iShares Global Healthcare ETF (IXJ +0.60%) offers international diversification and a higher yield, while iShares U.S. Healthcare ETF (IYH +0.72%) focuses on domestic giants and has recently delivered stronger total returns.
These two funds from iShares target the same sector but different geographies. While the U.S. healthcare market is the largest globally, many medical innovators are headquartered in Europe and Asia. Choosing between them depends on whether investors want pure domestic exposure or a global footprint.
Snapshot (cost & size)
| Metric | IYH | IXJ |
|---|---|---|
| Issuer | iShares | iShares |
| Share price (as of 9/28/26) | $72.67 | $104.11 |
| Expense ratio | 0.37% | 0.38% |
| 1-yr return (as of 2026-09-28) | 28.8% | 22.5% |
| Dividend yield | 1.1% | 1.4% |
| Beta | 0.56 | 0.55 |
| AUM | $3.9 billion | $4.3 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 iShares Global Healthcare ETF is marginally more expensive with a 0.38% expense ratio compared to the 0.37% charged by the iShares U.S. Healthcare ETF. However, the global fund offers a higher payout, providing a 1.4% yield versus the 1.1% found in the domestic version.
Performance & risk comparison
| Metric | IYH | IXJ |
|---|---|---|
| Max drawdown (5 yr) | (17.9%) | (18.1%) |
| Growth of $1,000 over 5 years (total return) | $1,394 | $1,329 |
What's inside
The iShares Global Healthcare ETF holds 109 stocks and focuses entirely on the healthcare sector. Its largest positions include Eli Lilly at 10.5%, Johnson & Johnson at 7.1%, and AbbVie at 5.3%. The fund launched in 2001. The iShares Global Healthcare ETF has paid $1.44 per share over the trailing 12 months, which on its recent ~$104.11 share price works out to a 1.4% yield.
In contrast, the iShares U.S. Healthcare ETF tracks 100 domestic companies with a breakdown of 99% healthcare and a minor 1% technology tilt. Top holdings include Eli Lilly at 14.6%, Johnson & Johnson at 7.06%, and AbbVie at 7.4%. The fund launched in 2000. The iShares U.S. Healthcare ETF has paid $0.80 per share over the trailing 12 months, which on its recent ~$72.67 share price works out to a 1.1% yield.
For more guidance on ETF investing, check out the full guide at this link.
IYH & IXJ: Performance Comparison
Key Financial Metrics
Which looks like the better buy
Investors looking to establish a position in a healthcare REIT may be considering iShares' IYH and IXJ exchange-traded funds. These two funds charge nearly identical expense ratios, offer similar dividend yields, and have performed in tandem over the last one and five years. That's largely because they share the top five holdings, which are large healthcare stalwarts with global operations. In fact, these holdings make up more than 40% of the U.S.-focused portfolio and more than 30% of the international portfolio.
With just about 100 holdings in each fund, your preference may come down to just a handful of companies or a single investment goal. For example, the U.S. healthcare landscape is being dominated by GLP-1 drug adoption, and several large drugmakers are facing patent cliffs and regulatory pressures that could impact their performance over the next few years.
IXJ may appeal to investors looking to maximize diversity and eke out a bit more income. International healthcare stocks tend to be more defensive value plays compared to their higher-growth domestic counterparts, but they also come with the risk of foreign currency fluctuations.
