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        <name>Option Care Health Inc</name>
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        <name>Medtronic PLC</name>
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        <name>Nomura Securities International, Inc.</name>
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        <name>Celldex Therapeutics Inc</name>
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        <fairValLevel>1</fairValLevel>
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        <name>Duality Biotherapeutics Inc</name>
        <lei>N/A</lei>
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        <invCountry>HK</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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        <name>United Therapeutics Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Immunome Inc</name>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>AbbVie Inc</name>
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        <name>ICON PLC</name>
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        <title>ICON PLC</title>
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        <fairValLevel>1</fairValLevel>
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        <name>Stryker Corp</name>
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        <name>Soleno Therapeutics Inc</name>
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        <title>SOLENO THERAPEUT</title>
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        <name>Kymera Therapeutics Inc</name>
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        <name>Apogee Therapeutics Inc</name>
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        <title>APOGEE THERAPEUT</title>
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        <name>Alignment Healthcare Inc</name>
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        <name>HSBC Bank USA</name>
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        <name>Bristol-Myers Squibb Co</name>
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        <name>Nuvalent Inc</name>
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        <title>NUVALENT INC-A</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Dianthus Therapeutics Inc</name>
        <lei>549300Z3N6ODPCOFC890</lei>
        <title>DIANTHUS THERAPE</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Regeneron Pharmaceuticals Inc</name>
        <lei>549300RCBFWIRX3HYQ56</lei>
        <title>REGENERON PHARM</title>
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          <isin value="US75886F1075"/>
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        <curCd>USD</curCd>
        <valUSD>235827069.90000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      </invstOrSec>
      <invstOrSec>
        <name>HeartFlow Inc</name>
        <lei>N/A</lei>
        <title>HEARTFLOW INC</title>
        <cusip>42238D107</cusip>
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          <isin value="US42238D1072"/>
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        <balance>2256545.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>67402999.15000000</valUSD>
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        <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>
          <loanByFundCondition isLoanByFund="Y" loanVal="39774892.00000000"/>
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      </invstOrSec>
      <invstOrSec>
        <name>Argenx SE</name>
        <lei>7245009C5FZE6G9ODQ71</lei>
        <title>ARGENX SE</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="NL0010832176"/>
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        <balance>1165992.00000000</balance>
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        <currencyConditional curCd="EUR" exchangeRt="1.18535000"/>
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        <pctVal>2.496876992520</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>BE</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Eisai Co Ltd</name>
        <lei>353800HDEE0ZYEX4QV91</lei>
        <title>EISAI CO LTD</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3160400002"/>
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        <balance>8514317.00000000</balance>
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        <currencyConditional curCd="JPY" exchangeRt="0.00646200"/>
        <valUSD>237374340.74000000</valUSD>
        <pctVal>0.604441891671</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>HCA Healthcare Inc</name>
        <lei>529900PH4ZGUH2MNEU89</lei>
        <title>HCA HEALTHCARE I</title>
        <cusip>40412C101</cusip>
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          <isin value="US40412C1018"/>
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        <balance>933410.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>455756100.70000000</valUSD>
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        <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>
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      </invstOrSec>
      <invstOrSec>
        <name>Astellas Pharma Inc</name>
        <lei>529900IB708DY2HBBB35</lei>
        <title>ASTELLAS PHARMA</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3942400007"/>
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        <balance>9027178.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00646200"/>
        <valUSD>125567014.70000000</valUSD>
        <pctVal>0.319739545816</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Genmab A/S</name>
        <lei>529900MTJPDPE4MHJ122</lei>
        <title>GENMAB A/S</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DK0010272202"/>
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        <balance>1345944.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="DKK" exchangeRt="0.15872100"/>
        <valUSD>438489008.05000000</valUSD>
        <pctVal>1.116553392740</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>DK</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>HSBC Bank USA</name>
        <lei>CYYGQCGNHMHPSMRL3R97</lei>
        <title>HSBC TRIPARTY TREAS</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS0000201X2"/>
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        <balance>34000000.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>34000000.00000000</valUSD>
        <pctVal>0.086576435569</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="CYYGQCGNHMHPSMRL3R97" name="HSBC Bank USA"/>
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          <isTriParty>Y</isTriParty>
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          <maturityDt>2026-02-02</maturityDt>
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            <repurchaseCollateral>
              <principalAmt>61202600.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>34680011.57000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
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          </repurchaseCollaterals>
