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MEDX

GradeDNASDAQ Global Market

Horizon Kinetics Medical ETF

Active Equity · Horizon Kinetics · Inception 2023-01-27

$35.30−0.54 (−1.51%)

As of Sep 23, 2026, 2:03 PM EDT

History starts Feb 1, 2023.
Intraday session: down, 9 prints from 35.84 to 35.30. Range 35.23 to 35.95. Use the arrow keys to read each point.$35.20$35.40$35.60$35.80$36.0010 AM12 PM2 PM4 PM
Expense ratio
0.85%
Fund size
$17M
1Y return
+22.7%
Yield · Last 12 months
1.14%
Holdings
32
Volume · 30D
0M sh
NAV per share
$35.55
52W range
low $28.86high $37.90

The ETF.net MEDX Grade

D

31/ 100

Rank 33 of 35 in US Active Sector⁠

Confidence Medium

Six-pillar profile for MEDX. Scores out of 100: Cost 19, Risk 44, Mission not scored, Tradability 40, Holdings 28, Durability 45. Strongest: Durability (45). Weakest: Cost (19). Based on 5 of 6 pillars.
F< 25
D≥ 25
C≥ 40
B≥ 55
A≥ 70

Score 31 of 100 sits in the D band. Bands: A ≥ 70, B ≥ 55, C ≥ 40, D ≥ 25, F < 25; the scale skips E.

  • Cost

    What you pay to own it — the expense ratio plus trading frictions, ranked within its category.
    FScore 19
    Category rank28/35 · bottom quartile

  • Mission

    How faithfully it does the job it claims — tracking its mandate or index with minimal slippage.
    Not scored
    —

  • Risk

    How violently it can move — volatility, drawdown depth, and downside capture versus its category.
    CScore 44
    Category rank21/35 · mid-pack

  • Tradability

    How cheaply and easily you can get in and out — liquidity, spread, and premium/discount stability.
    CScore 40
    Category rank24/35 · mid-pack

  • Holdings

    What it actually owns — the quality, breadth, and concentration of the underlying portfolio.
    DScore 28
    Category rank35/35 · bottom quartile

  • Durability

    Whether it will still be here — the fund’s assets, age, flows, and issuer staying power.
    CScore 45
    Category rank24/35 · mid-pack

Graded as of Sep 22, 2026 · Based on 5 of 6 pillars

Our read on MEDX

ETF.net Research

DMost healthcare funds chase drugmakers' profits. MEDX aims at the bill itself: pre-expense returns that generally track the U.S. healthcare cost inflation rate, held in a concentrated, actively run book.

Stated mandate

The Fund seeks to provide long-term growth of capital.

Why people hold it

  1. 01Unusual mandate: the fund seeks pre-expense returns that generally track the U.S. healthcare cost inflation rate, not the price of the healthcare sector.
  2. 02Concentrated by design, roughly 30 positions. You can read the whole portfolio in a sitting instead of owning a sector index tail.
  3. 03Actively managed by Horizon Kinetics since its 2023 launch, so the book is picked against the inflation goal rather than assembled by market cap.

Worth knowing

  1. 01At 0.85% a year, it costs more than the median active US equity fund (0.65%), and multiples of broad core rivals like DFAU (0.12%) and FELC (0.18%).
  2. 02Small asset base and light trading volume. Spreads can widen, so limit orders do real work here.
  3. 03Distributions arrive once or twice a year, and against hundreds of active US equity peers it sits in the bottom quartile on our overall review.

MEDX Holdings

As of Sep 20, 2026, 9:12 AM
Asset class
Stocks
Holdings
32
Top-10 weight
72%
Largest holding
LLY18.5%

Sectors

  • Health Care100.0%

Geography

  • United States74.63%
  • Switzerland10.94%
  • United Kingdom8.86%
  • Ireland5.56%

