The three most-profitable drug developers in 2023 were Johnson & Johnson, Novartis, and Bristol Myers Squibb. The largest drug developer as of this writing is Eli Lilly, which is riding a wave of momentum from big wins across its cardiometabolic (obesity), neuroscience (Alzheimer's), and oncology portfolios. They might be the Fab Four of pharma, but they're dwarfed by the four largest information technology companies.

These four drug developers had combined revenue of $209.7 billion, earnings before income taxes (EBIT) of $39.2 billion, and operating cash flow of $55.1 billion in 2023. That roughly matches the revenue of Microsoft ($211.9 billion) and the EBIT of Amazon ($37.6 billion) – each the worst of the four Big Tech companies above. The comparison falls apart on operating cash flow, as the worst value among information technology leaders (Amazon's $84.9 billion) easily outpaces the combined performance of pharma's Fab Four.

Oh, and you'd have to include Johnson & Johnson's medical devices business segment.