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Health Care: pay and profit in the S&P 500

The sector splits cleanly. Drug developers employ scientists and post the narrowest ratios; insurers and hospital operators employ hundreds of thousands of administrative and clinical staff and post the widest.

59
companies covered
213:1
median CEO-to-worker pay ratio
$80,380
median worker pay (sector midpoint)
$56,500
profit per employee (midpoint)

Health Care's median ratio of 213:1 sits just above the index median of 196:1, and its median worker pay of $80,380 is close to the middle. Those averages combine two business models with very different workforces.

Biotech and pharma: small, highly paid, narrow ratios

The narrowest ratios in the sector all belong to drug developers. Regeneron at 43:1 on a median of $174,138. Vertex at 80:1 on $264,487. Biogen at 83:1 on $208,335. Moderna at 84:1 on $225,053. Bristol Myers Squibb at 98:1 on $167,191. Incyte's median of $295,914 is the highest in the sector and among the highest in the index.

These companies employ research scientists, clinicians and regulatory specialists almost exclusively. There is no manufacturing floor or call centre to pull the midpoint down, and the ratios are correspondingly compressed. As with utilities, the narrow gap is mostly a fact about who the industry hires rather than a statement about pay policy.

Insurers and hospital operators: the widest gaps

UnitedHealth Group is the sector's most consequential entry: 748:1 across 390,000 employees, on a median of $81,474 and three-year average CEO compensation of $60.9 million. The median here is not low, since this is a well-paid workforce by index standards, so the compositional explanation that covers most extreme ratios is unavailable. The numerator is what puts it near the top.

HCA Healthcare at 379:1 across 320,000 employees works differently. Its median of $62,955 reflects a hospital workforce including large numbers of support and ancillary staff, and its CEO compensation of $23.9 million is comparatively modest. The gap comes more from the denominator.

Align Technology posts the sector's widest ratio at 800:1, and it is a manufacturing story: a median of $31,454 across 20,290 employees, reflecting production operations outside the United States, against an unremarkable $25.2 million package. This is the same pattern that dominates the technology hardware companies.

Thermo Fisher at 604:1 sits between the two: a $71,333 median across 125,000 employees and a $43.1 million three-year average.

Device makers and the outliers

Becton Dickinson's 376:1 on a $45,831 median and Baxter's 412:1 on $72,402 reflect global manufacturing footprints. Solventum, the 3M health-care spinoff, enters at 366:1.

Veeva Systems deserves a note: 411:1 on a median of $140,473, which is a very well-paid workforce of 7,928 software staff. Its three-year average CEO compensation of $57.8 million is inflated by a single $172.4 million grant, one of the largest one-year figures in the index, and a clear illustration of why we average over three years. On the peak year alone the ratio would exceed 1,200:1.

Profit per employee

The sector median is $56,500, but the spread is wide. Zoetis leads at $641,026 per head across 3,900 employees, followed by Vertex at $367,188, Gilead at $287,059, Regeneron at $278,391 and Eli Lilly at $243,200.

The pattern is consistent: patent-protected drug developers generate very high profit per worker, and they also pay very well. On Fair500's second measure, worker pay against profit per employee, these companies do reasonably rather than exceptionally, because both numbers are large.

The hospital operators and insurers sit at the other end. HCA's profit per employee across 320,000 staff is a fraction of Vertex's, and UnitedHealth's $16.3 billion profit spread across 390,000 employees produces a figure near the index median despite being the sector's second-largest absolute profit.

Three companies in the sector averaged a loss over the three-year window and appear in the map's loss band: Centene, Moderna and Viatris. Moderna is the notable case: a company with a $225,053 median and an 84:1 ratio whose post-pandemic revenue decline pushed its three-year average negative.