Developed 100% · Emerging 0% of the foreign sleeve

The fund’s holdings, weight-ordered — page 1 of 3.
#TickerCompanyWeight %SharesMarket valueIn ETFs
001LLYEli Lilly & Co18.48%2,654$3M569
002ABBVAbbVie Inc9.67%6,068$2M511
003—US BANK MMDA - USBGFS 7 06/01/20318.25%1,366,806$1M7
004NVSNovartis AG6.43%7,582$1M49
005JNJJohnson & Johnson6.19%3,798$1M521
006ALKSAlkermes PLC4.77%18,198$790K151
007MRKMerck & Co Inc4.71%5,308$780K506
008AZNAstraZeneca PLC4.55%4,533$753K68
009BMYBristol-Myers Squibb Co4.55%11,936$753K460
010AMGNAmgen Inc4.34%1,864$719K470
011PFEPfizer Inc3.42%20,472$566K374
012BIIBBiogen Inc3.21%2,464$531K331
013CRSPCRISPR Therapeutics AG2.85%8,342$472K83
014ALNYAlnylam Pharmaceuticals Inc2.84%1,960$470K258
015REGNRegeneron Pharmaceuticals Inc2.70%570$447K401

Showing 1–15 of 33 holdings

MEDX Performance

Shows how $10,000 changes over the selected period, with cash distributions reinvested at the closing price on each ex-dividend date.

MEDX$12,266
SPY tracks large US stocks. It provides market context, rather than representing this fund’s strategy, asset class or investment benchmark.$11,723
Sep 22, 2025 to Sep 22, 2026. MEDX $12,266. SPY $11,723. Use the arrow keys to read each point.$9,257$11,242$13,226Sep 2025Mar 2026Sep 2026

Sep 22, 2025 – Sep 22, 2026

Returns run to the Sep 22, 2026 close, with cash distributions reinvested. Each period starts on the same date that many months or years earlier. Periods over one year show the average yearly return.

Trailing total return for MEDX. Periods over one year show the average yearly return.
PeriodMEDX
Year to date+8.0%
1 month−4.5%
3 months+4.2%
1 year+22.7%
3 years+10.0%per year
5 yearsFund is under 5 years old—per year
10 yearsFund is under 10 years old—per year

As of the close, with distributions reinvested.

Calendar-year total return with cash distributions hypothetically reinvested at the ex-dividend date’s closing price. The current year shows year to date.

Annual total returns for MEDX
YearReturn barMEDX
2026 YTD+8.0%
2025+28.6%
2024−4.7%
2023−5.0%

History from Feb 1, 2023

MEDX in the news

ETF.net Research hasn’t filed on MEDX yet — coverage lands here as it’s written.

MEDX Dividends

Adds up every distribution paid per share over the last 12 months, divided by the last completed close. Distributions are counted by ex-date. Data through Sep 22, 2026.
1.14%Last 12 months
Payout per share
$0.41Last 12 months
Last payment
$0.41 per share
Paid on
Shares bought on or after this date do not qualify for this distribution.
Frequency
Annual

Distribution history

2023–2026

One bar per payment. 3 payments from 2023 to 2026 YTD. Dec 27, 2023 $1.64; Dec 24, 2024 $0.51; Dec 23, 2025 $0.41. Use the arrow keys to read each point.2023202420252026YTD
Ex-datePay dateAmount per share
Dec 23, 2025Dec 24, 2025$0.41
Dec 24, 2024Dec 26, 2024$0.51
Dec 27, 2023Dec 29, 2023$1.64

MEDX Risk

How much the fund’s monthly returns vary, scaled to a year.
15.4%
Annualised · 36 months to Aug 2026
How it’s calculated: standard deviation

The sample standard deviation of monthly total returns, multiplied by the square root of 12.

Uses up to 36 complete months, with at least 12 required. Total returns include reinvested distributions.

Return above 3-month US Treasury bills per unit of volatility.
0.36
vs 3-month T-bills · to Aug 2026
How it’s calculated: Sharpe ratio

Subtract each month’s Treasury-bill return from the fund’s monthly total return.

Divide the average of those excess returns by their sample standard deviation, then multiply by the square root of 12.

Uses up to 36 complete months, with at least 12 required. Each month uses the Treasury yield quoted at the end of the previous month.

The largest fall from a peak to the low that followed.
−23.1%
43 months · trough Apr 2025
How it’s calculated: maximum drawdown

The largest percentage decline from an earlier peak, using total returns with reinvested distributions.

Uses up to five years through the last close, with at least 12 months required.

How strongly the fund’s returns move with its asset-class index.
0.52
vs its asset-class index
How it’s calculated: beta

The beta figure is supplied by FMP. The comparison index depends on the fund’s broad asset class.

MEDX Cost

Expense ratio0.85%
  • The middle half of US Active Sector funds
  • Median 0.65%

25 of the 33 US Active Sector funds charge less.

MEDX costs $85.00 a year on $10,000. The median US Active Sector fund costs $65.00.