XLV offers broader large-cap healthcare exposure and charges a 0.08% fee; IBB focuses on biotech and charges 0.44%. As of Sept. 24, 2026, IBB’s 12-month return was 45.28%, against XLV’s 24.31%, but IBB had the deeper five-year maximum drawdown.
Over five years, IBB’s maximum drawdown was 39.8%, compared with 17.1% for XLV. A $1,000 investment grew to $1,204 in IBB and $1,381 in XLV. XLV’s trailing 12-month dividend yield was 1.49%, versus 0.20% for IBB.
XLV tracks healthcare companies in the S&P 500 across areas including pharmaceuticals, biotechnology, providers and medical equipment. IBB targets U.S. biotechnology companies. XLV’s largest holdings include Eli Lilly, Johnson & Johnson and AbbVie; IBB’s include Gilead Sciences, Vertex Pharmaceuticals and Amgen.
