The 28 Biotech Stocks Hedge Funds Are Buying and Holding in 2026 (Q2 13F Special Report)

Every quarter, 45 hedge funds that invest in nothing but biotech, including Baker Bros Advisors, Perceptive Advisors, RA Capital, OrbiMed, EcoR1 and Fairmount, disclose every US stock position they hold in SEC Form 13F filings. BiopharmaWatch has tracked all of them for 22 consecutive quarters, 55,914 positions in total. With the Q2 2026 filings complete as of August 14, their combined disclosed portfolio stands at a record $127.3 billion across 520 biotech stocks.

This report answers the question that data exists to answer: which biotech stocks do hedge funds actually agree on, and what has that agreement been worth to an investor who followed it?

The headline finding: only 28 of the 520 stocks are held by 12 or more of the 45 specialist funds, and a basket of those high-agreement names turned $10,000 into $26,260 since late 2021, while the stocks held by only one or two funds lost a quarter of their value over the same period.

The 28 biotech stocks hedge funds are buying and holding in 2026

Consensus among biotech specialists is far rarer than most investors assume. The median stock in the combined book is held by just 3 of the 45 funds, and 144 stocks are held by exactly one. Twelve or more funds agreeing on a single name means twelve independent teams of MDs, PhDs and analysts reached the same conclusion with real money. Here is the complete list from the Q2 2026 filings, ranked by how many funds hold each stock.

* Spyre Therapeutics files under its former ticker AGLE; Abivax appears in filings under a foreign listing line. Both are shown here under their common US identifiers. Source: SEC Form 13F filings, Q2 2026, share positions only.

The most widely held stock in the panel, Revolution Medicines (RVMD), was owned by 19 of the 45 funds as of June 30, their single largest position at $5.8 billion. On August 26, the FDA approved its drug daraxonrasib, the first broad RAS-targeted medicine. The filings predate that approval by eight weeks. The fastest-growing position was Avalo Therapeutics (AVTX), which added six new fund holders in a single quarter while the panel's combined share count rose roughly 159%.

What hedge fund agreement is worth: the ownership staircase

To measure whether specialist agreement predicts returns, we bucketed every stock in the panel by the number of funds holding it, then held each bucket as an equal-weight basket, rebalanced quarterly on the filing deadline so the test only ever uses information that was public at the time. The result is a staircase.

According to BiopharmaWatch's analysis of 22 quarters of 13F filings, biotech stocks held by 12 or more specialist hedge funds outperformed the average 13F-held biotech by about 5 percentage points per quarter, while stocks held by only one or two specialist funds reliably underperformed.

Two honesty notes belong next to that table. First, the figures charge no trading costs and are a measurement, not a product. Second, the positive edge, at roughly 5 points per quarter, sits just below conventional statistical significance across 19 quarters. The finding that does clear the bar is the negative one: thin specialist ownership is a reliable warning sign (t = -2.35). If almost none of the 45 firms that do this full time owns a biotech, that absence is information.

How the specialists are positioned: a record book, concentrated

The panel's combined disclosed portfolio grew from $87.4 billion in mid-2023 to $127.3 billion today, an all-time high. Decomposing that growth shows discipline rather than chasing: the funds realised $33.1 billion of net gains into the rising market while the market repriced their existing holdings $79.8 billion higher. They also concentrated. The book covered 696 companies in 2021 and covers 520 now, with the average capital per company roughly doubling from about $149 million to about $245 million.

Only 3 of 19 therapeutic areas attracted net new capital over three years: oncology, dermatology and ophthalmology. Selling into strength while doubling down on fewer names is what conviction looks like in institutional filings.

Not all specialists are equal: a 289-point performance spread

Across the identical universe and the identical quarters, the best fund's disclosed book compounded about +300% over three years while the weakest managed +11%. Manager selection inside biotech mattered more than the decision to be in biotech at all. Concentration also paid at the fund level: the most concentrated quartile of managers returned +149% over three years against +99% for the most diversified quartile.

Where the smart money rotated: oncology and small molecules

By therapeutic area, oncology took six full percentage points of the specialist book in three years, reaching 25.8% of classified holdings, while no other area gained even one point. The RAS franchise, led by Revolution Medicines and Erasca (ERAS), sits at the center of that shift, funded largely out of the obesity and hematology complexes.

By drug type, the rotation runs against the decade's dominant narrative: small molecules gained 7 points of the book and now hold roughly three fifths of specialist capital, while biologics gave up share and cell therapy roughly halved. The oral obesity wave, including Structure Therapeutics (GPCR), which began dosing a Phase 3 oral obesity drug in August, is a major driver.

How specialists build portfolios, and the 45-day catch

The median specialist holds 41 companies with 46% of its capital in its top five positions; one fund runs 81% of its book in just five names. And position turnover is high: 23% of all positions in our 22-quarter history lasted exactly one quarter, while only 11% survived three years. Combined with the 45-day statutory filing delay, this is why a single 13F snapshot ages quickly, and why the signal lives in the flow of filings quarter after quarter rather than in any one document.

The portfolios built on this data

BiopharmaWatch runs two model portfolios constructed directly from the ownership-breadth signal documented above, selecting large-cap commercial-stage names with the broadest specialist agreement, equal weighted and rebalanced quarterly on the filing deadline.

The Conservative model portfolio (15 names) has returned +184.6% over 21 quarters, against +3.1% for the XBI biotech index over the identical period, with a maximum drawdown of 19.4% against 44% for the index. The Aggressive model portfolio (the 10 highest-agreement names) has returned +247.7%, with a slightly shallower drawdown than the 15-name version. Both are model portfolios, not investment advice, and both hold only positions already public in filings on each rebalance date.

Methodology and data sources

Panel: 45 biotech specialist hedge fund managers, every SEC Form 13F filing from Q1 2021 through Q2 2026 (22 quarters, 55,914 positions). Share positions only; options-only positions are excluded, and a fund holding both stock and calls in the same name is counted once. Holder counts are distinct managers. For every return measurement, a stock held in one quarter earns its return over the following quarter, measured filing deadline to filing deadline, so no result uses information before it was public. Return series exclude a small number of verified data artifacts from unadjusted reverse splits, detected from the filings' own share counts. Statistical significance is computed across quarters, not across holdings. Form 13F covers long US-listed equity only: no short positions, no private holdings, no non-US listings and no cash are visible. Disclosed portfolio returns are not fund returns. Prices and market values as of August 29, 2026.

Explore the underlying data yourself: the hedge fund holdings tracker and the biotech screener update as filings arrive, and the FDA calendar tracks the catalysts these positions are built around.

Download the full report

Download The Conviction Economy as a 14-page PDF (free, no signup). We rerun the entire analysis when the Q3 2026 filings land in November.

This material is for information only and is not investment advice or a recommendation to buy or sell any security. Past performance, including model portfolio and backtested performance, is not indicative of future results.