Key Points
First Trust NYSE Arca Biotechnology Index Fund tracks a concentrated index of 30 biotech stocks, while Simplify Health Care ETF is an actively managed fund with broader healthcare exposure.
Simplify Health Care ETF features a lower expense ratio and has experienced a significantly lower maximum drawdown over the last five years compared to the First Trust fund.
First Trust NYSE Arca Biotechnology Index Fund has outperformed on 1-year total return, though it carries higher volatility and a more narrow sector focus.
Simplify Health Care ETF (NYSEMKT:PINK) provides broad, active healthcare exposure with a charitable tilt, whereas the First Trust NYSE Arca Biotechnology Index Fund (NYSEMKT:FBT) offers a concentrated, index-based play on biotech.
Investors seeking medical sector exposure can choose between broad innovation or narrow sub-industry focus. PINK targets leaders across medtech and services under active management, while FBT tracks a benchmark of 30 biotechnology firms, presenting a higher-volatility option for specific industry growth.
Snapshot (cost & size)
| Metric | FBT | PINK |
|---|---|---|
| Issuer | First Trust | Simplify |
| Share price | $269.25 (as of 2026-10-23) | $39.64 (as of 2026-10-23) |
| Expense ratio | 0.55% | 0.51% |
| 1-yr return (as of Oct. 23, 2026) | 42.2% | 21.0% |
| Dividend yield | N/A | 0.8% |
| Beta | 0.68 | 0.72 |
| AUM | $3.0 billion | 0.3 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 Simplify fund is the more affordable option between the two, carrying a 0.51% expense ratio. The First Trust fund is slightly more expensive for investors, with an annual fee of 0.55%.
Performance & risk comparison
| Metric | FBT | PINK |
|---|---|---|
| Max drawdown (5 yr) | (27.4%) | (18.7%) |
| Growth of $1,000 over 5 years (total return) | $1,652 | $1,576 |
What's inside
Simplify Health Care ETF actively selects companies across healthcare innovation. Its portfolio covers healthcare at 90%, consumer cyclical at 4%, and industrials at 3%. With 58 holdings, its largest positions include Humana (NYSE:HUM) at 7.69%, Arcutis Biotherapeutics (NASDAQ:ARQT) at 7.55%, and Johnson & Johnson (NYSE:JNJ) at 7.31%. The fund was launched in 2021. It features a currency hedge and a unique pro bono mission, donating all net profits to breast cancer research through the Susan G. Komen foundation.
First Trust NYSE Arca Biotechnology Index Fund tracks a benchmark of 30 biotechnology companies. The portfolio is 100% concentrated in the healthcare sector. Top holdings include Genmab (NASDAQ:GMAB) at 3.88%, Halozyme Therapeutics (NASDAQ:HALO) at 3.74%, and Biogen (NASDAQ:BIIB) at 3.65%. The fund was launched in 2006. It features no specific quirks or charitable mandates, sticking to its rules-based index rather than active management selection.
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Which looks like the better buy
Biotechnology has been the standout corner of healthcare over the past year, and FBT has captured that momentum directly. Its 30 equal-weighted biotech names delivered stronger trailing-12-month returns than PINK, and it manages nearly 10 times more assets, a sign that investors have been voting with their dollars.
PINK is built around a different idea about what a healthcare fund can be. Its active managers range across the broader healthcare landscape rather than concentrating in biotech alone, which has produced steadier but more modest returns during a period when biotech specifically was leading. What sets PINK apart is its structure: The fund donates its entire management fee to Susan G. Komen cancer research, making it the only ETF in which owning it directly contributes to a cause.
With nearly identical fees, this choice depends on your investing style. For investors who want to ride biotech's current momentum with a proven index approach, FBT is the stronger near-term bet. PINK is the better fit for those who want active, diversified healthcare management and like an investment that funds cancer research at no extra cost.
Sara Appino has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends Genmab A/s. The Motley Fool recommends Biogen and Johnson & Johnson. The Motley Fool has a disclosure policy.