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NASDAQ biotech index: Healthcare investment from India

Denila Lobo
February 6, 2026
2 minutes read
NASDAQ biotech index: Healthcare investment from India

The NASDAQ Biotechnology Index has entered 2026 on a strong trajectory. The flagship IBB ETF delivered 27.7% returns over the past year after years of underperformance. For Indian investors seeking exposure to cutting-edge healthcare innovation, biotech offers compelling growth potential alongside significant volatility. This guide covers everything from fund mechanics to tax-efficient investment strategies for accessing this high-growth sector from India.

IBB ETF overview: The gateway to biotech investing

The iShares Biotechnology ETF (IBB), managed by BlackRock, remains the dominant vehicle for accessing NASDAQ biotech stocks. The fund holds $8.5 billion in assets under management with 261 holdings as of February 2026. After years of lacklustre performance, the fund has surged to $174.52 per share, approaching its 52-week high of $179.64.

Key fund metrics (February 2026):

  • Expense ratio: 0.44%
  • Dividend yield: 0.22%
  • Average daily volume: 1.78-2.04 million shares
  • Inception date: February 5, 2001
  • Beta: 0.96

Historical performance:

PeriodAnnualized Return
1-Year27.71%
3-Year7.51%
5-Year1.54%
10-Year3.89%
Since Inception6.31%

The fund tracks the NYSE Biotechnology Index using a modified market-cap weighting methodology. This approach caps the top 5 holdings at 8% and the remaining holdings at 4%. The structure prevents excessive concentration in mega-cap names while maintaining exposure to industry leaders.

Top 10 holdings (January 2026):

RankCompanyTickerWeight
1Vertex PharmaceuticalsVRTX8.63%
2Gilead SciencesGILD8.05%
3AmgenAMGN7.82%
4RegeneronREGN6.89%
5Alnylam PharmaceuticalsALNY4.55%
6InsmedINSM3.23%
7argenx SEARGX3.00%
8NateraNTRA2.65%
9BiogenBIIB2.27%
10BeOne MedicinesONC1.94%

The top 10 holdings represent approximately 47% of assets. This provides concentrated exposure to established biotech leaders while the remaining 251 holdings capture emerging innovation.

Top biotech holdings driving index performance

The most extensive IBB holdings represent companies with proven commercial franchises and substantial pipelines.

Amgen (AMGN) — $338.59 | Market cap: $184 billion

The biotech pioneer continues to deliver strong results. Q4 2025 earnings beat expectations at $5.29 EPS versus $4.76 consensus. Amgen's obesity drug MariTide generated significant excitement at the J.P. Morgan Healthcare Conference. The drug shows patients maintain weight loss with less frequent dosing than competitors. Key revenue drivers include Enbrel, Prolia/Xgeva, and Repatha. Goldman Sachs raised its price target to $415 following strong guidance.

Gilead Sciences (GILD) — $144.56 | Market cap: $179 billion

Gilead reached a 52-week high of $145.94 in early February 2026. The dominant HIV franchise drives performance, with Biktarvy continuing to gain market share. CEO Daniel O'Day declared at J.P. Morgan that Gilead has the most robust pipeline in company history. The oncology segment and cell therapy partnerships provide growth optionality beyond HIV.

Vertex Pharmaceuticals (VRTX) — $476.57 | Market cap: $121 billion

Vertex's cystic fibrosis franchise remains virtually unassailable. Trikafta treats approximately 90% of CF patients. The company's next growth chapter arrived with FDA approval of JOURNAVX, a first-in-class non-opioid painkiller. Casgevy, the world's first approved CRISPR gene-editing therapy, represents transformational innovation.

Regeneron (REGN) — $770.19 | Market cap: $83 billion

The company behind Eylea and blockbuster Dupixent continues impressive execution. Dupixent recently received EU approval as the first targeted medicine for chronic spontaneous urticaria in over a decade. JP Morgan raised its target to $950, maintaining an Overweight rating.

Moderna (MRNA) — $42.20 | Market cap: $16.5 billion

Despite trading near 52-week lows, Moderna pivots beyond COVID with substantial progress. The company filed for marketing authorisation of its flu vaccine across multiple markets. Its cancer vaccine partnership with Merck demonstrated 49% reduction in melanoma recurrence at 5 years.

Growth drivers in healthcare transforming biotech

Medical researcher analyzing DNA molecular structure for gene therapy and drug development

The biotech sector's investment thesis rests on multiple converging technological and demographic megatrends.

