Bellevue Biotech (CH)

Global equity markets recovered sharply in April with the MSCI World Index raising 9.6%, driven by easing Middle East tensions and strong Q1 2026 earnings results. Healthcare underperformed the broader market, with the MSCI World Health Care Index remaining flat for the month (-20 bp). The biotechnology sector was also a weak performer, with the Nasdaq Biotechnology Index (NBI) increasing just 0.4% in USD (-1.9% in CHF). The Bellevue Biotech (CH) Fund (ADGLBII shares; -3.8% in CHF) underperformed its NBI benchmark by 185 bp. A number of M&A deals were rumored and announced during the month, which supported the small and mid-cap Biotech segment.

Amongst healthcare subsectors, only healthcare services delivered a positive return in April (+14.4%; rebound driven by reimbursement rates and Q1 2026 company results). We saw disappointing performances from Healthcare IT (-6.4%), medtech (-4.5%), biotech (-2.6%), life science tools (-1.9%), and pharmaceuticals (-1.2%). Emerging market healthcare performed strongly in the month (+4.0%), followed by positive performances from Asia (+1.4%), and Europe (+0.7%). The US healthcare region delivered an negative absolute performance of -0.5% in April, with Johnson & Johnson the largest contributor.

Through the first half of the healthcare Q1 2026 earnings season (49/102 companies reported as of April 5, 2026), results and guidance changes were generally positive (+8.8% positive earnings). In addition, after several months of declining expectations, the full year 2026 earnings expectations for the sector increased during April.

April saw a mix of supportive regulatory and policy developments alongside continued strategic activity in biopharma. Eli Lilly’s approval of Foundayo (orforglipron) marked an important milestone for the oral GLP-1 market, while within healthcare services, Medicare Advantage (MA) rates came in higher than expected. Strategic activity also remained active, with Gilead acquiring Tubulis and Neurocrine acquiring Soleno. On the clinical side, Revolution Medicines reported notable pancreatic cancer data in metastatic PDAC, while AstraZeneca’s camizestrant faced a setback after the FDA’s advisory committee voted 6-3 against its benefit-risk profile in HR-positive, HER2-negative breast cancer with emergent ESR1 mutations.
Top absolute performers in the fund included Revolution Medicine (+48% in USD; strong clinical trial data in metastatic PDAC), Travere Therapeutics (+42.8%; FDA approval of FILSPARI in FSGS), and Axsome Therapeutics (+23%; FDA approval of Auvelity for Alzheimer’s disease agitation).

Top relative positive contributors included Travere Therapeutics (overweight; +35.5 bp contribution; +41.8%), Axsome Therapeutics (overweight; +30.4 bp; +22.9%), and Alnylam pharma (underweight; +21.6 bp; -6.5%; anticipation of new competitors). Top relative negative contributors included NewAmsterdam (overweight; -36.6 bp; -10.8%; share pullback, remains +10% over 1Y), Vera Therapeutics (overweight; -28.4 bp; -11.5%; increased IgAN competition), and Viridian Therapeutics (overweight; -20.2 bp; -31.1%; disappointing REVEAL-1 data of Elegrobart in TED in the month, although positive REVEAL-2 data was released on May 5).

Biotechnology may be entering a more durable phase of growth after several years of structural, regulatory, and capital-market headwinds. The sector is transitioning from a speculative, capital-intensive model toward sustainable, cash-generative growth, driven by premium pricing, leaner cost structures, and disciplined capital allocation. Fundamentals are stabilizing, and investor confidence is returning as the industry demonstrates consistent profitability and operational efficiency.

Long-term structural drivers remain compelling. Aging populations, expanding healthcare access in emerging markets, and accelerating innovation in AI-enabled drug discovery, precision medicine, and advanced biologics continue to broaden the opportunity set. Biotech innovation is increasingly central to healthcare system efficiency, reducing chronic-care burdens and containing long-term costs through curative interventions.

The fund maintains a selective, high-conviction strategy oriented toward late-stage, de-risked assets, proven pricing power, and scalable platforms capable of generating sustainable free cash flow.