Invesco Healthcare ETF vs VanEck Biotech: Which ETF Will Deliver the Healthiest Returns for 2026?

Invesco S&P 500 Equal Weight Health Care ETF (NYSEMKT:RSPH) offers equal-weighted exposure to the broad healthcare sector, whereas VanEck Biotech ETF (NASDAQ:BBH) concentrates heavily on the 25 largest biotechnology companies.

Investors may choose among these funds based on their preference for industry-specific concentration or diversified exposure to healthcare. While RSPH targets a wider range of medical services and products with a balanced weighting, BBH focuses strictly on the biotechnology industry using a market-cap-weighted model.

Snapshot (cost & size)

Beta measures price volatility relative to the S&P 500; beta is calculated from five-year monthly returns. The 1-yr return represents total return over the trailing 12 months. Dividend yield is the trailing-12-month distribution yield as of the July 10 close.

The VanEck fund is the more affordable option with an expense ratio of 0.35%, compared to 0.40% for the Invesco fund. In terms of income, RSPH provides a marginally higher trailing dividend yield of 0.70% versus 0.50% for BBH.

Performance & risk comparison

What's inside

The Invesco S&P 500 Equal Weight healthcare ETF provides exposure to the broad healthcare sector by equally weighting constituents of the S&P 500 Index. This approach ensures that smaller constituents have as much influence on performance as industry giants. Its largest positions include Moderna (NASDAQ:MRNA) at 2.5%, Bio-Techne (NASDAQ:TECH) at 2.2%, and Charles River Laboratories International (NYSE:CRL) at 2%. It holds 60 securities and was launched in 2006. Invesco S&P 500 Equal Weight Health Care ETF has paid $0.23 per share over the trailing 12 months, which on its recent ~$33.98 share price works out to a 0.70% yield.

The VanEck Biotech ETF focuses exclusively on 25 of the largest and most liquid U.S.-listed biotechnology companies. Its portfolio is market-cap-weighted, which leads to a heavy concentration in a handful of industry leaders. Its largest positions include Amgen (NASDAQ:AMGN) at 15.1%, Gilead Sciences (NASDAQ:GILD) at 12.8%, and Vertex Pharmaceuticals (NASDAQ:VRTX) at 9.1%. The fund was launched in 2011. VanEck Biotech ETF has paid $0.96 per share over the trailing 12 months, which on its recent ~$205.55 share price works out to a 0.50% yield.

Which fund is the better buy?

Both of these ETFs focus on the booming healthcare and biopharma industries, each dedicated solely to U.S.-listed equities. Interestingly, both are 54% in mid-cap stocks, with their differences coming from their large-cap and small-cap weightings.

BBH, the VanEck fund, is 8% in small caps, which aligns with its parameters to invest in the top 25 most liquid biotech stocks, which tend to be more large-cap. BBH has 38% of its holdings in large caps, mostly value-style companies.

The Invesco fund, RSPH, is more into small caps, at 19% of holdings, with 28% in large caps. It’s less concentrated in its top names, with 19% of its assets dedicated to its top 10 holdings compared to a highly concentrated 70% in the top 10 for BBH.

Performance-wise, the focus on a few popular names has worked very nicely for BBH. It has bested RSPH in every time frame but the 5-year and 10-year periods. BBH has tallied returns of 9.8%, 0.6%, and 7.8% over the 3-year, 5-year, and 10-year look-backs. By comparison, RSPH has returned 4.4%, 3.3%, and 8.9% over the 3-, 5-, and 10-year periods.

There is risk in going after BBH’s performance, as witnessed by its much higher maximum drawdown than RSPH. Yet the VanEck fund’s near- and mid-term performance has been consistently strong, making BBH the ETF to buy for biotech exposure in 2026.

For more guidance on ETF investing, check out the full guide at this link.

Brendan Coffey has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends Amgen, Gilead Sciences, Moderna, and Vertex Pharmaceuticals. The Motley Fool has a disclosure policy.