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Launched

Horizon Kinetics Medical ETF

MEDXNasdaqHorizon KineticsD

$38.07−0.39 (−1.01%)

At close: Nov 2, 2026, 4:00 PM ET

D29/ 100

Rank 32 of 35 in US Active Sector

D29/100Rank 32 of 35inUS Active Sector
Intraday session: down, 77 prints from 38.46 to 38.07. Range 37.93 to 38.12. Use the arrow keys to read each point.37.9038.0038.2038.3038.4010 AM12 PM2 PM4 PM
Expense ratio
0.85%
Fund size
$18M
1Y total return
+23.9%
Yield · Last 12 months
1.07%
Holdings
33
Avg volume · 30D
1.88K sh
52W range
low $31.03high $38.46
Launched

The ETF.net MEDX Grade

Based on 5 of 6 pillars

D

Score 29 out of 100

Category
US Active Sector⁠
Rank
32 of 35
Six-pillar profile for MEDX. Scores out of 100: Cost 19, Risk 54, Mission not scored, Tradability 21, Holdings 27, Durability 45. Strongest: Risk (54). Weakest: Cost (19). Based on 5 of 6 pillars.

Score 29 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.
    C54 out of 100
    Rank 19 of 35

  • Tradability

    How easy the fund is to trade: daily volume, and how far its price strays from net asset value.
    F21 out of 100
    Rank 32 of 35

  • Holdings

    How concentrated the fund is, and how complete and current its disclosed holdings are.
    D27 out of 100
    Rank 35 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

In short

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

  • Unusual mandate: the fund seeks pre-expense returns that generally track the U.S. healthcare cost inflation rate, not the price of the healthcare sector.
  • Concentrated by design, roughly 30 positions. You can read the whole portfolio in a sitting instead of owning a sector index tail.
  • Actively 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

  • At 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%).
  • Small asset base and light trading volume. Spreads can widen, so limit orders do real work here.
  • Distributions 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

Holdings pillarD27 out of 100Rank 35 of 35 in US Active Sector
Asset class
Stocks
Holdings
33
Top-10 weight
74%
Largest holding
LLY20.9%

Sectors

  • Health Care100.0%

Geography

  • United States80.50%
  • Switzerland11.17%
  • United Kingdom8.33%
The fund’s holdings, weight-ordered — page 1 of 3.
#TickerCompanyWeight %SharesMarket valueHeld by ETFs
1LLYEli Lilly & Co20.93%2,654$3.76M593
2ABBVAbbVie Inc9.95%6,068$1.79M523
3No dataUs Bank Mmda - Usbgfs 7 06/01/20317.61%1,368,770$1.37M7
4NVSNovartis AG6.78%7,582$1.22M54
5JNJJohnson & Johnson5.77%3,798$1.04M524
6AMGNAmgen Inc4.83%1,864$869K503
7AZNAstraZeneca PLC4.71%4,533$846K70
8ALKSAlkermes PLC4.59%18,198$825K152
9MRKMerck & Co Inc4.41%5,308$794K516
10BMYBristol-Myers Squibb Co4.15%11,936$746K471
11BIIBBiogen Inc3.48%2,464$625K332
12PFEPfizer Inc3.48%20,472$625K385
13REGNRegeneron Pharmaceuticals Inc2.94%570$529K422
14GSKGsk PLC2.45%8,900$441K46
15CRSPCRISPR Therapeutics AG2.39%8,342$429K82

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$12,394
SPY tracks large US stocks. It provides market context, rather than representing this fund’s strategy, asset class or investment benchmark.$11,199
Oct 31, 2025 to Oct 30, 2026. MEDX $12,394. SPY $11,199. Use the arrow keys to read each point.$10,000$11,000$12,000Oct 2025Apr 2026Oct 2026

Oct 31, 2025 – Oct 30, 2026

Returns run to the Oct 30, 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+15.2%
1 month+8.4%
3 months+9.5%
1 year+23.9%
3 yearsper year+15.1%
5 yearsFund is under 5 years oldper yearNo data
10 yearsFund is under 10 years oldper yearNo data

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+15.2%
2025+28.6%
2024−4.7%
2023−5.0%

History from Feb 1, 2023

MEDX in the news

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 30, 2026.
1.07%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

$10,000 in MEDX 3 years ago paid $902 in dividends.

MEDX Risk

Risk pillarC54 out of 100Rank 19 of 35 in US Active Sector
How much the fund’s monthly returns vary, scaled to a year.
15.3%
Annualised · 36 months to Oct 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.
0.71
vs 3-month T-bills · to Oct 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.

FMP measures it over up to five years of monthly returns.

MEDX Cost

Compare MEDX and TRUF

Overpaying vs TRUF, tied cheapest in US Active Sector

$14,093

On $10,000 over 30 years. 7% growth a year before fees, expense ratio only.

  • MEDX 0.85%

    $16,199

  • TRUF 0.10% Tied cheapest

    $2,106

$10,000
30 years

Cost over time

  • MEDX 0.85%
  • TRUF 0.10%
  • Overpaying
One line per fund, from year 0 to year 30. Use the arrow keys to read each point.$0$5K$10K$15K$20K051015202530MEDX $16,199TRUF $2,106

Year by year

YearMEDXTRUFOverpaying
10$1,508$183$1,325
20$5,706$717$4,989
30$16,199$2,106$14,093

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