At a glance
PSCH charges 0.29% a year, below the 0.42% average of the 6 funds most like it (the 2nd cheapest of 7). It has $183.9M in assets, the 4th largest of that group. Over the past year it returned +28.0% with distributions reinvested (S&P 500: +11.5%), 4th of those 7 funds; over three years it returned +16.4% a year. At its worst it fell 35.9% in the 2020 crash (S&P 500: 33.7%) and 28.7% in the 2022 bear market (S&P 500: 24.5%). Its ten largest positions make up 37.6% of the fund, out of 71 in all.
The short version
Invesco S&P SmallCap Health Care ETF (PSCH) tracks the S&P SmallCap 600 Capped Health Care Index, which holds about 70 small U.S. health care companies such as Corcept Therapeutics and Glaukos. Its 0.29% expense ratio is below the 0.42% average of funds with similar holdings. It is a narrow, volatile bet on one sector. It pays almost no dividends, and it fell 46.3% from June 2021 to October 2023.
Price history
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PSCH +28.0% over the year to Oct 27, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| PSCH official prospectus, to Dec 31, 2024 | — | +3.75% | — | +0.61% | +8.38% | — |
| PSCH price data to Oct 27, 2026 | +24.3% | +28.0% | +16.4% | -1.1% | +9.6% | +12.5% |
- Over the year to Oct 27, 2026, PSCH returned +28.0%, 4th of 7 among similar funds.
- Its 5-year annualized return was -1.1% and its 10-year +9.6%.
- In the 2020 COVID crash it fell 35.9% and regained its old high 6.7 months after the low.
- Its worst full calendar year was 2022 (-25.2%); its best was 2013 (+56.0%).
- The deepest fall in its price history was 46.3% (Jun 25, 2021 to Oct 27, 2023), not yet recovered.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +24.3% | — |
| 2025 | -0.5% | — |
| 2024 | +3.8% | +3.75% |
| 2023 | -2.7% | -2.61% |
| 2022 | -25.2% | -26.32% |
| 2021 | +5.8% | +5.61% |
| 2020 | +31.5% | +31.15% |
| 2019 | +20.2% | +19.91% |
| 2018 | +9.2% | +9.69% |
| 2017 | +34.9% | +34.43% |
| 2016 | +1.7% | +1.96% |
| 2015 | +20.3% | +20.29% |
| 2014 | +11.1% | — |
| 2013 | +56.0% | — |
| 2012 | +12.7% | — |
| 2011 | +12.5% | — |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 35.2% over that stretch · deepest drop along the way 35.9%, back to its old high 6.7 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 27.6% over that stretch · deepest drop along the way 28.7%, not recovered by the end of the data |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2026 (to date) | $0.0003 | |
| 2025 | $0.0150 | -88.5% |
| 2024 | $0.1300 | +3150.0% |
| 2023 | $0.0040 | -99.6% |
| 2022 | $1.0000 | +30203.0% |
| 2018 | $0.0033 | -50.7% |
| 2016 | $0.0067 | -98.7% |
| 2014 | $0.4967 | +7313.4% |
| 2013 | $0.0067 | -88.2% |
| 2012 | $0.0567 | -41.4% |
| 2011 | $0.0967 |
What's inside
As of Aug 31, 2026, the fund held 71 securities; the ten largest made up 37.63% of assets. It also reported 30.28% in a money-market fund, most likely cash collateral from lending out shares rather than uninvested money.
| Holding | Weight | |
|---|---|---|
| Corcept Therapeutics Inc. | 5.52% | |
| Glaukos Corp. | 5.37% | |
| Protagonist Therapeutics, Inc. | 4.55% | |
| Alkermes PLC | 3.99% | |
| TG Therapeutics, Inc. | 3.65% | |
| Teleflex Inc. | 3.21% | |
| PTC Therapeutics, Inc. | 2.94% | |
| Ligand Pharmaceuticals Inc. | 2.90% | |
| Merit Medical Systems, Inc. | 2.76% | |
| RadNet, Inc. | 2.74% | |
| Liquidia Corp. | 2.44% | |
| ICU Medical, Inc. | 2.20% | |
| Indivior Pharmaceuticals, Inc. | 2.17% | |
| Integer Holdings Corp. | 2.17% | |
| Concentra Group Holdings Parent, Inc. | 2.05% |
By country
United States 94.95%Ireland 5.02%By asset type
Stocks 99.97%What changed recently
- Over the three months to Aug 31, 2026, investors added a net $24.7M (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +16.05%, +1.95%, +2.17%.
How it works
PSCH is an index fund. It aims to match the S&P SmallCap 600 Capped Health Care Index, before fees, rather than beat it. S&P Dow Jones Indices builds the index from the health care companies in the S&P SmallCap 600, a list of about 600 small U.S. companies. "Health care" follows the Global Industry Classification Standard (GICS), a widely used system for sorting companies by business. It covers biotech, drugmakers, life sciences, medical equipment and care providers. As of October 31, 2025, the index had 73 members, valued between $496.2 million and $7.7 billion.
Invesco uses "full replication." That means the fund generally holds every stock in the index, at the index's own weights, and keeps at least 90% of its assets in those stocks. It buys or sells only when the index changes, even if a stock is doing poorly. Portfolio turnover, a measure of how much of the portfolio is traded in a year, was 42%.
As of August 31, 2026, the fund held 71 companies. The 10 largest made up 37.6% of assets, led by Corcept Therapeutics (5.5%), Glaukos (5.4%) and Protagonist Therapeutics (4.6%). The filing also shows a cash line of about 30%. This most likely reflects collateral from lending shares to other market participants, not money waiting to be invested. The fund held no derivatives.
