We use Vanguard Health Care, ETF (VHT ) for taxable account; excellent tax efficiency. For our IRA, we use a combination of PRHSX and VGHCX. We side stepped Fidelity's offering due to too frequent manager turnover.

@ MFO Members: BenWP made an excellent point when he said, "For me, it's a hold-forever sector, so to the extent possible, I try not to let short-term political winds blow me off course." To prove the point about long-term, VGHCX has had an annual return since it's inception in 1984 of 16.63%, while PRHSX since 1995 has returned 14.55%
Regards,
Red

@LLJB - Thanks for your suggestions. I agree that PRHSX, VGHCX and/or FSPHX would be what I'm looking for. I have a brokerage account with both Fido and Price, so either of their two funds will be my likely choice. SBIO seems too volatile and concentrated for me, much like FBIOX. These two options can soar much more than diversified options, but I have an aversion to Maalox and Tums. Thanks nonethless!

I think PRHSX, VGHCX and FSPHX are all good diversified healthcare options. Which one does best in the future is anyone's best guess so I would choose based on what's available to you NTF or whatever you have a prefer for one reason or another. I chose PRHSX because it was NTF for me and even though the manager has been a bit of a revolving door they've seemed to do a good job with replacements so far.
I also own HQL, which is a Life Sciences closed-end fund, because they have private equity investments. Tekla has 4 closed-end funds with slight differences, such as a bigger focus on income, broad healthcare, life sciences and global, that have been discussed here occasionally if not recently so you could search for those discussions if you're interested. If you're just looking for general healthcare exposure I'd probably stick with one of the 3 mutual funds but if your interests are more specific then one of Tekla's offerings might be interesting.
Finally, I have a small position in SBIO, which is a small cap offering of biotech companies that have drugs in Phase 2 or 3 clinical trials and have enough cash to last them for 24 months. This is just as volatile as FBIOX and often more volatile so you either have to be a big believer, like loving roller coasters, or you have to trade the volatility in order to tolerate the craziness.

I can't wait to read more responses to your questions; I own FSPHX and FBIOX in addition to VGHCX (which is not on your list; you may want to add that to your list to complete your research).
PRHSX was closed when I was reshuffling my portfolio, but now open to investors; but I am good with the trio of VGHCX, FSPHX and FBIOX. FBIOX is most volatile of the lot, so if there is any need to sell, it will be the first to go.....and VGHCX will be the last to go. Also, rounding this group is POAGX (which has ~30% in Healthcare but currently closed).
ACA repeal will be only for short-term reaction to the sector. On the flip side, the President has also vowed to revamp FDA so drugs can come to market faster. A lot of "issues" in this sector (regardless of regulation, innovation and pricing are big factors for the sector).
Some of the regulations only transfer "power" between the sub-sectors (sub-sectors: traditional Pharma, Biotech, Payers (Managed Care companies), Distributors, etc). For example, ACA and pricing "gave" the Payers more leverage recently. On that note, I think PRHSX may be the most diversified of the lot, VGHCX and FSPHX are broadly diversified and FBIOX is the most concentrated. .
I have had VGHCX and FSPHX for a long time (not selling them), and I bought FBIOX early last year when it was down big (I may sell soon). All of them are still lower compared to their 2015 highs.
But I will wait for the "correction" to buy. Look forward to other comments.

Ranking equity funds only:
VGHCX: 8.48%
VWINX: 1.41%

Investors have to take charge and be their own smart beta managers. Just using a simple empirically based moving average switch strategy on an index and a bond fund has produced risk mitigated alpha above buy and hold.
https://docs.google.com/document/d/1XwZjcWy7KlSwA7xi0rax7nevIBCtW0Uu4UZFH-Hc1ns/edit?usp=sharing
And if that's too complicated, then try a 60 / 40 balanced portfolio of vanguard specialized Health and Vanguard long bond https://portfoliovisualizer.com/backtest-portfolio?s=y&allocation1_1=60&showYield=false&endDate=02%2F28%2F2016&allocation2_1=40&startYear=1985&lastMonth=12&symbol1=VGHCX&endYear=2016&frequency=4&symbol2=VUSTX&s=y&inflationAdjusted=true&annualOperation=0&rebalanceType=1&initialAmount=10000&timePeriod=4&firstMonth=1&annualAdjustment=0&reinvestDividends=true&annualPercentage=0.0
As the finance industry is incentivized to sell "product and charge fees, there is a dearth of incentive and funding for quantitative research. Even something as simple as the moving average strategy would slip through the "echelons".