Every health care company in the S&P 500

Every Health Care company in the S&P 500 covered by Fair500 (59), ranked by CEO-to-worker pay ratio. Scroll sideways for more columns.
CompanyPay ratioMedian worker payCEO pay (3-yr avg)Profit (3-yr avg)Employees
Align TechnologyALGN800:1$31,454$25.2M$0.4B20,290
UnitedHealth GroupUNH748:1$81,474$60.9M$16.3B390,000
Thermo Fisher ScientificTMO604:1$71,333$43.1M$6.3B125,000
Baxter InternationalBAX412:1$72,402$29.8M$0.3B37,500
Veeva SystemsVEEV411:1$140,473$57.8M$0.7B7,928
HCA HealthcareHCA379:1$62,955$23.9M$5.9B320,000
Becton DickinsonBDX376:1$45,831$17.3M$1.6B72,000
SolventumSOLV366:1$82,152$30.0M$1.1B20,000
ViatrisVTRS328:1$46,729$15.3M−$1.4B30,000
Danaher CorporationDHR321:1$69,440$22.3M$4.1B60,000
Boston ScientificBSX314:1$67,539$21.2M$2.1B59,000
Johnson & JohnsonJNJ313:1$91,000$28.5M$25.3B138,200
McKesson CorporationMCK312:1$67,803$21.1M$3.7B43,000
Cooper CompaniesCOO309:1$48,540$15.0M$0.3B15,000
CVS HealthCVS308:1$63,262$19.5M$4.9B300,000
CignaCI304:1$73,674$22.4M$4.8B67,700
Cardinal HealthCAH291:1$72,657$21.1M$0.9B57,700
LabcorpLH284:1$62,929$17.9M$0.7B71,000
MedtronicMDT275:1$68,770$18.9M$4.4B95,000
Elevance HealthELV274:1$79,007$21.6M$5.9B97,100
IQVIAIQV273:1$102,424$28.0M$1.4B93,000
GE HealthCareGEHC271:1$76,951$20.9M$1.9B54,000
Universal Health ServicesUHS266:1$57,048$15.2M$1.1B101,500
Stryker CorporationSYK264:1$81,018$21.4M$3.1B56,000
Quest DiagnosticsDGX252:1$56,427$14.2M$0.9B57,000
PfizerPFE247:1$99,631$24.6M$6.0B75,000
Lilly (Eli)LLY246:1$125,100$30.8M$12.2B50,000
Charles River LaboratoriesCRL233:1$61,430$14.3M$0.1B19,700
DaVitaDVA217:1$71,839$15.6M$0.8B78,000
ZoetisZTS213:1$80,592$17.2M$2.5B3,900
HumanaHUM207:1$82,935$17.2M$1.6B67,060
Centene CorporationCNC206:1$94,800$19.6M−$0.2B61,100
RevvityRVTY201:1$57,745$11.6M$0.4B11,000
Insulet CorporationPODD199:1$94,703$18.9M$0.3B5,400
Merck & Co.MRK197:1$108,614$21.4M$11.9B75,000
Idexx LaboratoriesIDXX195:1$66,956$13.0M$0.9B11,000
ResMedRMD182:1$78,354$14.2M$1.1B10,600
Zimmer BiometZBH171:1$80,380$13.8M$0.9B17,000
Edwards LifesciencesEW167:1$89,827$15.0M$2.2B16,000
Abbott LaboratoriesABT161:1$145,528$23.4M$8.6B115,000
AmgenAMGN155:1$154,123$23.9M$6.2Bn/a
SterisSTE144:1$73,280$10.6M$0.6B18,000
Henry ScheinHSIC142:1$78,954$11.2M$0.4B25,000
Mettler ToledoMTD130:1$56,972$7.4M$0.8B9,300
AbbVieABBV129:1$169,019$21.8M$4.5B57,000
West Pharmaceutical ServicesWST129:1$64,635$8.3M$0.5B10,800
CencoraCOR127:1$92,438$11.7M$1.6B51,000
Intuitive SurgicalISRG127:1$124,131$15.8M$2.3B17,021
Waters CorporationWAT122:1$92,793$11.3M$0.6B7,900
IncyteINCY108:1$295,914$32.1M$0.6B2,844
DexcomDXCM107:1$58,663$6.3M$0.7B11,100
Gilead SciencesGILD104:1$238,979$24.9M$4.9B17,000
Agilent TechnologiesA101:1$82,873$8.4M$1.3B18,100
Bristol Myers SquibbBMY98:1$167,191$16.4M$2.0B32,500
ModernaMRNA84:1$225,053$19.0M−$3.7B4,700
BiogenBIIB83:1$208,335$17.3M$1.4B7,500
Vertex PharmaceuticalsVRTX80:1$264,487$21.1M$2.4B6,400
Bio-TechneTECH64:1$91,707$5.9M$0.2B3,100
Regeneron PharmaceuticalsREGN43:1$174,138$7.4M$4.3B15,410

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