First Trust Indxx Medical Devices ETF

First Trust Indxx Medical Devices ETF (MDEV) tracks the Indxx Medical Devices Index, which holds 50 US and foreign medical equipment companies at equal weights. That spreads money evenly across names like West Pharmaceutical Services, Demant and LivaNova, so the largest companies don't dominate. The drawbacks are a 0.70% annual expense ratio, compared with a 0.46% average for similar funds, and net assets of only about $1.9 million as of June 30, 2026.

• Over the year to Oct 27, 2026, MDEV returned +4.2%, 4th of 5 among similar funds.
• Its 5-year annualized return was -3.5%.
• Its worst full calendar year was 2022 (-28.6%); its best was 2023 (+7.5%).
• The deepest fall in its price history was 42.3% (Sep 7, 2021 to Sep 27, 2022), not yet recovered.

As of Jun 30, 2026, the fund held 50 securities; the ten largest made up 25.46% of assets.

• Over the three months to Jun 30, 2026, investors added a net $0.00 (creations minus redemptions, per the N-PORT report).
• Monthly total returns reported for that quarter: -2.52%, +2.05%, +1.27%.

MDEV is an index fund. It aims to match the price and yield of the Indxx Medical Devices Index, before fees. Indxx, Inc. builds and maintains the index. The fund generally uses full replication, which means it owns every stock in the index at the index's weight. Under normal conditions, it keeps at least 80% of net assets in index securities.

To qualify, a stock must trade in a developed or emerging market. It must also pass tests for size, float (shares available to trade), price and liquidity. The company must earn at least 50% of its revenue from medical equipment. That covers products for examination, diagnosis, monitoring, treatment, surgery and medical research, including lab procedures, plus related services. The 50 largest qualifying companies by market capitalization (share price times shares outstanding) make up the index, and each gets an equal weight. Indxx can also use its own judgment to exclude a stock over concerns such as governance or accounting.

The index resets to equal weights twice a year and reviews its member list once a year. The fund trades shortly after each change. Between resets, weights drift. As of June 30, 2026, the largest holding, West Pharmaceutical Services, was 2.86% of assets, and the top 10 made up 25.46%. US stocks were 55.35%, followed by Japan, Switzerland and the UK, so currency swings affect returns. The fund used no derivatives or leverage.

• MDEV charges 0.7% a year, versus an average of 0.46% for the similar funds below (5th of 5, cheapest first).

MDEV is a narrow, equal-weighted bet on one industry, with a 0.70% fee, about $1.9 million in assets as of June 30, 2026, and a 42.3% drop it had not recovered from.

MDEV could add a slice of medical equipment companies from the US, Europe and Japan, spread across 50 stocks. Its track record is short: it launched in June 2021, after the 2008 and 2020 crashes. In the 2022 bear market it fell 38.2%, and 2022 was its worst calendar year, at -28.36%. Its deepest drop was 42.3%, from September 2021 to September 2022. It had not recovered that loss as of October 27, 2026. A retiree who drew money from the fund during that slump would have locked in steep losses.

It pays very little income: the trailing yield was 0.09% as of October 27, 2026, paid once a year. The 0.70% expense ratio compares with a 0.46% average for similar funds. Past results don't predict the future, and a plan needs to look at the whole portfolio, not one fund.

Matched by holdings overlap from the latest N-PORT reports.