@msf: U.S. News & World Report ranks PSPHX #2 & ETHSX #16. My problem with ETHSX is it's load. There are many excellent health-care fund that are no-load. On the positive side is ETHSX's manager, Sam Isely, who's steady hand has managed the fund since inception in 1985
Regards,
Ted
ETHSX Category Percentile Rank:
http://performance.morningstar.com/fund/performance-return.action?t=ETHSX&region=usa&culture=en-US
FSPHX Category Percentile Rank:
http://performance.morningstar.com/fund/performance-return.action?t=FSPHX&region=usa&culture=en_US
PRHSX Category Percentile Rank:
http://performance.morningstar.com/fund/performance-return.action?t=PRHSX&region=usa&culture=en_US
JAGLX Category Percentile Rank:
http://performance.morningstar.com/fund/performance-return.action?t=JAGLX&region=usa&culture=en_US
VGHCX Category Percentile Rank:
http://performance.morningstar.com/fund/performance-return.action?t=VGHCX&region=usa&culture=en_US

Some other notables with steep monthly pullbacks:
Dodge & Cox International Stock (DODFX): -9.4% ... on top of -4.8 in Dec and -1.6 in Nov.
T Rowe Price Growth Stock (PRGFX): -9.1
Oakmark International I (OAKIX): -9.0
Fidelity Growth Company (FDGRX): -10.6
iShares MSCI Japan (EWJ): -8.2
iShares MSCI Emerging Markets (EEM): -6.6
American SMALLCAP World A (SMCWX): -9.2
T Rowe Price New Horizons (PRNHX): -9.3
Vanguard Health Care Inv (VGHCX): -8.9
Fidelity OTC Portfolio (FOCPX): -12.7
On the other hand:
Consumer Staples Select Sector SPDR (XLP): +0.6%
iShares US Preferred Stock (PFF): +1.0
iShares TIPS Bond (TIP): +1.5
PIMCO Income Inst (PIMIX): +0.3
T Rowe Price New Income (PRCIX): +1.0
iShares Core US Aggregate Bond (AGG): +1.4
Dodge & Cox Income (DODIX): -0.1
DoubleLine Total Return Bond I (DBLTX): +1.3
Vanguard Total Bond Market II Index Inv (VTBIX): +1.4
PIMCO Total Return Inst (PTTRX): +1.0
Vanguard Wellesley Income Inv (VWINX): -0.2

Even the most conservative of funds in this sector is suffering...Vanguard HC (VGHCX) down more than 8%, which I also own. But I'd rather own an up and coming biotech than anything in the oil patch...but, that's just me.

If the last thirty years are any indicator of future trends in Healthcare, maybe a 90/10 portfolio of VGHCX / VFISX vs Warren's VFINX / VFISX: (click on each image for better clarity)

willmatt72
Other than the usual suspects, mostly individual REITs in the non-taxable account.
Having said that...I did find something which occurred a few years ago in my taxable account...in 2011. All of my funds with the exception of VGHCX all lost money. But my entire income sleeve of individual dividend paying stocks had a 11% gain. So while most folks wouldn't consider that subset of stocks to be diversifiers, I do. It may have been just a weird alignment of stars, but it did happen.