What it really costs
- PSCH charges 0.29% a year, versus an average of 0.42% for the similar funds below (2nd of 7, cheapest first).
- Using the prospectus's standard example, $10,000 invested would cost about $30 in the first year and $368 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| PSCH | $30 | $93 | $163 | $368 |
In a retirement portfolio
PSCH is a concentrated, volatile bet on small health care stocks that pays almost no income, so it fits better as a small add-on than as a foundation.
PSCH adds small health care companies that large-company funds barely hold, and its price swings sharply. It launched in 2010, so it has no record from the 2008 crisis. It fell 35.9% in the 2020 COVID crash and recovered by October 2020. In the 2022 bear market it fell 28.7%. Its worst calendar year was 2022, at −26.3%. Its deepest drop, 46.3% from June 2021 to October 2023, had still not been fully recovered as of October 27, 2026. Selling shares or drawing cash in a year like that would lock in losses. Income is negligible: the trailing yield was about 0% as of October 27, 2026, and payouts come once a year. Costs are low at 0.29%, or $30 in the first year on $10,000 under the SEC's standard example. Past results don't predict the future, and a plan should look at the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Investors who want small U.S. health care stocks, from Corcept Therapeutics to RadNet, as a small add-on to broad index funds.
- Cost-conscious buyers: the 0.29% expense ratio is below the 0.42% average of funds with the most similar holdings.
- Long-horizon holders who could sit through a drop like the 46.3% slide from June 2021 to October 2023 without needing to sell.
Look elsewhere if
- Anyone wanting income: the trailing yield was about 0% as of October 27, 2026, with payouts only once a year.
- Investors wanting one fund for all small companies; PSCH holds only about 70 health care stocks, with 37.6% in its top 10.
- Those wanting the cheapest small-cap exposure; Vanguard's VIOG costs 0.10%, though it holds small growth stocks across sectors, not just health care.
Close alternatives
Matched by closest holdings overlap from the latest N-PORT reports (no similar fund shares 20% or more of its holdings).
| Fund | Overlap | Cost | Net assets | 1 yr | 3 yr |
|---|---|---|---|---|---|
| PSCH this fund | — | 0.29% | $183.9M | +28.0% | +16.4% |
| RZG Invesco S&P SmallCap 600® Pure Growth ETF | 20% | 0.35% | $137.8M | +12.4% | +18.8% |
| XHE SPDR S&P Health Care Equipment ETF | 19% | 0.35% | $151.4M | +14.1% | +11.7% |
| VIOG Vanguard S&P Small-Cap 600 Growth ETF | 15% | 0.1% | $1.09B | +14.5% | +17.9% |
| CAFG Pacer US Small Cap Cash Cows Growth Leaders… | 15% | 0.59% | $30.2M | +31.3% | +21.3% |
| FBT First Trust NYSE Arca Biotechnology Index F… | 15% | 0.56% | $2.81B | +43.6% | +27.7% |
| PTH Invesco Dorsey Wright Healthcare Momentum E… | 14% | 0.6% | $235.2M | +31.0% | +28.6% |
Questions investors ask
What does PSCH invest in?
PSCH holds small U.S. health care companies in the S&P SmallCap 600 Capped Health Care Index. S&P Dow Jones Indices builds that index from the S&P SmallCap 600. As of August 31, 2026, the fund held 71 stocks. The largest were Corcept Therapeutics (5.5%), Glaukos (5.4%), Protagonist Therapeutics (4.6%), Alkermes (4.0%) and TG Therapeutics (3.6%). The mix spans biotech, drugmakers, medical devices and care providers. About 95% was in U.S. companies, and Ireland-based Alkermes made up the rest.
Does PSCH pay a dividend?
Barely. Over the 12 months to October 27, 2026, PSCH paid about $0.0003 per share, a yield of roughly 0%, and it pays at most once a year. Many small health care companies, especially biotech firms, put their cash back into research instead of paying dividends. Anyone drawing cash from this fund would mostly have to sell shares, and selling after a steep drop can be costly.
What is PSCH's expense ratio?
PSCH's expense ratio is 0.29% a year, according to its prospectus filed December 18, 2025. The SEC's standard example assumes $10,000 invested with a 5% return each year. On that basis, costs come to about $30 after one year, $93 after three, $163 after five and $368 after ten. That makes PSCH the second cheapest of seven funds with similar holdings, which average 0.42%. Only Vanguard's VIOG, at 0.10%, costs less.
What's the difference between PSCH and XHE?
Both own health care stocks, but they cover different parts of the sector. PSCH holds small health care companies of all kinds, including biotech and drugmakers. SPDR's XHE, as its name suggests, tracks health care equipment makers. Only about 19% of their holdings overlap. PSCH costs 0.29% a year and XHE costs 0.35%. As of October 27, 2026, PSCH returned 28% over one year and 16.4% a year over three years. XHE returned 14.1% and 11.7% over the same periods.
How has PSCH performed over the long term?
Unevenly. According to its prospectus, PSCH returned 8.38% a year over the 10 years to December 31, 2024, but only 0.61% a year over five years. Based on price, it gained 24.3% from the start of 2026 through October 27. Even so, it had not fully made up its 46.3% fall from June 2021 to October 2023 by that date. Its strongest quarter was a gain of 28.4% (late 2020), and its weakest was a loss of 23.12% (late 2018). Past results don't predict future ones.