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Launched

Horizon Kinetics Medical ETF

MEDXNasdaqD

$34.62−0.08 (−0.24%)

At close: Oct 13, 2026, 4:00 PM

D28/ 100

Rank 33 of 35 in US Active Sector

D28/100Rank 33 of 35inUS Active Sector
Intraday session: down, 9 prints from 34.70 to 34.62. Range 34.62 to 35.17. Use the arrow keys to read each point.34.8034.9035.0035.1035.2010 AM12 PM2 PM4 PM
Expense ratio
0.85%
Fund size
$17M
1Y total return
+13.4%
Yield · Last 12 months
1.16%
Holdings
33
Avg volume · 30D
0M sh
NAV per share
$35.25
52W range
low $30.79high $37.90
Launched

The ETF.net MEDX Grade

Based on 5 of 6 pillars

D

Score 28 out of 100

Category
US Active Sector⁠
Rank
33 of 35
Six-pillar profile for MEDX. Scores out of 100: Cost 19, Risk 47, Mission not scored, Tradability 24, Holdings 28, Durability 45. Strongest: Risk (47). Weakest: Cost (19). Based on 5 of 6 pillars.

Score 28 of 100 falls in the D band. A is 70 or higher, B 55 to under 70, C 40 to under 55, D 25 to under 40, F under 25.

  • Cost

    The fund’s net expense ratio, ranked against its category.
    F19 out of 100
    Rank 28 of 35

  • Mission

    Whether the fund did what it promised, tested against its stated mandate.
    Not scored

  • Risk

    How the fund held up when markets fell: downside volatility, drawdowns and tail loss.
    C47 out of 100
    Rank 20 of 35

  • Tradability

    How easy the fund is to trade: daily volume, and how far its price strays from net asset value.
    F24 out of 100
    Rank 30 of 35

  • Holdings

    How concentrated the fund is, and how complete and current its disclosed holdings are.
    D28 out of 100
    Rank 34 of 35

  • Durability

    Whether the fund is likely to stay open, judged by its age, its assets and its issuer’s assets.
    C45 out of 100
    Rank 24 of 35

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 Oct 12, 2026
Asset class
Stocks
Holdings
33
Top-10 weight
72%
Largest holding
LLY18.9%

Sectors

  • Health Care100.0%

Geography

  • United States75.36%
  • Switzerland11.02%
  • United Kingdom8.55%
  • Ireland5.07%

Developed 100% · Emerging 0% of the foreign sleeve

The fund’s holdings, weight-ordered — page 1 of 3.
#TickerCompanyWeight %SharesMarket valueIn ETFs
001LLYEli Lilly & Co18.87%2,654$3M583
002ABBVAbbVie Inc10.12%6,068$2M522
003—Us Bank Mmda - Usbgfs 7 06/01/20318.25%1,368,770$1M7
004NVSNovartis AG6.57%7,582$1M53
005JNJJohnson & Johnson5.99%3,798$993K528
006AMGNAmgen Inc4.66%1,864$773K491
007MRKMerck & Co Inc4.66%5,308$773K515
008ALKSAlkermes PLC4.46%18,198$739K150
009AZNAstraZeneca PLC4.35%4,533$722K72
010BMYBristol-Myers Squibb Co4.26%11,936$706K463
011PFEPfizer Inc3.49%20,472$579K378
012BIIBBiogen Inc3.35%2,464$556K324
013ALNYAlnylam Pharmaceuticals Inc2.75%1,960$456K259
014IONSIonis Pharmaceuticals Inc2.69%9,856$446K122
015CRSPCRISPR Therapeutics AG2.69%8,342$445K81

Showing 1–15 of 33 holdings

MEDX Performance

Launched Jan 27, 2023

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

Not enough history yet.Not enough history yet.
MEDX$11,340
SPY tracks large US stocks. It provides market context, rather than representing this fund’s strategy, asset class or investment benchmark.$12,044
Oct 10, 2025 to Oct 12, 2026. MEDX $11,340. SPY $12,044. Use the arrow keys to read each point.$9,573$10,970$12,368Oct 2025Apr 2026Oct 2026

Oct 10, 2025 – Oct 12, 2026

Returns run to the Oct 12, 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+6.2%
1 month+0.8%
3 months−1.2%
1 year+13.4%
3 yearsper year+9.2%
5 yearsFund is under 5 years oldper year—
10 yearsFund is under 10 years oldper 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+6.2%
2025+28.6%
2024−4.7%
2023−5.0%

History from Feb 1, 2023

MEDX in the news

Filtered to MEDX · US Active Sector

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 Oct 12, 2026.
1.16%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 Sep 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.
0.38
vs 3-month T-bills · to Sep 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%
44 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%

27 of the 35 US Active Sector funds charge less.

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

Other funds in US Active Sector

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