At a glance
PILL charges 0.98% a year. It has $20.7M in assets; it paid 0.41% of its price in distributions over the past 12 months, quarterly. Over the past year it returned +73.8% with distributions reinvested (S&P 500: +11.5%); over three years it returned +45.3% a year. At its worst it fell 73.4% in the 2020 crash (S&P 500: 33.7%) and 48.8% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 10 months and 48 months after the lows. Its ten largest positions make up 19.3% of the fund, out of 66 in all.
The short version
Direxion Daily Pharmaceutical & Medical Bull 3X Shares (PILL) seeks three times the daily return of an S&P pharmaceutical-stock index that weights small and large drugmakers about equally. Its leverage resets every day, so longer-term results can stray far from three times the index and swing sharply: it lost 43% in 2022 and gained 75% in 2025. It charges 0.98% a year.
Price history
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PILL +73.8% over the year to Oct 27, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| PILL official prospectus, to Dec 31, 2025 | — | +75.04% | — | -12.64% | — | -7.71% |
| PILL price data to Oct 27, 2026 | +20.0% | +73.8% | +45.3% | -2.2% | — | -4.4% |
- Over the year to Oct 27, 2026, PILL returned +73.8%.
- Its 5-year annualized return was -2.2%.
- In the 2020 COVID crash it fell 73.4% and regained its old high 9.5 months after the low.
- Its worst full calendar year was 2022 (-43.1%); its best was 2025 (+75.0%).
- The deepest fall in its price history was 88.7% (Aug 29, 2018 to Apr 10, 2025), not yet recovered.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +20.0% | — |
| 2025 | +75.0% | +75.04% |
| 2024 | -7.3% | -6.92% |
| 2023 | -12.0% | -12.65% |
| 2022 | -43.1% | -43.13% |
| 2021 | -37.3% | -37.17% |
| 2020 | +0.3% | -0.32% |
| 2019 | +19.3% | +18.19% |
| 2018 | -21.2% | -19.57% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 73.4% over that stretch · deepest drop along the way 73.4%, back to its old high 9.5 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 45.3% over that stretch · deepest drop along the way 48.8%, back to its old high 48.2 months after the low |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2026 (to date) | $0.0310 | |
| 2025 | $0.0800 | -11.1% |
| 2024 | $0.0900 | -40.0% |
| 2023 | $0.1500 | +134.4% |
| 2022 | $0.0640 | +63900.0% |
| 2021 | $0.0001 | -99.9% |
| 2019 | $0.1003 | -47.2% |
| 2018 | $0.1900 |
What's inside
As of Jul 31, 2026, most of the fund sat in cash, Treasury bills and money-market holdings (32.53% of net assets), with its exposure coming from 4 swap and futures positions rather than from owning the stocks outright.
| Holding | Weight | |
|---|---|---|
| CRINETICS PHARMACEUTICALS IN | 2.77% | |
| MBX BIOSCIENCES INC | 2.42% | |
| ATAIBECKLEY INC | 2.16% | |
| Definium Therapeutics, Inc | 2.13% | |
| AMYLYX PHARMACEUTICALS INC | 1.72% | |
| ENLIVEN THERAPEUTICS INC | 1.68% | |
| CORCEPT THERAPEUTICS INC | 1.67% | |
| ALUMIS INC | 1.60% | |
| NUVATION BIO INC | 1.57% | |
| TREVI THERAPEUTICS INC | 1.55% | |
| LIQUIDIA CORP | 1.47% | |
| NEKTAR THERAPEUTICS | 1.42% | |
| AMNEAL PHARMACEUTICALS INC | 1.36% | |
| BRISTOL-MYERS SQUIBB CO | 1.34% | |
| EDGEWISE THERAPEUTICS INC | 1.33% |
By country
United States 72.89%Canada 2.13%By asset type
Stocks 75.02%What changed recently
- Over the three months to Jul 31, 2026, investors added a net $914K (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +1.31%, +44.90%, +4.25%.
How it works
PILL tracks a modified equal-weighted index of stocks from the S&P Total Market Index that fall in the pharmaceuticals sub-industry of GICS, a standard industry classification. Equal-weighted means each company gets a similar slice rather than one sized by market value, so small drug developers count as much as large drugmakers. Stocks must pass size and trading tests, starting at $300 million in freely traded market value. The index is rebalanced quarterly and had 59 stocks as of December 31, 2025.
The fund aims for 300% of the index's return each trading day, before fees. It combines index stocks with swaps (contracts in which a financial firm pays the fund the index's return) and futures. As of July 31, 2026, stocks equaled 75% of net assets, alongside four swaps on the S&P Pharmaceuticals Select Index and about 33% in cash and similar holdings. If a swap firm fails to pay, the fund loses money.
