US stocks ended slightly lower on Tuesday as a decline in healthcare and biotech stocks offset gains in United Technologies and Verizon.
A 5.7% drop to $140.64 in IBM also weighed on the market. The stock hit a five-year intraday low at $140.28 after it reported a bigger-than-expected decline in quarterly revenue and cut its full-year profit forecast.
The S&P healthcare sector fell 1.5%, while the Nasdaq Biotech Index dropped 3.2%. Concerns about drug pricing have hit biotech and other healthcare shares.
"You're seeing weakness in momentum names in general. Obviously the healthcare names are under pressure again, especially pharma companies. That further increases the pall over that sector," said Michael O'Rourke, chief market strategist at JonesTrading in Greenwich, Connecticut.
At the same time, O'Rourke said, investors seem to be buying more stable names such as Apple . Apple rose 1.8% to $113.77.
Stocks have mostly gained this month following a selloff in the third quarter, though concern about third-quarter earnings has added to caution.
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Among companies beating analysts' expectations, United Technologies rose 3.9% to $95.62, giving the Dow its biggest boost.
Verizon's shares were up 1.2% at $45.24 after the largest US wireless service provider reported better-than-expected revenue and profit.
The Dow Jones industrial average fell 13.43 points, or 0.08%, to 17,217.11, the S&P 500 lost 2.89 points, or 0.14%, to 2,030.77, and the Nasdaq Composite dropped 24.50 points, or 0.5%, to 4,880.97.
The S&P 500 is up 5.8% so far in October.
Earnings for S&P 500 companies are expected to have fallen about 4% in the third quarter, while revenue is expected to have declined 3.8%, according to Thomson Reuters data.
Of the S&P 500 companies that have reported so far, roughly 40% have beaten revenue expectations, below the long-term average, according to Thomson Reuters data.
Travelers rose 2.5% to $108.95. The insurer's quarterly profit topped estimates, helped by higher underwriting gains.
Harley Davidson skidded 13.9% to $48.25 after the motorcycle maker cut its full-year shipment forecast.
Shares of Tesla dropped 6.6% to $213.03 in heavy volume. Consumer Reports magazine found that advanced fuel-saving technology and digital multimedia systems in vehicles including the Tesla Model S sedan are hurting reliability.
After the bell, shares of Yahoo were down 1% at $32.50 as it reported a drop in quarterly revenue, while Intuitive Surgical was up 7.6% at $508.70% after it posted a revenue increase.
During the regular session, advancing issues outnumbered declining ones on the NYSE by 1,888 to 1,170, for a 1.61-to-1 ratio on the upside; on the Nasdaq, 1,426 issues fell and 1,345 advanced for a 1.06-to-1 ratio favoring decliners.
The S&P 500 posted 24 new 52-week highs and 3 new lows; the Nasdaq recorded 66 new highs and 49 new lows.
About 6.0 billion shares changed hands on US exchanges, below the 7.3 billion daily average for the past 20 trading days, according to Thomson Reuters data.