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Healthcare ETF Flows Are Recovering After a Strong Biopharma Rally

Healthcare ETF Flows Are Recovering After a Strong Biopharma Rally

J.P. Morgan sees healthcare ETF flows recovering after years of relative weakness, while large-cap biopharma has already outperformed. The setup could support further rotation, but fund flows alone are not enough to sustain the sector’s valuation gains.

Healthcare stocks have already outperformed in 2026, and J.P. Morgan sees fund flows beginning to catch up. The bank’s U.S. large-cap biopharma work, as reported by Benzinga, suggests that a multi-year period of weak relative ETF flows may be reversing, creating a potential second tailwind for a sector that has already benefited from stronger stock performance.

According to the source, J.P. Morgan’s positioning data through September 2 showed $8.3 billion of year-to-date inflows into healthcare ETFs, equal to 5.9% of assets. Technology ETFs had attracted much more capital in absolute terms, but healthcare flows were improving after diverging from broader ETF inflows beginning in 2023.

Performance has already moved ahead of the fund-flow recovery. J.P. Morgan said U.S. large-cap biopharma had gained 22% year to date, compared with a 14% increase for the S&P 500. The bank also said the group outperformed in 2025. That means the rotation thesis is no longer based on a depressed sector waiting for a catalyst. Investors are considering whether capital flows can reinforce a move that is already underway.

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LLYEli Lilly and Company
$1,240.34-1.33%
3:40 PM10:30 AM11:50 AM1:10 PM2:25 PM3:55 PM1,2401,2451,2501,2551,260
Market data may be delayed. JINI analysis is research assistance, not personalized investment advice.

Valuation remains part of the case. The source says large-cap biopharma traded at about a 5% discount to the S&P 500 on next-12-month earnings, with the discount widening to roughly 15% when Eli Lilly is excluded. Those figures are J.P. Morgan estimates and should not be treated as universal market multiples because methodology, index composition and forward earnings assumptions can differ across data providers.

For broad exposure, the Health Care Select Sector SPDR Fund is one of the most relevant vehicles. The source identified Eli Lilly, Johnson & Johnson, AbbVie, Merck and Gilead among major holdings. A healthcare ETF therefore allows investors to express a sector-rotation view without depending on a single drug, regulatory decision or clinical catalyst.

The Vanguard Health Care ETF offers a broader sector basket, while the SPDR S&P Biotech ETF provides more concentrated exposure to biotechnology and generally carries higher company-specific and clinical risk. These vehicles are not interchangeable. Large pharmaceutical companies tend to have established cash flows, dividends and diversified portfolios, while biotech funds can be much more sensitive to trial results, financing conditions and regulatory outcomes.

The core investment question is whether healthcare can continue to attract capital after its recent outperformance. A sustained flow recovery could support valuations, but fund flows are not a fundamental earnings driver by themselves. They can amplify demand for the sector while underlying returns still depend on product launches, patent cycles, pipeline execution, pricing policy and earnings growth.

Policy risk also remains relevant. Healthcare can look defensive relative to economically sensitive sectors, yet pharmaceutical pricing, reimbursement rules and regulatory decisions can quickly change company-level expectations. The sector’s lower sensitivity to AI disruption does not make it low risk.

The better way to use the flow data is as a positioning signal. If fundamentals remain stable and healthcare continues receiving a larger share of incremental ETF capital, the sector can benefit from both earnings support and multiple normalization. If performance stalls while flows reverse again, the same mechanism can work in the opposite direction.

BTI’s bottom line: the healthcare rotation has moved beyond a purely contrarian setup. J.P. Morgan’s reported flow data suggest investors are returning to the sector after years of relative neglect, but the next leg depends on fundamentals holding up after a strong run rather than on ETF inflows alone. Concentration inside the major healthcare ETFs is another consideration. A fund labeled as broad healthcare exposure can still be heavily influenced by a handful of mega-cap pharmaceutical companies. Strong performance from Eli Lilly, AbbVie or Johnson & Johnson can materially affect sector returns even when smaller healthcare companies lag.

This also means investors should separate the sector-rotation thesis from a pure defensive thesis. Healthcare can benefit when investors move away from richly valued technology, but parts of the sector remain growth-sensitive and catalyst-driven. Biotechnology, managed care, medical devices and large-cap pharmaceuticals can behave very differently in the same market environment. ETF selection therefore changes the type of healthcare exposure an investor actually owns.

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Novavax said it is eligible for royalties in the high teens to low twenties as a percentage of Sanofi's global net Nuvaxovid sales. It could also receive up to $350 million of Phase 3 and commercial milestones tied to Sanofi's influenza and COVID-19 combination products. New vaccines using Matrix-M can generate additional milestones and mid-single-digit royalties.

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