Which returned more over the last year, FXH or XLV?

In the year to Oct 28, 2026, with distributions reinvested, FXH returned +21.5% and XLV +25.6%.

Which is cheaper, FXH or XLV?

XLV is cheaper, by 0.53 percentage points a year. That is about $53 on $10,000 held for a year. Fees come from each fund's prospectus.

How much do FXH and XLV overlap with the S&P 500?

By their latest filed holdings, 59% of FXH and 100% of XLV by weight is stocks the S&P 500 already holds.

Data as of Oct 28, 2026.

Across categories

FXH vs XLV: Differences, Returns & Fees

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Over the year to Oct 28, 2026, FXH returned +21.5% to XLV's +25.6%; 30% of their weight is in the same names.

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Net assets on Oct 27, 2026: $1.1bn for First Trust Health Care AlphaDEX Fund and $47.0bn for State Street Health Care Select Sector SPDR ETF.

FXH on its own →XLV on its own →

At a glance

+21.5%

FXH total return, 1 year

+25.6%

XLV total return, 1 year

0.61%

FXH expense ratio

0.08%

XLV expense ratio

Pair scorecard

XLV costs 0.53 points a year less; their one-year returns differ by 4.1 points; XLV is far larger, $47.0bn against $1.1bn.

FXH vs XLV: Differences, Returns & Fees
Measure	FXH	XLV
Return
Measure	FXH	XLV
Total return, 1 year	+21.5%	+25.6%
Benchmark
Measure	FXH	XLV
What it tracks	StrataQuant Health Care Index	Health Care Select Sector Index
Cost and size
Measure	FXH	XLV
Expense ratio	0.61%	0.08%
Net assets, as of Oct 27, 2026	$1.1bn	$47.0bn
Holdings
Measure	FXH	XLV
Holdings in common	30%
Top ten holdings, share of the fund	24.7%	60.6%

Holdings in common uses holdings dated Oct 27, 2026. Method

Risk and return

May 18, 2007 to Oct 23, 2026 · 1,014 weekly returns

FXH XLV

Return

Total return edge FXH (slight) +601.0% +586.7%

Annualized edge Tie +10.5% +10.4%

Price return edge FXH +581.6% +390.0%

Risk

Volatility edge XLV (slight) 18.5% 16.8%

Max drawdown edge XLV (slight) −41.9% −37.9%

Risk-adjusted

Sharpe edge XLV (slight) 0.55 0.58

Sortino edge XLV (slight) 0.77 0.82

Calmar edge XLV (slight) 0.25 0.27

Reading

FXH returned slightly more: +601.0% to +586.7%. XLV swung slightly less: 16.8% to 18.5%. XLV fell slightly less at its worst: −37.9% to −41.9%.

Full scorecard

9 measures, with how each is measured Open ↓

Risk and return: FXH vs XLV: Differences, Returns & Fees
Measure	FXH	XLV	Edge	How it is measured
Return
Total return	+601.0%	+586.7%	FXH (slight)	Price change plus distributions, reinvested.
Annualized	+10.5%	+10.4%	Tie	Total return as a yearly rate.
Price return	+581.6%	+390.0%	FXH	Price change alone, distributions left out.
Risk
Volatility	18.5%	16.8%	XLV (slight)	Spread of weekly returns, annualized. Lower is steadier.
Downside deviation	13.2%	11.9%	XLV	Like volatility, counting only weeks below the Treasury bill rate.
Max drawdown	−41.9%	−37.9%	XLV (slight)	Deepest fall from a high to the low after it.
Risk-adjusted
Sharpe	0.55	0.58	XLV (slight)	Return above Treasury bills per unit of volatility.
Sortino	0.77	0.82	XLV (slight)	Return above Treasury bills per unit of downside deviation.
Calmar	0.25	0.27	XLV (slight)	Annualized return divided by the max drawdown.

Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 1,014 weekly returns. Cash rate: the 13-week Treasury bill.

What they share

30%

By the books each fund has filed, FXH and XLV hold 30% of their money in the same securities at the same weight. Holdings dated Oct 27, 2026.

