Whale-Driven Momentum in Health Care Stocks: Opportunities and Risks in 2026

The healthcare sector, long a cornerstone of institutional portfolios, is entering a pivotal phase as 2026 approaches. Options activity-often a leading indicator of institutional sentiment-reveals divergent signals across key names. While Novo Nordisk (NVO), Eli Lilly (LLY), and UnitedHealth Group (UNH) show robust bullish momentum, Omeros (OMER), Moderna (MRNA), and Hims & Hers Health (HIMS) face bearish headwinds. By dissecting strike prices, expiration dates, and volume anomalies, traders and investors can identify actionable opportunities and risks.

Bullish Momentum: NVO, LLY, and UNH

Novo Nordisk (NVO) has emerged as a standout in the diabetes and obesity therapeutics space, with options data underscoring institutional confidence. As of December 29, 2025, NVO's total open interest surged to 1.2 million contracts, surpassing its 52-week average of 502,261 contracts. The September 12, 2025, expiration saw a 5,011-contract increase in open interest, reflecting anticipation of sustained demand for its GLP-1 drugs. While the put/call ratio of 0.8 hints at mild bearishness, the overall rise in open interest-particularly in call options-suggests a net bullish bias.

Eli Lilly (LLY), another GLP-1 leader, exhibited mixed but ultimately constructive options activity. A total of 15,152 contracts were traded in Q4 2025, with the $1,040 strike put expiring January 2, 2026, attracting 567 contracts. However, this put volume pales in comparison to the broader call activity. The total volume of 15,152 contracts implies that call options dominated, with 14,585 contracts traded in bullish bets. This suggests that while short-term hedging is evident, long-term positioning remains robust.

UnitedHealth Group (UNH) presents a more nuanced picture. Despite a put/call dollar volume ratio of 89.9% favoring puts, the total open interest for UNH options climbed to 1.6 million contracts, exceeding its 52-week average of 1.0 million. The most notable increase occurred in the December 5, 2025, expiration, with put open interest rising to 532,062 contracts. However, the sheer scale of open interest-particularly in the $375–$520 strike range-indicates that institutional players are hedging against regulatory risks while maintaining exposure to the stock's upside potential.

Bearish Signals: OMER, MRNA, and HIMS

Omeros (OMER), a smaller-cap biotech, shows a put/call open interest ratio of 0.45, suggesting a bullish bias. Yet, this ratio belies deeper bearish trends. Unusual options activity-defined as high volume relative to open interest-has been observed in the $375–$520 strike range, with large institutional trades indicating targeted short-term bearishness. The discrepancy between the bullish ratio and the volume anomalies highlights a potential short-term correction risk.

Moderna (MRNA) faces headwinds as the market digests its mRNA platform's long-term viability. While 48,465 contracts were traded in Q4 2025, the $33 strike call expiring January 2, 2026, accounted for 14,786 contracts. This suggests a short-term rally, but the lack of follow-through in other strike prices indicates waning conviction. With the biotech sector facing valuation pressures, MRNA's options activity reflects a bearish undercurrent.

Hims & Hers Health (HIMS), a digital health disruptor, lacks granular options data in the latest reports. However, platforms like Yahoo Finance and MarketBeat show elevated put open interest relative to calls, a pattern consistent with bearish sentiment. The stock's reliance on consumer discretionary spending and regulatory scrutiny likely contribute to this dynamic.

Strategic Implications for 2026

For traders, the options data underscores a key theme: conviction in NVO and LLY's long-term growth, while hedging against near-term volatility in UNH and OMER. Long-term investors may find value in NVO and LLY's call options, particularly those expiring in late 2025, to capitalize on sustained demand for GLP-1 therapies. Conversely, MRNA and HIMS warrant caution, with put options offering downside protection.

Institutional players are also signaling a shift in risk appetite. The surge in open interest for NVO and LLY suggests a willingness to lock in gains, while the bearish skew in OMER and MRNA reflects profit-taking and sector rotation. As 2026 unfolds, monitoring expiration dates-particularly January 2026 for LLY and MRNA-will be critical for timing entries and exits.

Conclusion

Options activity paints a clear picture of divergent momentum in healthcare. NVO and LLY are poised to benefit from institutional bullishness, while UNH's regulatory risks create a mixed landscape. OMER, MRNA, and HIMS, meanwhile, face bearish headwinds that could amplify volatility. By aligning strategies with these signals, investors can navigate the sector's opportunities and risks with greater precision.