Pharmaceutical companies largely focus on the mechanical bits of clinical trials, logistics, manufacturing, distribution, marketing, etc because those are much

Pharmaceutical companies largely focus on the mechanical bits of clinical trials, logistics, manufacturing, distribution, marketing, etc because those are much more predictable at the scale of a large multinational. They're not the R&D powerhouses they once were because they have run out of easy small molecule drugs. Since the market size/fit/price sensitivity is extremely predictable and there are so few customers to negotiate with (insurance companies, nationalized healthcare, medical purchasing groups, etc.), this is far more efficient for pharmaceutical companies than having a broad and risky drug discovery pipeline. Instead they acquire early and mid stage biotech companies with promising pre-clinical trial results or phase 1/2 successes - in essence externalizing the risk of early R&D even further to academia, venture capital, private equity, and retail investors. With the increasing availability of easy capital of the last few decades, this has become even more of a win-win for investors and the pharma giants recently.