At each market close, adviser Rafferty Asset Management resets exposure, adding after up days and trimming after down days. So over longer periods, the fund's return will very likely differ from three times the index's return. The prospectus warns it will lose money if the index is flat over time and could lose even if the index rises. This constant trading produced 88% portfolio turnover.
What it really costs
- PILL charges 0.98% a year.
- Of that, 0.75% is the management fee; the rest covers other fund expenses.
- The fee includes a 0.24% waiver from the adviser, which may end.
- Using the prospectus's standard example, $10,000 invested would cost about $100 in the first year and $1,456 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| PILL | $100 | $363 | $647 | $1,456 |
Structure and tax notes
- Resets its exposure every day. Over periods longer than a day, compounding means returns can differ sharply from 3× the index — usually worse in choppy markets. Built for short-term trading, not buy-and-hold.
In a retirement portfolio
Its 3x exposure resets daily, and people who held it for several years have faced deep, long-lasting losses, including an 88.7% fall from its 2018 peak.
PILL is built for single-day trades. It launched in 2017, after the 2008 crisis. In the 2020 COVID crash it fell 73.4% in about five weeks, recovering by January 2021. In the 2022 bear market it dropped 48.8% from January 3 to June 16 and took about 48 months to regain that peak. Its worst calendar year was 2022, a 43.1% loss. Its deepest slide, 88.7% from August 2018 to April 2025, remained unrecovered as of October 27, 2026. Withdrawals during such slumps would lock in deep losses.
Income is slim: a 0.41% yield for the 12 months to October 27, 2026, paid quarterly. The annual expense ratio is 0.98%, and the SEC's standard example puts costs at $1,456 over 10 years on $10,000 earning 5% a year. Past results don't predict the future, and a plan should look at the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Active traders who check positions daily and want three times the one-day move in pharmaceutical stocks, knowing the leverage resets at each market close.
- Short-term traders wanting leveraged exposure that weights drugmakers roughly equally; on July 31, 2026, Crinetics and MBX Biosciences outweighed Bristol-Myers Squibb.
- Experienced investors who understand swaps, compounding and counterparty risk, and could absorb losses like the 61.37% drop in the first quarter of 2020.
Look elsewhere if
- Retirees and long-term savers: PILL lost money in six of its eight full calendar years through 2025, including 43% in 2022.
- Income seekers: distributions totaled about $0.061 per share, a 0.41% yield, over the 12 months to October 27, 2026.
- Anyone wanting unleveraged pharmaceutical exposure: daily resets mean PILL can lose money even when its index rises, and it charges 0.98% a year.
Close alternatives
Matched by leveraged/inverse funds on the same index (the index could not be identified from the name).
No close alternatives found.
Questions investors ask
Is PILL good for retirement?
It isn't built for retirement portfolios. PILL seeks three times its index's return for a single trading day and does not aim for that over longer periods. Holding it for years has gone badly: the prospectus shows an average annual loss of 12.64% over the five years through December 31, 2025, and 7.71% a year since its November 2017 launch. It also fell 88.7% from its August 2018 peak to its April 2025 low.
Why doesn't PILL return 3x the index over a year?
Because it resets daily. PILL targets 300% of the index's return each trading day, then resizes its exposure at the market close, so each day's gain or loss compounds from a new starting point. Over weeks or years, that compounding usually pulls results away from three times the index, especially when prices zigzag. The prospectus says the fund will lose money if the index is flat over time and could lose money even if the index rises.
What stocks does PILL hold?
As of July 31, 2026, PILL's largest stock positions were Crinetics Pharmaceuticals (2.8% of net assets), MBX Biosciences (2.4%), AtaiBeckley (2.2%), Definium Therapeutics (2.1%) and Amylyx Pharmaceuticals (1.7%). Because its index weights companies roughly equally, the top 10 made up only 19.3%, and Bristol-Myers Squibb was 1.3%. Stocks totaled 75% of net assets. The rest of its exposure came from four swaps on the S&P Pharmaceuticals Select Index, alongside about 33% in cash and similar holdings.
What's the difference between PILL and a regular pharmaceutical ETF?
The difference is leverage and the daily reset. A regular, unleveraged fund on a pharmaceutical index simply moves with it. PILL aims for three times the index's daily move, so its swings are far bigger: volatility, a measure of how widely returns vary, was 69.9% over the year to October 27, 2026. PILL also relies on swaps, which carry counterparty risk, the chance the firm on the other side fails to pay. Its expense ratio is 0.98%.
Does PILL pay dividends?
Yes, but very little. PILL pays distributions quarterly. Over the 12 months to October 27, 2026, they totaled about $0.061 per share, a yield of 0.41%. That income is tiny next to the fund's price swings: it gained 75% in 2025 after losing 43% in 2022. The fund is built to magnify daily price moves in pharmaceutical stocks, not to produce income, so it offers little to investors who depend on regular payouts.