AI drug discovery has gone mainstream. NVIDIA and Eli Lilly announced a $1 billion co-innovation AI lab at J.P. Morgan 2026. Isomorphic Labs signed partnerships with J&J after prior deals with Lilly and Novartis. AI-designed therapeutics have progressed from concept to human trials at unprecedented speed.

GLP-1 obesity drugs represent the fastest-growing market. The GLP-1 market exploded to $63-70 billion in 2025. Projections target $200-315 billion by 2033-2035. One in eight US adults has now tried GLP-1 drugs. More than 100 pipeline candidates are chasing this massive opportunity.

CRISPR gene editing has been validated. The CRISPR gene therapy market projects growth from $4.76 billion (2025) to $18.89 billion by 2035. Casgevy generated $100+ million in revenue in 2025, with patient initiations nearly tripling year over year.

Precision oncology dominates cancer care—the precision medicine market is projected to reach $537 billion by 2035. Remarkably, 72% of US hospital oncology treatments now incorporate precision-based protocols.

mRNA technology expands beyond vaccines. Over 120 clinical trials are underway for RNA cancer vaccines. Moderna and Merck's personalised cancer vaccine showed 44% reduction in recurrence risk in Phase 2b trials.

Biosimilars create new market dynamics. The biosimilars market reached $32-40 billion and is projected to hit $122-175 billion by 2033-2035. The FDA approved 72 biosimilars through mid-2025.

M&A activity reaches historic levels. Biopharma M&A totalled $138 billion across 129 deals in 2025. This tripled the $44 billion of 2024. Patent expirations affecting $230-300 billion in annual sales force Big Pharma into aggressive acquisition strategies.

FDA approval impacts on biotech stocks

The FDA approval process creates uniquely volatile investment dynamics in biotech. Understanding this regulatory framework proves essential for managing risk.

2025 approval statistics: The FDA approved 46 new molecular entities in 2025. Oncology and haematology led with 14 new drugs. Small molecules accounted for 65% of approvals, while antibodies accounted for 20%.

Key approval pathways:

  • Standard review: 10 months from application acceptance
  • Priority review: 6 months from acceptance
  • Breakthrough therapy: Expedited development for substantial improvements
  • Accelerated approval: Based on surrogate endpoints

FDA policy under Commissioner Makary has introduced significant changes. These include radical transparency, such as publishing Complete Response Letters in real time. The agency plans to require a single pivotal trial, rather than the historical two-trial standard. A new National Priority Voucher Program promises 1-2-month reviews of drugs aligned with the administration's health priorities.

Key PDUFA dates Q1-Q2 2026:

DateDrugCompanyIndication
Feb 8, 2026ClemidsogeneREGENXBIOHunter syndrome
Mar 2026OrforglipronEli LillyObesity/diabetes
Mar 28, 2026KresladiRocket PharmaLAD-I
Apr 6, 2026Orca-TOrca BioHematologic malignancies

Stock impact example: Replimune's stock plummeted 76% after the FDA rejection of its melanoma drug RP1 in July 2025. This illustrates the binary event risk inherent to biotech investing.

Risk factors unique to biotech investing

Biotech investing carries distinct risks that demand careful portfolio construction.

Clinical trial failure rates represent the sector's fundamental challenge. Only 6.7-14.3% of drugs progress from Phase 1 through approval. The Phase 2-to-Phase 3 transition in 2028 has a success rate of only 28-32%. Oncology has the lowest likelihood of approval at just 5% from Phase 1.

Patent cliff concerns drive current M&A activity—Keytruda (Merck, $29B+ annuallyances 2028 expiration. Eliquis (BMS/Pfizer, $12.2B) expires 2026-2028. Companies aggressively acquire to replace revenue at risk.

Drug pricing pressures from the Inflation Reduction Act are reshaping the economics. Medicare drug price negotiations cover 10 drugs effective January 1, 2026. Estimated savings of $6 billion annually for Medicare come directly from pharmaceutical revenues.

Capital-intensive nature challenges smaller companies. More than half of publicly traded biotechs ended 2024 with less than 2 years of cash runway. Average drug development costs $1-2.6 billion over 10-15 years.

Portfolio allocation suggestions for biotech exposure

Person reviewing stock market investment charts on computer screen for portfolio analysis

Person reviewing stock market investment charts on a computer screen for portfolio analysis.