50%

0 half 100%

half

30% in common

Positions both hold · largest shared weight first FXH XLV

Eli Lilly and Company 2.04% 15.77%

Amgen Inc. 1.96% 3.72%

Bristol-Myers Squibb Company 1.82% 1.93%

Medtronic Plc 1.92% 1.77%

AbbVie Inc. 1.41% 7.78%

Elevance Health Inc. 1.40% 1.41%

Regeneron Pharmaceuticals, Inc. 1.98% 1.23%

The Cigna Group 2.53% 1.21%

HCA Healthcare, Inc. 1.36% 1.02%

Boston Scientific Corporation 1.90% 1.00%

Abbott Laboratories 0.96% 2.74%

Pfizer Inc. 0.96% 2.61%

Only in one fund ↓

Only in FXH

Halozyme Therapeutics, Inc. 2.68%

Caris Life Sciences, Inc. 2.53%

Globus Medical, Inc. (Class A) 2.49%

Medpace Holdings, Inc. 2.48%

Guardant Health, Inc. 2.30%

Natera, Inc. 2.29%

Exelixis, Inc. 2.06%

Tempus AI, Inc. (Class A) 2.03%

Only in XLV

MERCK + CO. INC. 5.38%

GILEAD SCIENCES INC 3.03%

CVS HEALTH CORP 1.79%

MCKESSON CORP 1.73%

MODERNA INC 1.19%

CENCORA INC 0.95%

CARDINAL HEALTH INC 0.88%

EDWARDS LIFESCIENCES CORP 0.81%

Check overlap with more funds →

Side by side

FXH First Trust Health Care AlphaDEX Fund XLV State Street Health Care Select Sector SPDR ETF

Where it sits Stock ETF Stock ETF

Issuer First Trust State Street

What it is Tracks an index Tracks an index of Health care

Total return, 1 year +21.5% +25.6%

Expense ratio 0.61% 0.08%

Already in the S&P 500 59.2% 99.7%

Holdings 72 62

Net assets, as of Oct 27, 2026 $1.1bn $47.0bn

FXH and XLV on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.

Client brief · page 1 of 2 Report BR-AE53FE86D4

FXH and XLV are built for the same job. How do they differ in cost, holdings and results?

What each follows. FXH follows StrataQuant Health Care Index and XLV follows Health Care Select Sector Index.
Holdings in common. 30% of the weight is in the same securities (holdings dated Oct 27, 2026).
One-year total return. Over 1 year to Oct 28, 2026 FXH returned +21.5% and XLV +25.6% with distributions reinvested, a gap of 4.1 points.

Data as of Oct 28, 2026.

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About each fund

FXH

FXH tracks an index. Over the year to Oct 28, 2026 it returned +21.5% with distributions reinvested. The prospectus expense ratio is 0.61% a year. By its holdings published by its issuer for Oct 27, 2026, 59% of the fund by weight is stocks the S&P 500 also holds, across 72 positions, with the top ten at 24.7%.

XLV

XLV tracks an index of Health care. Over the year to Oct 28, 2026 it returned +25.6% with distributions reinvested. The prospectus expense ratio is 0.08% a year. By its holdings published by its issuer for Oct 27, 2026, 100% of the fund by weight is stocks the S&P 500 also holds, across 62 positions, with the top ten at 60.6%.

Questions people ask

Which returned more over the last year, FXH or XLV?: In the year to Oct 28, 2026, with distributions reinvested, FXH returned +21.5% and XLV +25.6%.
Which is cheaper, FXH or XLV?: XLV is cheaper, by 0.53 percentage points a year. That is about $53 on $10,000 held for a year. Fees come from each fund's prospectus.
How much do FXH and XLV overlap with the S&P 500?: By their latest filed holdings, 59% of FXH and 100% of XLV by weight is stocks the S&P 500 already holds.

Other comparisons

FXH vs VHT FHLC vs FXH FXH vs IHE FXH vs IHF IHE vs XLV PPH vs XLV IHF vs XLV IXJ vs XLV

Where to next

FXH on its own →XLV on its own →Hold both: look the portfolio through →Rankings →FXH dividend history →FXH holdings →XLV dividend history →XLV holdings →Standards and sources →

Sources and dates

FXH filings on SEC EDGAR ↗

FXH prospectus with the expense ratio (SEC) ↗

First Trust page for FXH ↗

XLV filings on SEC EDGAR ↗

XLV prospectus with the expense ratio (SEC) ↗

State Street website ↗

Links are sources, not endorsements. A comparison is not a recommendation.

How this is computed

Overlap adds up the smaller of the two weights for each security both funds hold.

Cite this pageCitation, APA and Markdown

ETFIQ, FXH against XLV, data as of Oct 28, 2026. https://etfiq.com/compare/any/fxh-vs-xlv

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Free to use with attribution for data ETFIQ computes; issuer data stays under its owner's terms.