They don't have to be in the PL right now, and there probably are players who could do a similar role in a great team if I could be bothered to think.
Many, many great/good teams have had a guy who is praised for 'providing balance', who generally goes around kicking people and doing the work of two of his more talented teammates. They usually don't cost those teams much either, often picked up for a bargain, or discovered after having been knocking around in their set-up for a while, sometimes even in a different position.
For example, the praise an ordinary Coquelin, who was pulled back from loan at fecking Charlton, received when he returned and became a player Arsenal couldn't leave out, simply because he is aggressive and closes down, tells enough. This is often the route these players take into top teams, as opposed to signing for £32m, which your lot spent on Kante a year after he was picked up for £5m in his mid twenties. Staying with Arsenal, Flamini had a similar season - highly praised for doing the dirty work and being one of the best players for a year. Again, he is still only Mathieu Flamini. No footballing great, but when you acknowledge your limitations amongst better players and are willing to work tirelessly, you can rack up many MOTM awards.
I will continue. Last season's Champions League winners had 'no balance' until they brought Casemeiro back from loan in Portugal, as after all, someone needs to kick opponents. His contribution has been praised to the heavens, and he did a good job, but the point is, no transfer records need to be smashed for these players, valuable as they are. They are usually picked up from obscurity but have the right attitude. Top teams will continue to find players who can do this for them, and I'd wager that they will continue to find them for south of £15m too.
United have had Phil fecking Neville winning MOTM awards against Arsenal's for doing similar jobs in midfield. It's one of the easier jobs to fill, should you wish to deploy such a player. It will cost you far less, and is less rare a skill set than the midfielder who invariably lines up alongside him.
Marouane Fellaini has 'excelled' so far this season when all footballing responsibilities have been taken from him, and he's been made to understand his role is to tackle and kick people. None of this ' he should be played off the striker' or 'he's a box to box player'. He suddenly looks very good when just asked to work hard.