Biotech volatility demands disciplined allocation strategies tailored to individual risk tolerance.

Recommended biotech allocation:

  • Conservative investors: 3-5% of equity allocation
  • Moderate investors: 5-10% of equity allocation
  • Aggressive investors: 10-15% of equity allocation

Diversification strategy: Combine IBB (large-cap stability) with XBI (small-cap growth potential). A 60%/40 IB/XBI allocation provides balanced exposure. Add individual biotech stocks only for concentrated conviction plays.

Dollar-cost averaging: Weekly or monthly SIPs smooth entry points in this volatile sector. These naturally built positions occur during market corrections.

Rebalancing protocol: Review biotech allocation quarterly. Rebalance if allocation drifts more than 2-3% from target to maintain risk discipline.

Alternative biotech ETFs for Indian investors

Indian investors should understand the full ETF landscape when allocating to biotech.

ETFPrice (Feb 2026)AUMExpense RatioHoldings1-Year ReturnMethodology
IBB$174.52$8.5B0.44%26127.71%Market-cap weighted
XBI$127.37$8.4B0.35%15335.84%Equal-weighted
ARKG$30.32$1.27B0.75%~3516.74%Actively managed
FBT$211.81$2.4B0.54%3124.25%Equal-dollar weighted
BBH$196.48~$700M0.35%2521.43%Market-cap weighted

IBB vs XBI: The core choice

XBI's equal-weighted methodology delivered 35.84% returns versus IBB's 27.71% in 2025. XBI captures more upside from smaller biotech companies. It has 80% mid- and small-cap exposure, compared with IBB's 79% large- and mid-cap focus. However, XBI carries higher volatility. Over 10 years, XBI generated 7.81-10.31% annualised returns versus IBB's 6.06-7.66%.

ARKG offers actively managed genomics exposure through Cathie Wood's ARK Invest. Its 2.76 beta makes it significantly more volatile than passive alternatives.

LABU (3X Bull) and LABD (3X Bear) serve exclusively for short-term trading. LABU gained 86.88% in 2025 but lost 23.79% annualised since inception due to daily rebalancing decay. These remain unsuitable for buy-and-hold investors.

How Indian investors can access NASDAQ biotech

The regulatory framework and platform ecosystem enable Indian residents to invest directly in US biotech ETFs.

Top investment platforms:

Vested Finance offers access to 10,000+ US stocks and ETFs, including IBB and XBI. Fractional investing starts at $1. Brokerage fees range from 0.15-0.25% of trade value (maximum $35).

INDmoney provides zero-commission trading on US stocks and ETFs across 9,000+ securities. The platform charges a 0.75% deposit fee (capped at ₹1,000) plus $5 withdrawal fees.

Interactive Brokers serves active traders with professional-grade tools.

For detailed platform comparisons, read our guide on comparing US stock trading platforms available to Indian investors.

Access spans 170+ global markets at USD 0.0005-0.0035 per share.

LRS framework:

  • Annual limit: USD 250,000 per financial year
  • Eligible: Indian residents (including minors via guardian)
  • Documentation: PAN card, Form A2 declaration, KYC documents

TCS (effective April 2025):

AmountTCS Rate
Up to ₹10 lakh0%
Above ₹10 lakh20%

Tax implications:

  • LTCG (holding >24 months): 12.5%
  • STCG (holding ≤24 months): Taxed at slab rate
  • US dividend withholding: 25% under India-US DTAA
  • Mandatory disclosure: Schedule FA in ITR-2 or ITR-3

The biotech sector enters February 2026 with improving fundamentals after years of underperformance.

For broader healthcare sector analysis, read our comprehensive US healthcare stocks outlook covering pharma, insurance, and healthcare services.

XBI rallied 36% in 2025 versus the S&P 500's 16%, suggesting sector rotation into healthcare innovation. Key 2026 catalysts include Biogen's Leqembi subcutaneous formulation PDUFA decision, Eli Lilly's orforglipron FDA decision, and Moderna/Merck cancer vaccine Phase 3 readouts. For Indian investors willing to accept significant volatility and maintain a 5+ year horizon, the NASDAQ Biotech Index offers exposure to transformative innovation in global healthcare.

Disclaimer: The views and recommendations made above are those of individual analysts or brokerage companies, and not of Winvesta. We advise investors to check with certified experts before making any investment decisions.

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