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        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Vanguard Cmt Funds-Vanguard Market Liquidity Fund</name>
        <lei>1I6HV0TLSTR3A4XQ6L78</lei>
        <title>Vanguard Market Liquidity Fund</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="FAID" value="SLBBH1142"/>
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        <balance>590392.42900000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>STIV</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <cashCollateralCondition cashCollateralVal="59039242.90000000" isCashCollateral="Y"/>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Biogen Inc</name>
        <lei>W8J5WZB5IY3K0NDQT671</lei>
        <title>BIOGEN INC</title>
        <cusip>09062X103</cusip>
        <identifiers>
          <isin value="US09062X1037"/>
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        <balance>2913639.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>524134519.71000000</valUSD>
        <pctVal>1.334638190446</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>
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      <invstOrSec>
        <name>Merck &amp; Co Inc</name>
        <lei>4YV9Y5M8S0BRK1RP0397</lei>
        <title>MERCK &amp; CO</title>
        <cusip>58933Y105</cusip>
        <identifiers>
          <isin value="US58933Y1055"/>
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        <balance>18111825.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>1997190942.75000000</valUSD>
        <pctVal>5.085578616885</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>
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      <invstOrSec>
        <name>Nomura Securities International, Inc.</name>
        <lei>OXTKY6Q8X53C9ILVV871</lei>
        <title>NOM TSY FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS0000201SC"/>
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        <balance>80000000.00000000</balance>
        <units>PA</units>
        <curCd>USD</curCd>
        <valUSD>80000000.00000000</valUSD>
        <pctVal>0.203709260162</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="OXTKY6Q8X53C9ILVV871" name="Nomura Securities International, Inc."/>
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          <isTriParty>Y</isTriParty>
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          <maturityDt>2026-02-02</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>81346000.00000000</principalAmt>
              <principalCd>USD</principalCd>
              <collateralVal>81600086.23000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
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          </repurchaseCollaterals>
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        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Encompass Health Corp</name>
        <lei>549300FVRPM9DRQZRG64</lei>
        <title>ENCOMPASS HEALTH</title>
        <cusip>29261A100</cusip>
        <identifiers>
          <isin value="US29261A1007"/>
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        <balance>1600016.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>151249512.48000000</valUSD>
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        <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>
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      <invstOrSec>
        <name>Protagonist Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>PROTAGONIST THER</title>
        <cusip>74366E102</cusip>
        <identifiers>
          <isin value="US74366E1029"/>
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        <balance>1062977.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>86951518.60000000</valUSD>
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        <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>
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      <invstOrSec>
        <name>Aktis Oncology Inc</name>
        <lei>N/A</lei>
        <title>AKTIS ONCOLOGY I</title>
        <cusip>01021M104</cusip>
        <identifiers>
          <isin value="US01021M1045"/>
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        <balance>1523479.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>30850449.75000000</valUSD>
        <pctVal>0.078556528678</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>
          <loanByFundCondition isLoanByFund="Y" loanVal="344250.00000000"/>
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      <invstOrSec>
        <name>Inspire Medical Systems Inc</name>
        <lei>549300XQQCQ7HCJKTW25</lei>
        <title>INSPIRE MEDICAL</title>
        <cusip>457730109</cusip>
        <identifiers>
          <isin value="US4577301090"/>
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        <balance>1094019.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>82904759.82000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>JP Morgan Securities LLC</name>
        <lei>ZBUT11V806EZRVTWT807</lei>
        <title>JPM TRIPARTY TREAS FICC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS0000201G1"/>
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        <balance>70000000.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>70000000.00000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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          <transCat>Repurchase</transCat>
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              <invstCat>UST</invstCat>
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      <invstOrSec>
        <name>BNP Paribas Securities Corp.</name>
        <lei>2J5703FH5U5M97R1I237</lei>
        <title>PARIB TRIPARTY MORTGAGE</title>
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          <other otherDesc="VID" value="VS00002020W"/>
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        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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          <transCat>Repurchase</transCat>
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              <invstCat>AMBS</invstCat>
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        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>UCB SA</name>
        <lei>2138008J191VLSGY5A09</lei>
        <title>UCB SA</title>
        <cusip>B93562120</cusip>
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          <isin value="BE0003739530"/>
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        <balance>3023965.00000000</balance>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>BE</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Natixis SA</name>
        <lei>KX1WK48MPD4Y2NCUIZ63</lei>
        <title>NATIXIS TRIPARTY TR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="VID" value="VS0000201JW"/>
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        <balance>71100000.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>71100000.00000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="KX1WK48MPD4Y2NCUIZ63" name="Natixis SA"/>
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          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.66000000</repurchaseRt>
