpatient care, surgeries and other patient services, largely paid by insurers and government programs.

Drugmakers and Medical Technology

From ninth place down, the list is mostly pharmaceutical and biotechnology companies, starting with Johnson & Johnson and Eli Lilly. They earn revenue from prescription drugs, vaccines and, in some cases, consumer products and diagnostics. Roche, for instance, has both a pharmaceuticals and a diagnostics division. Siemens Healthineers represents medical technology, selling imaging and diagnostic equipment.

These companies invent and manufacture the products that distributors and pharmacies resell, so a single prescription can show up in the revenue of several companies on the list: the drugmaker that sells it, the wholesaler that delivers it, the pharmacy that dispenses it and the PBM that processes the claim.

Revenue Rank Versus Market Value

Market capitalization (share price multiplied by shares outstanding) often points in the opposite direction from revenue rank. Eli Lilly sits in tenth place by revenue but has the largest market cap of the 30 companies, above $1 trillion. Johnson & Johnson and AbbVie also have market values several times their annual revenue. By contrast, the distributors and the Medicaid-focused insurers have market values well below their annual revenue.

A simple way to compare is the price-to-sales ratio:

Price-to-sales = market cap ÷ TTM revenue

Hypothetical example: Company A has $300 billion of revenue and a $60 billion market cap, a ratio of 0.2. Company B has $60 billion of revenue and a $480 billion market cap, a ratio of 8. Company A is five times larger by revenue, yet investors value Company B eight times higher. That gap usually reflects expectations about margins and growth, not size.

The ratio does not tell you which stock is cheap or expensive. It shows how much investors pay for each dollar of sales, which is only meaningful against companies with similar business models. Comparing a wholesaler’s ratio with a biotech’s says little. The largest companies by market cap ranking orders firms by value instead.

Names and Groups That Need a Closer Look

• Merck and Merck KGaA are separate companies. Merck (MRK) is a U.S. drugmaker. Merck KGaA (MRK.DE) is a German group with healthcare, life science and electronics businesses. They share a historical origin but have been independent for over a century, and the U.S. company operates as MSD outside North America.
• Bayer’s revenue includes crop science. Its total sales cover pharmaceuticals, consumer health and a large agricultural business, so its rank overstates its pure healthcare revenue.
• Johnson & Johnson is now pharma plus medtech. It spun off its consumer health business as Kenvue in 2023, so its current revenue comes from innovative medicine and medical devices.
• Fresenius is a German healthcare group whose revenue comes from businesses such as hospital operation and clinical nutrition and generic injectable drugs.

Where the Non-U.S. Companies Rank

Nineteen of the 30 companies are U.S.-based and 11 are headquartered elsewhere. The first non-U.S. entry is Roche at No. 11. Germany has the most international entries with four (Bayer, Fresenius, Siemens Healthineers and Merck KGaA), followed by Switzerland and the United Kingdom with two each (Roche and Novartis; AstraZeneca and GSK), and France, Denmark and Japan with one each (Sanofi, Novo Nordisk and Takeda).

Every non-U.S. company in the list is a drugmaker, a medtech firm or a diversified healthcare group. None is an insurer or a drug wholesaler. Many countries fund care through public or regulated insurance systems rather than large listed private insurers, which leaves their biggest listed healthcare companies concentrated in manufacturing.

The Spending Behind These Revenues

The concentration of U.S. companies at the top reflects how much the U.S. spends on care. According to the Peterson-KFF Health System Tracker, the U.S. spent about $13,432 per person on health in 2023, nearly double the $7,393 average of comparable high-income countries, and led on prescription drug spending at about $1,713 per person.

That spending is the pool these companies draw on. In the U.S., employers, households and government programs such as Medicare and Medicaid pay premiums to insurers and reimbursements to providers. Those dollars then move to hospitals, PBMs, pharmacies, wholesalers and manufacturers, each recording its share as revenue, so the ranking is largely a map of where U.S. healthcare dollars pass through.

How to Use the Ranking

1. Which companies handle the most healthcare spending? Revenue rank answers this directly.
2. Which are most profitable? Look at net income or margins. A company can post very large revenue in a year it records a loss.
3. Which does the market value most? Use market cap or the price-to-sales ratio within a business group.
4. Which are true peers? Compare insurers with insurers, distributors with distributors and drugmakers with drugmakers, since their revenue figures are built the same way.
5. Which make healthcare products? Start from the drugmakers and Siemens Healthineers, plus Cardinal Health and Medline on the supply side.

The Bottom Line

Investors and readers comparing healthcare companies should treat revenue rank as a measure of how much spending passes through each firm. It says nothing about profit or value. To judge profitability, look at net income or margins, and use market cap or price-to-sales only among companies with the same business model, such as insurers against insurers or drugmakers against drugmakers.