Skip to navigationSkip to main contentSkip to right columnADVERTISEMENTAndy Gould, The Motley FoolSat, August 1, 2026 at 11:31 PM GMT+2 5 min readThe State Street Health Care Select Sector SPDR ETF (NYSEMKT:XLV) provides broad exposure to the S&P 500 healthcare sector, whereas the Invesco Nasdaq Biotechnology ETF (NASDAQ:IBBQ) offers a targeted focus on biotechnology and pharmaceutical companies listed on the Nasdaq.Investors looking for healthcare exposure must often choose between the stability of a broad, diversified sector fund versus the higher upside -- and higher volatility -- of a narrower, growth-oriented fund. This comparison examines whether XLV's lower costs and track record outweigh the concentrated risk-reward profile of IBBQ.Snapshot (cost & size)MetricIBBQXLVIssuerInvescoState StreetExpense ratio0.19%0.08%1-year return (as of July 31, 2026)45.52%26.79%Dividend yield0.79%1.60%Beta0.610.51AUM$72.8 million$40.6 billionBeta measures price volatility relative to the S&P 500; beta is calculated from monthly returns over the available fund history (up to five years). The 1-year return represents total return over the trailing 12 months. Dividend yield is the trailing-12-month distribution yield.XLV is the less expensive option, with an expense ratio of 0.08% compared to IBBQ's 0.19%. XLV also pays a higher dividend yield of 1.60% versus IBBQ's 0.79%.Performance & risk comparisonMetricIBBQXLVMax drawdown (5 yr)(37.94%)(17.11%)Growth of $1,000 over 5 years (total return)$1,302$1,334This is where the two funds tell very different stories. IBBQ's 45.5% one-year return dwarfs what a broad healthcare fund like XLV typically delivers, but that performance has come with meaningfully larger swings along the way. A fund concentrated in biotech -- an industry driven by binary events like FDA approvals, clinical trial results, and patent cliffs -- will generally see bigger peaks and valleys than a diversified portfolio that spans pharma giants, insurers, and medical device makers. Investors chasing IBBQ's recent returns should go in with eyes wide open to the drawdown risk attached to that upside.What's insideLaunched in 1998, XLV tracks the Health Care Select Sector Index, giving investors broad exposure to the healthcare industry within the S&P 500. The fund holds 60 stocks spanning pharmaceuticals, medical equipment, healthcare providers, and life sciences tools. Its largest positions include Eli Lilly (NYSE:LLY) at 16.5%, Johnson & Johnson (NYSE:JNJ) at 10.6%, and AbbVie (NYSE:ABBV) at 7.7%.IBBQ tracks the Nasdaq Biotechnology Index, offering concentrated exposure to biotech and pharma companies trading on the Nasdaq. It holds 251 stocks, led by Vertex Pharmaceuticals (NASDAQ:VRTX) at 8.1%, Amgen (NASDAQ:AMGN) at 7.9%, and Gilead Sciences (NASDAQ:GILD) at 6.9%. IBBQ was launched in 2021.Terms and Privacy PolicyEU DSA contactPrivacy & Cookie SettingsMore Info