          <maturityDt>2026-02-02</maturityDt>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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        <isRestrictedSec>N</isRestrictedSec>

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        <fairValLevel>1</fairValLevel>
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        <isRestrictedSec>N</isRestrictedSec>

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          <transCat>Repurchase</transCat>
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        <name>Shionogi &amp; Co Ltd</name>
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        <fairValLevel>2</fairValLevel>
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        <name>Scholar Rock Holding Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Shandong Weigao Group Medical Polymer Co Ltd</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Crinetics Pharmaceuticals Inc</name>
        <lei>549300Q1CNFXK5P31D28</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Incyte Corp</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Ionis Pharmaceuticals Inc</name>
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        <fairValLevel>1</fairValLevel>
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        <name>Zai Lab Ltd</name>
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        <invCountry>HK</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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        <name>Newamsterdam Pharma Co NV</name>
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        <fairValLevel>1</fairValLevel>
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        <fairValLevel>1</fairValLevel>
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        <name>Eli Lilly &amp; Co</name>
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        <fairValLevel>1</fairValLevel>
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        <name>Abbott Laboratories</name>
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        <name>Jiangsu Hengrui Pharmaceuticals Co Ltd</name>
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        <name>Arcus Biosciences Inc</name>
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        <name>Madrigal Pharmaceuticals Inc</name>
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        <name>GSK PLC</name>
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        <fairValLevel>2</fairValLevel>
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        <name>Chugai Pharmaceutical Co Ltd</name>
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        <fairValLevel>2</fairValLevel>
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        <name>Intuitive Surgical Inc</name>
        <lei>54930052SRG011710797</lei>
        <title>INTUITIVE SURGIC</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Dexcom Inc</name>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Daiichi Sankyo Co Ltd</name>
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        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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      <invstOrSec>
        <name>Cytokinetics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Structure Therapeutics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Barclays Capital Inc.</name>
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        <isRestrictedSec>N</isRestrictedSec>

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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Agilent Technologies Inc</name>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Edwards Lifesciences Corp</name>
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        <title>EDWARDS LIFE</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>BNP Paribas Securities Corp.</name>
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        <title>PARIB TRIPARTY TREASURY</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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          <transCat>Repurchase</transCat>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>AstraZeneca PLC</name>
        <lei>PY6ZZQWO2IZFZC3IOL08</lei>
        <title>ASTRAZENECA PLC</title>
        <cusip>N/A</cusip>
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        <invCountry>GB</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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      <invstOrSec>
        <name>Immunocore Holdings PLC</name>
        <lei>213800IUE3DFS84BVN18</lei>
        <title>IMMUNOCORE HOLDI</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Vertex Pharmaceuticals Inc</name>
        <lei>54930015RAQRRZ5ZGJ91</lei>
        <title>VERTEX PHARM</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Danaher Corp</name>
        <lei>S4BKK9OTCEWQ3YHPFM11</lei>
        <title>DANAHER CORP</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Natera Inc</name>
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        <title>NATERA INC</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>PTC Therapeutics Inc</name>
        <lei>549300UJLWOIWFDGB318</lei>
        <title>PTC THERAPEUTICS</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Acadia Healthcare Co Inc</name>
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        <title>ACADIA HEALTHCAR</title>
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        <invCountry>US</invCountry>

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        <name>Apellis Pharmaceuticals Inc</name>
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        <title>APELLIS PHARMACE</title>
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        <name>Novo Nordisk A/S</name>
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        <invCountry>DK</invCountry>

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        <name>Alnylam Pharmaceuticals Inc</name>
        <lei>529900S3ZI14OWRJII50</lei>
        <title>ALNYLAM PHARMACE</title>
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        <invCountry>US</invCountry>

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        <fairValLevel>1</fairValLevel>
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        <name>Galderma Group AG</name>
        <lei>89450001OK6O8ELQ4584</lei>
        <title>GALDERMA GROUP A</title>
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        <invCountry>CH</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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        <name>Vaxcyte Inc</name>
        <lei>254900M7NMHTGASX8D95</lei>
        <title>VAXCYTE INC</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>CVS Health Corp</name>
        <lei>549300EJG376EN5NQE29</lei>
        <title>CVS HEALTH CORP</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Mineralys Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>MINERALYS THERAP</title>
        <cusip>603170101</cusip>
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        <balance>1215766.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Xenon Pharmaceuticals Inc</name>
