iShares' IYH or Invesco's PBE: Which Healthcare ETF Is the Better Long-Term Buy?

The iShares U.S. Healthcare ETF (NYSEMKT:IYH) provides broad sector exposure at a lower cost, while the Invesco Biotechnology & Genome ETF (NYSEMKT:PBE) offers a concentrated, high-conviction bet on genomics.

Investors seeking healthcare exposure often choose between broad industry coverage and niche subsectors. This comparison pits the wide-reaching iShares fund against the specialized Invesco biotech fund to determine which approach fits a portfolio's risk tolerance and growth objectives as of Aug. 28, 2026.

Snapshot (cost & size)

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.

The iShares fund is more affordable, carrying a 0.38% expense ratio compared to the 0.58% fee for the Invesco fund. The Invesco fund currently offers a higher payout, with a 0.49 percentage point lead in dividend yield over its peer.

Performance & risk comparison

What's inside

The iShares U.S. Healthcare ETF tracks a broad index of American healthcare stocks, maintaining a diversified portfolio of 100 positions. Its exposure is primarily concentrated in healthcare at 99%, with a 1% allocation to technology. Largest positions in the fund include Eli Lilly (NYSE:LLY) at 14.97%, Johnson & Johnson (NYSE:JNJ) at 10.00%, and Abbvie (NYSE:ABBV) at 7.15%. This fund was launched in 2000 and currently manages $3.9 billion in assets under management (AUM). iShares U.S. Healthcare ETF has paid $0.80 per share over the trailing 12 months, which on its recent ~$72.63 share price works out to a 1.1% yield.

The Invesco Biotechnology & Genome ETF targets a much narrower slice of the market by tracking the Dynamic Biotech & Genome Intellidex Index. It holds 31 companies focused on biotech research and genetic engineering, with a portfolio entirely weighted toward healthcare. Its top holdings include CareDx (NASDAQ:CDNA) at 5.48%, Amgen (NASDAQ:AMGN) at 5.38%, and Regeneron Pharmaceuticals (NASDAQ:REGN) at 5.26%. The fund was launched in 2005 and has $404.8 million in AUM. Invesco Biotechnology & Genome ETF has paid $1.55 per share over the trailing 12 months, which on its recent ~$98.54 share price works out to a 1.6% 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 generating more investment headlines than it has in years, driven by record dealmaking, drug innovation, and a wave of FDA approvals rewarding investors who picked the right corner of the market. Investors can access that opportunity through either of these funds, but the portfolios behind them look nothing alike.

IYH owns the whole healthcare neighborhood: pharmaceuticals, medical devices, health insurers, and biotech all under one roof. That breadth delivers income and the kind of stability that makes healthcare a reliable long-term sector allocation. PBE takes a sharper view, selecting 31 biotechnology and genomics companies through a factor-based screen that evaluates momentum, earnings quality, and value. That methodology has delivered extraordinary returns over the past year as biotech surged.

The fee difference between these two funds works against PBE from the start, requiring it to outperform IYH before investors see any net benefit from the higher cost. For most long-term investors, IYH's lower cost, income, and broader diversification make it the stronger foundation. PBE is the better bet for those specifically targeting biotechnology innovation who are comfortable with a concentrated, higher-fee approach.

Sara Appino has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends AbbVie, Amgen, Eli Lilly, and Regeneron Pharmaceuticals. The Motley Fool recommends Johnson & Johnson. The Motley Fool has a disclosure policy.