Analysis: The State Street Healthcare ETF (XLV) has an expense ratio of 0.08% and a diversified portfolio, while the Invesco Biotechnology ETF (PBE) has an expense ratio of 0.58% and focuses on small-cap stocks; PBE is up 10.2% year-to-date, outperforming XLV.

An analysis article on Yahoo Finance compared two healthcare-themed ETFs: the State Street Health Care Select Sector SPDR ETF (XLV) and the Invesco Biotechnology & Genome ETF (PBE). The analysis noted that XLV provides broad exposure to the S&P 500 Healthcare Sector, has an expense ratio of 0.08%, and primarily holds large-cap stocks. In contrast, PBE focuses on 30 U.S. small-cap companies in the biotechnology and genomics sectors and has an expense ratio of 0.58%.

In terms of performance, PBE has stood out recently, rising 10.2% year-to-date in 2026, while XLV has risen 3.4% over the same period. Over the past three years, PBE’s annualized return was 13%, higher than XLV’s 7.9%. However, XLV has outperformed over the longer term, with annualized returns of 4% and 8.4% over the past five and ten years, respectively, compared to PBE’s 6.4% and 10.1% during the same periods. Analysts believe that PBE may continue to benefit from its preference for small-cap stocks in 2026, while XLV remains a wise long-term choice for investors seeking diversification and a focus on large-cap stocks.