Bellevue Diversified Healthcare

Global equities rose modestly in November 2025 (MSCI World Index; +0.3%), with healthcare significantly outperforming (MSCI World Health Care Index; +8.1%) as policy visibility continued to improve and the sector benefited from strong earnings momentum. It was a remarkable month for the sector, which also saw Eli Lilly becoming the first healthcare company with a market capitalization over USD1 tn. The Bellevue Diversified Healthcare (Lux) Fund (I shares) gained 7.5% in USD, underperforming its benchmark due to an underweight position in the more value/defensive style large-cap biopharma names which rallied in the month (e.g. Merck & Co, Regeneron).

In early November, Eli Lilly and Novo Nordisk became the latest major pharma companies to reach agreements with the US administration on drug pricing and manufacturing commitments. These agreements build on the initial framework set by Pfizer, AstraZeneca, and Merck KGaA. These developments helped shift sentiment from maximum uncertainty toward increasing confidence, representing a de-risking catalyst for investors.

M&A activity remained strong in November. Abbott Labs announced plans to acquire Exact Sciences for a total of USD 23 bn, significantly expanding its diagnostics presence in oncology screening. After a bidding war with Novo Nordisk, Pfizer completed the acquisition of obesity drug company Metsera for up to USD 10 bn. In addition, consumer-goods company Kimberly-Clark Corporation announced the acquisition of Kenvue for USD 40 bn.

In terms of innovation, Roche reported two unexpectedly positive clinical trial outcomes in the month, driving a significant rally in the shares (up 19% in the month). Despite prior failures from rivals, the Swiss company’s BTK inhibitor fenebrutinib reported positive data in relapsing-remitting multiple sclerosis. Later in the month, its oral SERD giredestrant became the first-in-class to show superior invasive disease-free survival in early breast cancer. On the negative side, Novo Nordisk's GLP-1 semaglutide failed to delay the progression of Alzheimer’s disease in the Evoke study.

In terms of subsector performance, pharma, biotech, and medtech subsectors gained 12.7%, 7.7%, and 4.5%, respectively, while life-science tools and healthcare services also advanced. Regionally, the US led with a 9.0% gain, followed by Europe (+6.0%) and Asia (+2.7%), contributing to strong overall sector performance.

Among portfolio holdings, Madrigal Pharmaceuticals (+42.5%; strong MASH sales launch), Teva Pharmaceuticals (+31.3%; inline price discount in IRA for Austedo), Penumbra (+28.9%; continued commercial momentum), and Eli Lilly (+24.8%; agreement with the US administration on GLP-1) delivered the strongest absolute returns in November.

The healthcare sector is entering a new and durable phase of growth following several years of structural and policy headwinds. Healthcare equities remain materially underrepresented at around 10% of the S&P 500 despite contributing roughly 18% to US GDP, with valuations still their near decade-long lows. After a prolonged period marked by pricing uncertainty and regulatory overhang, fundamentals are stabilizing and investor confidence is returning. Within this recovery, biotechnology has emerged as a key driver – transitioning to cash-generative growth supported by premium drug pricing, leaner cost structures, and disciplined capital allocation.

Long-term secular drivers – aging populations, expanded access to healthcare in emerging markets, and accelerating innovation in fields such as AI, robotics, and precision medicine – remain firmly intact. Innovation not only drives growth but also enhances system efficiency by mitigating long-term care costs. Against this backdrop, the fund maintains a selective, high-conviction strategy with diversified exposure across healthcare subsectors, emphasizing biotechnology and life-science tools as core overweight positions to target structural and cyclical outperformance.