It's certainly more tax efficient to reduce your reported profits by finding ways to bury revenue

This is the best breakdown I can find on their parent company RELX: https://www.macrotrends.net/stocks/charts/RELX/relx/cash-flo...

Elsevier is a pretty big company offering lots of different products and services[1]. I suspect even Elsevier is smart enough to see that the current publishing business isn't sustainable and are trying to pivot into something else. The profits from their publishing arm (which is undoubtedly a lot more than 38%) is no doubt financing a lot of that pivoting

[1] https://www.elsevier.com/solutions

Likely some other company in the Cayman islands owns their intellectual property, and they they pay a good portion of their revenue to license it.

They invest in making clinic decision support software to make research accessible to doctors, etc (it’s practically also making decisions for them at times).

Source - have attended an Elsevier CDSS Sales presentation for HCPs

Distribution costs are negligible when you just make the PDFs free to everyone, but publishers spend a bunch of money on access control, security, and web interfaces that make you jump through hoops to download the actual PDF while doing everything possible to convince you to read the papers through their (possibly "social"/"collaborative") online platform instead.

The rest might be laundered somehow.