Investors love health care exchange traded funds and they like the more traditional offerings. That much is confirmed by the roughly $2.5 billion combined that flowed into the Health Care Select Sector SPDR (NYSEArca: XLV) and the Vanguard Health Care ETF (NYSEArca: VHT) last year.

However, ETF issuers are taking increasingly focused, refined approaches to health care ETFs. The ALPS Medical Breakthroughs ETF (NYSEArca: SBIO), which debuted on Dec. 31, is a prime example.

SBIO tracks the Poliwogg Medical Breakthroughs Index (PMBI), which is comprised “of small-cap and mid-cap pharmaceutical and biotechnology stocks listed on U.S. stock exchanges that have one or more drugs in either Phase II or Phase III U.S. FDA clinical trials,” according to a statement released by ALPS.

That approach is similar to that of the BioShares Biotechnology Clinical Trials Fund (NasdaqGM: BBC), which also debuted last month. BBC’s holdings are companies with a lead drug candidate in a Phase I, Phase II or Phase III trial. [Unique Biotech ETFs Come to Market]

SBIO, the new ALPS ETF, features a tilt toward more mid- and small-cap firms, stocks that often rocket higher on positive clinical trials data.

Many of the blockbuster drugs from the 1990s and 2000s have lost patent protections over the past few years,” said ALPS Vice President and Portfolio Manager Michael Akins in the statement, “and Big Pharma is scrambling to fill its pipelines. Given the lengthy process and high rate of failure for new drug development, it makes sense for the established companies to look toward new therapies being developed by smaller innovative firms.”