Profits at private healthcare group Bupa tumbled 72% to £118m in 2010 in a year of cost cutting, write-downs, and redundancies.
Bupa blamed difficult economic conditions in the key UK and US markets, where unemployment and health care reforms have affected operations.
Profits were hit after the company made a £249.2m write-down on the value of properties and acquisitions.
With this one-off hit stripped out, underlying profits were up 9% to £465m.
Revenues in the Europe and the US division rose 1%, as companies cut jobs and reduced health benefits to staff.
But Bupa performed better outside these regions, with revenues at other international operations up 20%.
Ray King, chief executive of Bupa, said he hoped UK customer numbers would stabilise in 2011.
"Until corporates expand their payrolls again, the opportunity for growth is somewhat constrained," he said.
In the UK, Bupa cut staff numbers by 15% - almost 500 people - resulting in a one-off restructuring charge of £6.6m.
However, "with continued growth in Asia Pacific and Latin America, we anticipate further strong momentum for our businesses in these markets," Mr King said.