        <lei>549300XV44Q9Z1MIPQ03</lei>
        <title>XENON PHARMACEUT</title>
        <cusip>98420N105</cusip>
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          <isin value="CA98420N1050"/>
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        <balance>3546755.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>145452422.55000000</valUSD>
        <pctVal>0.370375067331</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>
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      </invstOrSec>
      <invstOrSec>
        <name>Cardinal Health Inc</name>
        <lei>CCU46N3GJMF4OK4N7U60</lei>
        <title>CARDINAL HEALTH</title>
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          <isin value="US14149Y1082"/>
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        <valUSD>610431318.88000000</valUSD>
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        <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>STERIS PLC</name>
        <lei>N/A</lei>
        <title>STERIS PLC</title>
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          <isin value="IE00BFY8C754"/>
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        <balance>1012472.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>265875147.20000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Bio-Techne Corp</name>
        <lei>54930073RLKQ51TILZ35</lei>
        <title>BIO-TECHNE CORP</title>
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        <valUSD>174332618.98000000</valUSD>
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        <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>
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      </invstOrSec>
      <invstOrSec>
        <name>Credit Agricole</name>
        <lei>969500TJ5KRTCJQWXH05</lei>
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          <other otherDesc="VID" value="VS0000201HZ"/>
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        <balance>8100000.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>8100000.00000000</valUSD>
        <pctVal>0.020625562591</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>RA</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <repurchaseAgrmt>
          <transCat>Repurchase</transCat>
          <notClearedCentCparty isCleared="N">
            <counterpartyInfos>
              <counterpartyInfo lei="969500TJ5KRTCJQWXH05" name="Credit Agricole"/>
            </counterpartyInfos>
          </notClearedCentCparty>
          <isTriParty>Y</isTriParty>
          <repurchaseRt>3.66000000</repurchaseRt>
          <maturityDt>2026-02-02</maturityDt>
          <repurchaseCollaterals>
            <repurchaseCollateral>
              <principalAmt>10799900.00000000</principalAmt>
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              <collateralVal>8262027.74000000</collateralVal>
              <collateralCd>USD</collateralCd>
              <invstCat>UST</invstCat>
            </repurchaseCollateral>
          </repurchaseCollaterals>
        </repurchaseAgrmt>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Ascendis Pharma A/S</name>
        <lei>549300B66JN3W3J8GH73</lei>
        <title>ASCENDIS PHA-ADR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="US04351P1012"/>
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        <balance>1103469.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>249494340.90000000</valUSD>
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        <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>QIAGEN NV</name>
        <lei>54930036WK3GMCN17Z57</lei>
        <title>QIAGEN NV</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="NL0015002SN0"/>
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        <balance>5130344.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>275345562.48000000</valUSD>
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        <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>UnitedHealth Group Inc</name>
        <lei>549300GHBMY8T5GXDE41</lei>
        <title>UNITEDHEALTH GRP</title>
        <cusip>91324P102</cusip>
        <identifiers>
          <isin value="US91324P1021"/>
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        <balance>4772250.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1369301692.50000000</valUSD>
        <pctVal>3.486742933980</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>Cencora Inc</name>
        <lei>AI8GXW8LG5WK7E9UD086</lei>
        <title>CENCORA INC</title>
        <cusip>03073E105</cusip>
        <identifiers>
          <isin value="US03073E1055"/>
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        <balance>2632712.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>945722804.64000000</valUSD>
        <pctVal>2.408156160650</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>Johnson &amp; Johnson</name>
        <lei>549300G0CFPGEF6X2043</lei>
        <title>JOHNSON&amp;JOHNSON</title>
        <cusip>478160104</cusip>
        <identifiers>
          <isin value="US4781601046"/>
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        <balance>5367039.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1219659612.75000000</valUSD>
        <pctVal>3.105699467042</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>Otsuka Holdings Co Ltd</name>
        <lei>N/A</lei>
        <title>OTSUKA HOLDINGS</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="JP3188220002"/>
        </identifiers>
        <balance>7893800.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="0.00646200"/>
        <valUSD>472588988.11000000</valUSD>
        <pctVal>1.203384414110</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Roche Holding AG</name>
        <lei>549300U41AUUVOAAOB37</lei>
        <title>ROCHE HLDG-GENUS</title>
        <cusip>H69293217</cusip>
        <identifiers>
          <isin value="CH0012032048"/>
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        <balance>1206949.00000000</balance>
        <units>NS</units>
        <currencyConditional curCd="CHF" exchangeRt="1.29357700"/>
        <valUSD>548847460.55000000</valUSD>
        <pctVal>1.397566376633</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>CH</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>REVOLUTION Medicines Inc</name>
        <lei>549300JU3X0LBCQ65892</lei>
        <title>REVOLUTION MEDIC</title>
        <cusip>76155X100</cusip>
        <identifiers>
          <isin value="US76155X1000"/>
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        <balance>2383815.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>231110864.25000000</valUSD>
        <pctVal>0.588492789648</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>
    </invstOrSecs>
    <signature>
      <ncom:dateSigned>2026-03-30</ncom:dateSigned>
      <ncom:nameOfApplicant>VANGUARD SPECIALIZED FUNDS</ncom:nameOfApplicant>
      <ncom:signature>Ashley Grim</ncom:signature>
      <ncom:signerName>Ashley Grim</ncom:signerName>
      <ncom:title>Treasurer</ncom:title>
    </signature>
  </formData>
</edgarSubmission>
