The table at my website link below includes a summary and statistics for the 25 healthcare exchange-traded funds (ETFs) which are currently on the market. The group posted a 23.5% loss over the past year on an equal-weight basis with an average of about $400M in net assets. However, the top eight ETFs by net assets account for 88.5% of all net assets for the entire group of 25, including Healthcare Sector SPDR (XLV), Pharma HOLDRs (PPH), iShares Nasdaq Biotech (IBB), Biotech HOLDRs (BBH), iShares Dow Jones U.S. Healthcare (IYH), iShares S&P Global Healthcare (IXJ), Vanguard Healthcare (VHT), and SPDR S&P Biotech (XBI).
Only BBH managed to post a gain over the past year thanks to a concentrated bet in the following three biotech blue chip companies: Genentech (DNA) (42.8%), Amgen (AMGN) (20.9%), and Gilead Sciences (GILD) (18.3%). Of the Biotech HOLDRs 14 positions , the top three account for over three-quarters of the fund's investments and just two other companies have meaningful weightings in BBH, including Biogen (BIIB) (8.1%) and Genzyme (GENZ) (5.6%).
Below are eight new ETF Innovators global healthcare indexes and product ideas, with a focus on small/mid-cap companies in health business segments which do not currently offer any exchange-traded products.
1.) Hospitals & Outpatient Care : The index includes companies with market caps of at least $150M which derive the majority of their revenue from any of the following activities: inpatient hospital services, emergency medical transport + care services, hospice services, skilled nursing services, rehabilitation care, physical therapy, eye care, dental care, hospitalist products + services, mental healthcare services, dialysis care, home healthcare services, and outpatient medical care facilities. All activities related to retirement communities and assisted living facilities are excluded from this index.
a.) Pet spending in the U.S. is estimated at $43.4B in 2008, up from $32.4B in 2003
b.) About 63% of U.S. households have a pet, which equals over 71M homes
c.) The worldwide market for animal healthcare, excluding bulk feed and nutrition products, is expected to reach just under $20B in 2008, experiencing growth of 26% from $15.6B in 2003
3.) Cosmetic & Reconstructive Medicine : Includes companies with market caps over $100M engaged in cosmetic medicine products, regenerative medicine + stem cells, orthopedic repair, joint replacements, and cardiovascular (heart + blood vessels) treatments.
4.) Healthcare Cost Containment : The index includes generic drug companies such as Teva Pharma (TEVA) and Perrigo (PRGO) as well as pharmacy benefit managers such as Express Scripts (ESRX), which share the common theme of promoting the use of generics to lower healthcare costs.
5.) Health Information Technology : An index of companies which provide electronic prescribing (e-prescribing), computerized medical records, remote patient monitoring, and healthcare information systems.
6.) Preventive Medicine : An index of companies engaged in diabetes care, diagnostics, lab services, and vaccines.
7.) Health Innovators : An index of companies with new product approvals in the past year, which represent new chemical entities for therapeutics and original PMA approvals for medical devices to track if R&D spending translates into better stock price performance.
8.) Health Benefit Providers : The index contains retail pharmacies such as Rite Aid (RAD), pharmacy benefit managers such as MedcoHealth Solutions (MHS), managed care companies such as UnitedHealth (UNH), supplemental health insurers such as Aflac (AFL), hospital pharmacy operators such as PharMerica (PMC), workers compensation insurers such as Amerisafe (AMSF), and specialty health service providers such as Healthways (HWAY).
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