Which Healthcare ETF Is the Better Buy: Fidelity's Broad FHLC or Simplify's Actively Managed PINK?
Key Points
Fidelity MSCI Health Care Index ETF provides low-cost, broad-market exposure with an expense ratio of 0.08%.
Simplify Health Care ETF uses active management and a philanthropic model to target capital appreciation, resulting in a higher 0.51% expense ratio.
Simplify Health Care ETF has delivered higher total returns over the last year, though it carries higher volatility as measured by beta.
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Investors choosing between Fidelity MSCI Health Care Index ETF (NYSEMKT:FHLC) and Simplify Health Care ETF (NYSEMKT:PINK) must decide between a low-cost, diversified indexing strategy and an actively managed, concentrated portfolio with a charitable mandate.
The healthcare sector offers a combination of stable defensive assets and high-growth biotechnology opportunities. While FHLC provides broad exposure to the entire U.S. healthcare market, PINK focuses on a more select group of innovators. This comparison examines whether the active approach of PINK justifies its higher costs.
Snapshot (cost & size)
| Metric | PINK | FHLC |
|---|---|---|
| Issuer | Simplify | Fidelity |
| Share price | $40.41 (as of 2026-08-10) | $81.90 (as of 2026-08-10) |
| Expense ratio | 0.51% | 0.08% |
| 1-yr return (as of Aug. 10, 2026) | 42.0% | 33.7% |
| Dividend yield | 0.6% | 1.2% |
| Beta | 0.73 | 0.60 |
| AUM | $0.4 billion | $3.3 billion |
Beta 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-yr return represents total return over the trailing 12 months. Dividend yield is the trailing-12-month distribution yield.
FHLC is significantly more affordable for long-term investors, charging just 0.08% compared to the 0.51% expense ratio for PINK. Additionally, the Fidelity fund provides a higher trailing-12-month dividend yield of 1.2% versus 0.6% for Simplify.
Performance & risk comparison
| Metric | PINK | FHLC |
|---|---|---|
| Max drawdown (4 yr) | (18.8%) | (16.9%) |
| Growth of $1,000 over 4 years (total return) | $1,602 | $1,369 |
What's inside
Fidelity MSCI Health Care Index ETF aims to match the performance of the MSCI USA IMI Health Care Index, maintaining a broad portfolio of 365 holdings. Its largest positions include Eli Lilly & Co (NYSE:LLY) at 13.45%, Johnson & Johnson (NYSE:JNJ) at 8.82%, and AbbVie (NYSE:ABBV) at 6.15%. The fund is a nearly pure-play sector bet, with 99% of its assets in healthcare stocks. The fund was launched in 2013. Fidelity MSCI Health Care Index ETF has paid $1.0 per share over the trailing 12 months, which on its recent ~$81.9 share price works out to a 1.2% yield.
Simplify Health Care ETF is an actively managed fund led by Michael Taylor, who selects pioneering companies across sub-sectors like biotechnology and gene therapy. With 58 holdings, its largest positions include Eli Lilly & Co at 10.15%, Thermo Fisher Scientific (NYSE:TMO) at 7.07%, and Purecycle Technologies (NASDAQ:PCT) at 6.61%. The portfolio is less concentrated in healthcare at 87% and incorporates a currency hedge. A unique feature is its pro bono mission, donating all net profits to the Susan G. Komen foundation; these contributions totaled $0.4 million as of Sept. 1, 2025. The fund was launched in 2021. Simplify Health Care ETF has paid $0.3 per share over the trailing 12 months, which on its recent ~$40.4 share price works out to a 0.6% yield.
For more guidance on ETF investing, check out the full guide at this link.
Which looks like the better buy
The healthcare sector is having one of its most eventful stretches in recent memory. GLP-1 drugs have reshaped metabolic medicine, biopharma M&A surged to its strongest quarter since 2020 earlier this year, and the FDA continues approving treatments at a steady pace. Both FHLC and PINK are chasing the same healthcare opportunity, but from opposite ends of the investment spectrum.
FHLC owns nearly 400 healthcare companies from large pharmaceutical giants down to smaller specialty names, tracked passively at a rock-bottom cost. This is the kind of fund designed to be owned for decades without a second thought.
PINK starts from a conviction that active stock-picking can find tomorrow's medical breakthroughs before the market does. Its management team makes concentrated bets on medical innovation, and the fund directs a portion of its proceeds to cancer research. It’s an unusual feature of this ETF that resonates with investors who want their dollars to do more than generate returns.
Unfortunately, the math works against PINK from the start. Its significantly higher fee creates a performance hurdle that active healthcare funds have historically struggled to clear year after year. For most long-term investors, FHLC is the stronger foundation.
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Sara Appino has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends AbbVie, Eli Lilly, and Thermo Fisher Scientific. The Motley Fool recommends Johnson & Johnson. The Motley Fool has a disclosure policy.
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