MEDX vs TRUT

MEDXDHorizon Kinetics Medical ETF

TRUTBVanEck Technology TruSector ETF

In short

MEDX Most 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.

TRUT Diversification rules force most tech ETFs to trim their biggest names. TRUT's answer: own the giants directly up to the legal line, then top up with sector ETFs so the portfolio mirrors the sector's real shape.

Stated mandate

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

TRUT The Fund seeks long-term capital appreciation through active investment in securities of information technology-related companies or instruments providing exposure to them.

Why people hold it

• MEDX 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.

• TRUT The mechanism is the point. Fund rules cap one stock at 25% and stocks above 5% at 50% combined; TRUT fills the gap with targeted sector ETFs instead of overweighting smaller names.vaneck.comvaneck.com 2
• 0.14% a year for an actively managed fund, against a median near 0.65% across active US equity peers. Cheap enough to sit alongside index products.
• One of the two originals in VanEck's TruSector line, launched in 2025. The approach has since been extended across all 11 GICS sectors.vaneck.comvaneck.com 2
• About 80 positions, quarterly distributions, and steady day-to-day trading. On cost and tradability it lands in the upper tier of its active US equity cohort.

Worth knowing

• MEDX 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.

• TRUT Part of the exposure arrives through other ETFs rather than shares the fund holds outright. That is the workaround that makes uncapped weights possible, and it adds a layer.vaneck.com
• Uncapped means concentrated. Leaning fully into tech's largest companies ties results to a handful of mega-caps more tightly than a capped sector fund would.vaneck.com
• Launched August 2025, so there is only a short record of how closely the hybrid build actually shadows an uncapped tech benchmark.

Full MEDX profile⁠

Full TRUT profile⁠