Several of my favorite funds are mentioned on this thread, VHCOX which I've owned since 2001, and POAGX, since 2007. As you can imagine, they've both had some style drift as their assets have expanded...not that I'm going to complain too loudly though. Much less SC than before.
Bee...One of the funds I've recently purchased for my rollover IRA which I believe will be a nice complement to these 2, would be SCMFX. It is a small/mid blend, and if you do a performance comparison between that and POAGX, you will see a fairly even performance match until the biotechs powered the Primecap fund ahead over the last 2 years. SCMFX has been profiled on MFO, and it held up fairly well over the recent turmoil perhaps due to the additional value component.
Per your comment as well, I was also intrigued by the Eventide family, and have a starting position in ETNHX. More spice than my VGHCX holding, but I am thinking this is a lower risk way to get exposure to the biotechs than an individual holding, and I wanted to stay away from the ETFs.
press

Using YahooFinance's portfolio tool I got these results:

IGPAX reported at 6:59 pm yesterday. Etf (VHT) will usually report at 4:00 pm usually while you have to wait until about 6:25 pm for VGHCX...similar holdings, but not identical. I sometimes monitor VHT during the day as a close proxy for how the mutual fund will do.
Doctor Copper need patients to remember to have patience...try to enjoy your stay in the investment waiting room.

@Ted, M* says $10,000 become $35,280 in 10 years with VGHCX so you should probably send the bill for 2 dinners!

@PRESSMUP; Next time I go out to eat, I'm sending you the bill. A $10,000 investment in VGHCX 10 years ago in now worth $23,440--Nice work ! Note MFO Members what long-term comittment to a fund can bring.

Ted...I bought VGHCX over 10 years ago because HC was a defensive sector. Funny how being cautious worked out, eh?

I charted an investment in FCNTX on the day Will Danoff became the funds manager (09/17/1990) vs. LEXCX.

I wanted to indulged your chart a bit further. 1990 was about the time when I first invested in Vanguard Healthcare, VGHCX. Here are LEXCX, FCNTX, and VGHCX over the last 25 years:. All three seem to have great market cycle performance (30ish years).

" In 1945, the largest 25 mutual funds in the United States cost an average of 0.76 percent per year. ... The biggest active funds in 2004 cost 1.56 percent."
I don't know about 2004, but in 2015, the average ER of the 25 largest active funds (using the share class that M* picks with "distinct portfolio") is 0.66%, about 13% lower than it was in 1945.
"No active fund is as cheap as it appears [because of trading costs]." Misleading in a couple of ways, the main one being that index funds also have trading costs (for the most part, it's turnover, not index vs. active, that matters). The minor issue is that there is a fund that never changes its portfolio, and it's not an index fund. Most of the people here don't need to be reminded of it - LEXCX.
If one talks about bond funds, even index funds, they're going to have a lot of trades, because they're constantly replacing bonds that mature (or come too close to maturity to keep in the portfolio). Looking at the pure equity funds in the largest 25 active, one sees turnover ratios ranging from 11-12% (D&C Int'l DODFX and Harbor Int'l HAINX) all the way up to 45% (Fidelity Contra FCNTX); no other fund is above 0.39%. These are all way below the "average" fund's 72% turnover.
Then there is a trading cost particular to index funds - front running (related to reconstitution). No mention of it in this article. And what about index funds that are not market (or at least free float) weighted? They have higher turnover by design. See, e.g.
http://www.investingdaily.com/11263/equal-weighted-index-etfs-pros-and-cons/
None of this is to suggest that index fund "hidden" costs are higher than active fund costs. Just that it would be nice to read articles that didn't start from a conclusion and apply data selectively to reach that conclusion.
For completeness, the bond/hybrid funds in the largest 25 funds are:
ABALX, CAIBX, AMECX, MBLOX, SGENX, FKINX, MWTRX, PTTRX, TPINX, VFSTX, VWELX
The equity funds in the largest 25 funds are:
AMCPX, CWGIX, AEPGX, ANCFX, AGTHX, AIVSX, ANWPX, AWSHX (all American Funds!), and DODFX, DODGX, FCNTX, HAINX, VGHCX, VWNFX

Over the last 20 years Health Care funds have shellac the overall market in both to the upside on gains as well to the downside on losses. Here's VGHCX (Health Care) vs VTSMX (the Market) over the last 20 years. Will this continue?