From Q4 2024 to Q4 2025, Armistice Capital’s disclosed portfolio value dropped from $7.33 billion to $5.80 billion, a decline of roughly $1.53 billion. Over that same period, the fund shed positions, rotated out of several long-held healthcare names, and ended the year as a net seller of stock by approximately $1.1 billion in its most recently reported quarter alone, according to Stockzoa filing data. The numbers, read alongside the specific positions added and exited, sketch a picture of a healthcare-concentrated fund navigating a difficult year for small- and mid-cap biotech while selectively reallocating toward names with clearer near-term commercial footing.
The Scale of the Reduction
The AUM figure disclosed in 13F filings covers long equity positions reported to the SEC and does not capture the full scope of a fund’s activity, including short positions, cash, or derivatives. With that caveat, the disclosed drop from $7.33 billion to $5.80 billion across four quarters is significant on its face. The fund’s total holding count also shifted, from 231 positions reported in the Q4 2024 filing to 364 in Q4 2025, reflecting both new positions initiated and the fund’s tendency to carry a long tail of smaller holdings alongside its concentrated core bets.
Net selling of $1.1 billion in a single quarter is a meaningful figure for a fund of this size. It does not, by itself, indicate distress or forced liquidation. Hedge funds reduce positions for a range of reasons: to lock in gains, rebalance toward higher-conviction names, manage overall exposure in a volatile sector, or meet redemption requests. What the 13F record can show is where the reductions were concentrated.
PTC Therapeutics: The Largest Single Exit
PTC Therapeutics (NASDAQ: PTCT) was for several years the most prominent disclosed holding in Armistice Capital’s portfolio. At the end of Q4 2024, the fund held 6,378,000 shares valued at approximately $287.9 million. By Q3 2025, that position had been reduced by 48%, leaving 3.3 million shares valued at approximately $201 million. PTC remained among the top five equity holdings despite the reduction, reflecting how large the original position had been rather than signaling renewed conviction at current levels.
PTC Therapeutics focuses on rare genetic disorders, including Duchenne muscular dystrophy and phenylketonuria. Its $2.9 billion collaboration with Novartis for the Huntington’s disease candidate PTC518, announced in 2024, provided the fund with a material catalyst to book into. Novartis paid $1 billion upfront with potential for an additional $1.9 billion in milestones plus profit-sharing arrangements on U.S. sales. The timing of Armistice’s reduction, which accelerated in the quarters following that deal’s announcement, is consistent with a fund trimming after a catalyst resolves rather than holding through what may be a longer commercial development cycle.
Wellington Management and Vanguard Group both maintain institutional positions in PTC, providing continued broad ownership even as event-driven managers adjust their exposure post-catalyst.
Grifols: A Separate Trajectory
The Grifols (NASDAQ: GRFS) reduction followed a different pattern. Armistice had been steadily building its Grifols position through 2024, reaching 10,036,000 shares valued at approximately $74.7 million at the end of Q4 2024. By Q3 2025, that position had been cut by 77%, leaving 2.2 million shares valued at roughly $22 million. The pace and depth of the reduction stand apart from the PTC trim. Grifols, a Barcelona-based plasma-derived therapeutics company, had drawn broad institutional interest for its immunoglobulin and albumin product lines, but the company faced margin pressures and governance questions that weighed on its share price through the period. Permian Investment Partners remained a significant holder with 16,187,321 shares as of early 2025, suggesting not all institutional capital moved in the same direction.
What Replaced the Capital
The portfolio’s top five equity holdings for Q4 2025 were PTC Therapeutics, Madrigal Pharmaceuticals, Immunovant, Travere Therapeutics, and Supernus Pharmaceuticals. Two of those names, Madrigal and Travere, had significant FDA catalysts materialize during the year. Madrigal’s Rezdiffra generated $958.4 million in net sales in its first full commercial year following its March 2024 approval for MASH. Travere’s FILSPARI received full FDA approval for FSGS in April 2026, the first and only approved medicine for that rare kidney disease.
Armistice Capital’s Madrigal position grew 149% quarter-over-quarter as of the Q3 2025 filing, reaching 250,000 shares valued at approximately $115 million. Regeneron Pharmaceuticals (NASDAQ: REGN) saw a 346% share increase. GE Healthcare Technologies (NASDAQ: GEHC) more than doubled. These additions point to capital from the PTC and Grifols reductions moving toward names with either established commercial revenue or imminent regulatory resolution, rather than earlier-stage clinical bets.
The Broader Sector Context
Armistice Capital’s portfolio activity in 2025 unfolded against a difficult backdrop for small- and mid-cap biotech. The Russell 2000 entered correction territory in March 2026 as rising yields pressured the segment, and biotech stocks, which function as long-duration assets with valuations tied to future earnings, absorbed some of the sharpest declines. An estimated 41% to 46% of Russell 2000 companies were unable to cover interest expenses with operating profits during the period, compounding pressure on smaller names. Healthcare companies now make up approximately 16% of the Russell 2000 by weight, most of them high-risk pre-revenue biotechs, compared to roughly 5% two decades ago.
For healthcare-focused hedge funds, that environment creates asymmetric pressure. Positions in companies that reach commercial milestones can hold or appreciate in value, while broader small-cap healthcare exposure drags on disclosed portfolio values. The pattern in Armistice Capital’s filings, selling down longer-held positions following catalyst resolution while adding to names approaching their own inflection points, fits the logic of a fund managing a concentrated book through a sector under pressure. The total position count expanding from 231 to 364 at the same time AUM declined also points to diversification across a wider set of smaller bets, rather than a wholesale pullback from the sector.
Point72, Millennium Management, and other multi-strategy funds have similarly increased their emphasis on companies with near-term FDA timelines in recent years, treating regulatory decisions as discrete, analyzable events rather than binary risks to be avoided. Armistice Capital’s Q4 2025 filings, taken together, reflect a fund repositioning within healthcare rather than away from it.
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