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GLP-1 drugs are reshaping healthcare and consumer markets. These ETFs offer targeted exposure to the booming obesity-drug trend.

Revolution Medicines was a top contributor during the quarter. AbbVie, by contrast, traded largely sideways, as investors continued to assess its post-patent earnings durability. While Eli Lilly delivered strong absolute performance — driven by continued GLP-1 demand and the FDA approval of Zepbound — our underweight position in the name was a significant detractor from relative results. During the quarter, we purchased Avidity Biosciences, a clinical-stage biopharma company focused on RNA therapies for rare muscle diseases, and Abivax SA, a clinical-stage biopharma company focused on chronic inflammatory diseases.

During the fourth quarter, the Harbor Health Care ETF returned 10.43% (NAV), underperforming the Russell 3000® Growth Health Care Index, which returned 16.71%. The underperformance was primarily driven by stock selection and relative underexposure to higher-beta names, particularly within development-stage biotechnology and more speculative areas of medtech. From a factor perspective, the ETF's overweight exposure to volatility was the largest tailwind to relative performance, offsetting a headwind from an underweight exposure to size.

During the third quarter, the Harbor Health Care ETF returned 7.30% (NAV), outperforming the Russell 3000® Growth Health Care Index, which returned 3.80%. We purchased IDEXX Laboratories, a MedTech company primarily focused on veterinary services, with a strong market position, steady end markets, and a strong growth profile, in our opinion. We sold Verona Therapeutics, a commercial stage biopharma company focused on lung disease, when the stock hit our price target following the announcement that Merck would be acquiring the company.

MEDI Group has filed for a $15 million US IPO, but its revenue is declining from a small base, with negative free cash flow and increased cash used in operations. The IPO valuation appears excessive, with management seeking an EV/Revenue of 22.5x and EV/EBITDA of 148.7x despite weak fundamentals. MEDI faces intense competition in a fragmented market, with limited differentiation and significant customer/geographic concentration risks.

The Health Care sector rebounded in the first quarter of 2025, navigating a volatile but opportunistic landscape. During the first quarter, the Harbor Health Care ETF returned 2.18% (NAV), outperforming the Russell 3000® Growth Health Care Index, which returned 1.99%. Relative performance was driven by our overweight in commercial-stage biotechnology, as well as solid contributions from health care services.

Eli Lilly and Company (LLY) posted robust fourth-quarter 2023 earnings, beating estimates on both the top and bottom lines driven by strong sales of its diabetes and weight-loss treatments.
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