U.S. Healthcare ETFs Lead Defensive Sectors — How Should Healthcare Assets Be Allocated?

In last night’s U.S. equity session, healthcare and pharmaceutical stocks posted broad-based strength, with related healthcare ETFs clearly outperforming the broader market. Against a backdrop of tech sector dispersion and more cautious market sentiment, healthcare has once again moved into focus for capital allocation.

From both a fundamental and trading-logic perspective, the rebound in the healthcare sector is not accidental:

The defensive profile is reasserting itself: Amid ongoing macro uncertainty, healthcare remains a classic non-cyclical, demand-inelastic sector. With stable cash flows and relatively low earnings volatility, healthcare assets tend to attract inflows when risk appetite moderates.

Valuation repair has become a key driver: After the prior correction, overall valuations across the U.S. healthcare sector have fallen back toward the lower end of their historical range. Certain subsectors—particularly innovative pharmaceuticals and biotechnology—have even exhibited oversold characteristics, leaving room for near-term valuation normalization.

From an ETF perspective, both traditional healthcare and biotech-focused ETFs rebounded in tandem, suggesting that capital flows were not limited to isolated names, but rather reflected a broad-based, sector-level reallocation.

Below are the top eight U.S.-listed equity healthcare ETFs by performance yesterday, based on my screening criteria of ETF assets under management exceeding USD 250 million:

SS SPDR S&P Biotechnology ETF (XBI) tracks the S&P Biotechnology Select Industry Index, with total assets exceeding $8.4 billion. Year-to-date, the fund has a total return of 3.69%, with a daily increase of 3.55%. The fund's largest holding is MODERNA (MRNA.O), making up 1.53% of the net asset value, followed by Amicus Therapeutics (FOLD.O) at 1.51%.

iShares Biotechnology ETF (IBB) tracks the NASDAQ Biotechnology Index, with total assets of approximately $8.6 billion. Year-to-date, the fund has a total return of 4.71%, with a daily increase of 3.21%. The largest holding is Vertex Pharmaceuticals (VRTX.O), representing 8.79% of the net asset value, followed by Gilead Sciences (GILD.O) at 7.85%.

VanEck Biotechnology Index ETF (BBH) tracks the NYSE Arca Biotechnology Index, focusing on large-cap biotechnology companies, with total assets of approximately $385 million. Year-to-date, the fund has a total return of 5.46%, with a daily increase of 2.46%. The largest holding is Amgen (AMGN.O) at 14.79%, followed by Vertex Pharmaceuticals (VRTX.O) at 9.16%.

FT Biotechnology Index ETF (FBT) tracks the biotechnology sector with an equal-weight methodology, and has total assets of approximately $1.375 billion. Year-to-date, the fund has a total return of 6.16%, with a daily increase of 2.24%. The top two holdings are Exact Sciences (EXAS.O) and Illumina (ILMN.O), accounting for 4.93% and 4.44% of the net asset value, respectively.

ARK Genomic Revolution ETF (ARKG) focuses on cutting-edge fields such as gene editing, molecular diagnostics, and precision medicine, with total assets of approximately $1.166 billion. Year-to-date, the fund has a total return of 10.77%, with a daily increase of 1.87%. The fund has a relatively high management fee of 0.75%. The largest holding is Tempus AI (TEM.O), accounting for 10.18% of the net asset value, followed by CRISPR Therapeutics (CRSP.O) at 8.75%.

Simplify Healthcare ETF (PINK) covers healthcare and biotechnology sectors, with total assets of approximately $345 million. Year-to-date, the fund has a total return of 3.88%, with a daily increase of 1.85%. The top two holdings are UnitedHealth Group (UNH.N) at 6.30% and AbbVie (ABBV.N) at 5.44%.

iShares U.S. Pharmaceuticals ETF (IHE) primarily invests in large U.S. pharmaceutical companies, with total assets of approximately $865 million. Year-to-date, the fund has a total return of 1.56%, with a daily increase of 1.82%. The largest holding is Eli Lilly (LLY.N), representing 23.56% of the net asset value. Eli Lilly is one of the leading global pharmaceutical companies, with a strong fundamental outlook and consistent growth, resulting in significant stock performance. The second-largest holding is Johnson & Johnson (JNJ.N), a steady pharmaceutical blue-chip stock, accounting for 21.82% of the net asset value.

 Note:

Expense Ratio: The net fees paid by investors for the operation of a mutual fund, including fund management fees, expressed as a percentage.

Total Return: Incorporates both price changes and dividend distributions, with dividends reinvested in securities.

Data Sources: Wind, Bloomberg, and Tiger International.

Modify on 2026-01-08 20:11

Disclaimer: Investing carries risk. This is not financial advice. The above content should not be regarded as an offer, recommendation, or solicitation on acquiring or disposing of any financial products, any associated discussions, comments, or posts by author or other users should not be considered as such either. It is solely for general information purpose only, which does not consider your own investment objectives, financial situations or needs. TTM assumes no responsibility or warranty for the accuracy and completeness of the information, investors should do their own research and may seek professional advice before investing.

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