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        <name>ADMA BIOLOGICS INC</name>
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      <invstOrSec>
        <name>REPLIGEN CORP</name>
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      <invstOrSec>
        <name>BIOMARIN PHARMACEUTICAL INC</name>
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        <name>HALOZYME THERAPEUTICS INC</name>
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        <name>GILEAD SCIENCES INC</name>
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        <name>ILLUMINA INC</name>
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        <name>BIONTECH SE</name>
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        <name>VERACYTE INC</name>
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        <name>BEONE MEDICINES LTD</name>
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        <name>DAIWA CAPITAL MARKETS AMERICA INC.</name>
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        <name>NEUROCRINE BIOSCIENCES INC</name>
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        <name>UNITED THERAPEUTICS CORP</name>
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        <title>UNITED THERAPEUTICS CORP COM</title>
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        <name>KRYSTAL BIOTECH INC</name>
        <lei>549300YONUY68210OE41</lei>
        <title>KRYSTAL BIOTECH INC COM</title>
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          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>GENMAB A/S</name>
        <lei>529900MTJPDPE4MHJ122</lei>
        <title>GENMAB A/S SPONSORED ADS</title>
        <cusip>372303206</cusip>
        <identifiers>
          <isin value="US3723032062"/>
          <ticker value="GMAB"/>
        </identifiers>
        <balance>2686600.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>73800902.00000000</valUSD>
        <pctVal>2.623853860654</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>DK</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>VERTEX PHARMACEUTICALS INC</name>
        <lei>54930015RAQRRZ5ZGJ91</lei>
        <title>VERTEX PHARMACEUTICALS INC COM</title>
        <cusip>92532F100</cusip>
        <identifiers>
          <isin value="US92532F1003"/>
          <ticker value="VRTX"/>
        </identifiers>
        <balance>173968.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>86415124.64000000</valUSD>
        <pctVal>3.072329094373</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>NEOGENOMICS INC</name>
        <lei>549300KN62PPGHBVXB46</lei>
        <title>NEOGENOMICS INC COM NEW</title>
        <cusip>64049M209</cusip>
        <identifiers>
          <isin value="US64049M2098"/>
          <ticker value="NEO"/>
        </identifiers>
        <balance>9869496.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>143995946.64000000</valUSD>
        <pctVal>5.119508166851</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>ALKERMES PLC</name>
        <lei>N/A</lei>
        <title>ALKERMES PLC SHS</title>
        <cusip>000000000</cusip>
        <identifiers>
          <isin value="IE00B56GVS15"/>
          <ticker value="ALKS"/>
        </identifiers>
        <balance>2275074.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>119202502.23000000</valUSD>
        <pctVal>4.238023346596</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>IE</invCountry>

        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
    </invstOrSecs>
    <explntrNotes>
      <explntrNote note="Monthly returns presented in Item B.5(a) have been calculated without deducting any applicable sales loads or redemption fees." noteItem="B.5.a"/>
    </explntrNotes>
    <signature>
      <ncom:dateSigned>2026-08-21</ncom:dateSigned>
      <ncom:nameOfApplicant>First Trust Exchange-Traded Fund</ncom:nameOfApplicant>
      <ncom:signature>Derek Maltbie</ncom:signature>
      <ncom:signerName>Derek Maltbie</ncom:signerName>
      <ncom:title>Treasurer, Chief Financial Officer and Chief Accounting Officer</ncom:title>
    </signature>
  </formData>
</edgarSubmission>
