IXJ vs XPH: Global Healthcare ETF or Pharma Focus?

Source The Motley Fool

Key Points

  • iShares Global Healthcare ETF provides broad sector coverage with a higher dividend yield than State Street SPDR S&P Pharmaceuticals ETF.

  • State Street SPDR S&P Pharmaceuticals ETF has delivered stronger total returns over the last year but experiences significantly higher maximum drawdowns.

  • The iShares Global Healthcare ETF manages $4.2 billion in assets under management (AUM), offering much higher liquidity than the $0.6 billion found in the State Street fund.

  • 10 stocks we like better than iShares Trust - iShares Global Healthcare ETF ›

The iShares Global Healthcare ETF (NYSEMKT:IXJ) offers broad sector diversification and lower volatility, while the State Street SPDR S&P Pharmaceuticals ETF (NYSEMKT:XPH) provides concentrated exposure to U.S. drugmakers.

Investors seeking healthcare exposure must choose between broad-sector and sub-industry focus. While both funds target the same general space, they differ significantly in geographical reach, concentration, and historical risk profiles. This comparison evaluates whether global diversification or specialized pharma focus better aligns with your portfolio goals.

Snapshot (cost & size)

MetricXPHIXJ
IssuerSPDRiShares
Share price (as of 8/20/26)$72.29$105.67
Expense ratio0.35%0.38%
1-yr return (as of 8/20/26)57.2%22.1%
Dividend yield0.5%1.4%
Beta0.720.53
AUM$603 million$4.2 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.

The State Street SPDR S&P Pharmaceuticals ETF is slightly more affordable with a 0.35% expense ratio. However, the iShares Global Healthcare ETF offers a notably higher payout, providing a yield gap of 0.95 percentage points.

Performance & risk comparison

MetricXPHIXJ
Max drawdown (5 yr)(35%)(18.1%)
Growth of $1,000 over 5 years (total return)$1,574$1,274

What's inside

The iShares Global Healthcare ETF invests in 110 holdings across healthcare, technology, and cash. Its largest positions include Eli Lilly at 9.9%, Johnson & Johnson at 7.2%, and AbbVie at 4.9%. It was launched in 2001. iShares Global Healthcare ETF has paid $1.44 per share over the trailing 12 months, which on its recent ~$105.67 share price works out to a 1.4% yield.

The State Street SPDR S&P Pharmaceuticals ETF concentrates on 63 holdings within the healthcare sector, specifically pharmaceuticals and life sciences. Its top holdings include Amylyx Pharmaceuticals at 3.8%, MBX Biosciences at 3.2%, and Omeros Corp. at 3%. It was launched in 2006. State Street SPDR S&P Pharmaceuticals ETF has paid $0.34 per share over the trailing 12 months, which on its recent ~$72.29 share price works out to a 0.5% yield.

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

Which looks like the better buy

Domestic or international? Pharmaceutical concentration or broad healthcare sector investing? Overall return or dividend income? These are the questions investors are weighing when they consider the XPH and IXJ ETFs.

With XPH, investors focus on U.S. drugmakers. Its equal-weight methodology ensures that no single drugmaker drives the portfolio up or down. It's had a gangbusters return over the last year, but its five-year drawdown is also much more extreme than IXJ's. And it pays out less than half what IXJ delivers to investors in dividend income. Investing in pharmaceuticals stocks means capturing the upside potential of potentially blockbuster drugs, but also the regulatory complexity and research and development costs of the drug development process.

Zoom out to the broader healthcare market sector, and you'll find IXJ, which holds almost double the number of stocks as well as a much larger portfolio in terms of assets under management. This fund lets its leaders, like Eli Lilly and Johnson & Johnson, rise to the top, capitalizing on the stability and dividend income of healthcare's biggest names. But that stability comes at the expense of some growth potential. IXJ has barely outperformed the S&P 500 this year, and offers a comparable dividend yield.

XPH's one-year return is hard to argue with, and although past performance is no guarantee of future results, it looks like the more compelling option for investors seeking growth and willing to take on the sector-specific risk to get it.

Should you buy stock in iShares Trust - iShares Global Healthcare ETF right now?

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*Stock Advisor returns as of September 11, 2026.

Sarah Sidlow has positions in Johnson & Johnson. The Motley Fool has positions in and recommends AbbVie and Eli Lilly. The Motley Fool recommends Johnson & Johnson. The Motley Fool has a disclosure policy.

Disclaimer: For information purposes only. Past performance is not indicative of future results.
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