Data as of Oct 28, 2026.
XLV vs XLVI: Differences, Returns & Fees
Over the year to Oct 28, 2026, XLV returned +25.6% to XLVI's +18.6%, and XLV charges 0.08% to XLVI's 0.35%.
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Net assets on Oct 27, 2026: $47.0bn for State Street Health Care Select Sector SPDR ETF and $33m for State Street Health Care Select Sector SPDR Premium Income ETF.
Pair scorecard
XLV costs 0.27 points a year less; their one-year returns differ by 7.0 points; XLV is far larger, $47.0bn against $33m.
| Measure | XLV | XLVI |
|---|---|---|
| Return | ||
| Total return, 1 year | +25.6% | +18.6% |
| Price change, 1 year | rose 23.6% | rose 4.5% |
| Latest payout, annualized | 13.8% | |
| Return of capital, issuer estimate | 71% of the Oct 5, 2026 payment | |
| Benchmark | ||
| What it tracks | Health Care Select Sector Index | Benchmark: Health care sector, measured through XLV |
| Cost and size | ||
| Expense ratio | 0.08% | 0.35% |
| Net assets, as of Oct 27, 2026 | $47.0bn | $33m |
| Holdings | ||
| Holdings in common | 0% | |
| In the S&P 500, by weight | 100% | |
| Top ten holdings, share of the fund | 60.6% | |
Holdings in common uses holdings dated Oct 27, 2026. Method
Risk and return
Aug 8, 2025 to Oct 23, 2026 · 63 weekly returnsXLV returned more: +40.7% to +30.5%. XLVI swung less: 10.9% to 16.8%. XLVI fell less at its worst: −8.1% to −10.2%.
Full scorecard
9 measures, with how each is measured Open ↓
| Measure | XLV | XLVI | Edge | How it is measured |
|---|---|---|---|---|
| Return | ||||
| Total return | +40.7% | +30.5% | XLV | Price change plus distributions, reinvested. |
| Annualized | +32.5% | +24.6% | XLV | Total return as a yearly rate. |
| Price return | +37.7% | +12.0% | XLV | Price change alone, distributions left out. |
| Risk | ||||
| Volatility | 16.8% | 10.9% | XLVI | Spread of weekly returns, annualized. Lower is steadier. |
| Downside deviation | 9.3% | 6.7% | XLVI | Like volatility, counting only weeks below the Treasury bill rate. |
| Max drawdown | −10.2% | −8.1% | XLVI | Deepest fall from a high to the low after it. |
| Risk-adjusted | ||||
| Sharpe | 1.54 | 1.72 | XLVI | Return above Treasury bills per unit of volatility. |
| Sortino | 2.76 | 2.80 | Tie | Return above Treasury bills per unit of downside deviation. |
| Calmar | 3.19 | 3.02 | XLV (slight) | Annualized return divided by the max drawdown. |
Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 63 weekly returns. Cash rate: the 13-week Treasury bill.
What they share
By the books each fund has filed, XLV and XLVI hold 0% of their money in the same securities at the same weight. Holdings dated Oct 27, 2026.
half
0% in common
Only in one fund ↓
Side by side
XLV and XLVI on the fields both publish, as of Oct 28, 2026. Source: ETFIQ. Cash paid: distributions over the window, as a share of the starting price.
XLV and XLVI do different jobs. What does each one do in a portfolio?
- What each follows. XLV follows Health Care Select Sector Index and XLVI is measured against Health care sector through XLV.
- Holdings in common. 0% of the weight is in the same securities (holdings dated Oct 27, 2026).
- One-year total return. Over 1 year to Oct 28, 2026 XLV returned +25.6% and XLVI +18.6% with distributions reinvested, a gap of 7.0 points.
Data as of Oct 28, 2026.
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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%.
XLVI
Over the year to Oct 28, 2026, XLVI paid 12.6% of its starting value in cash distributions while its price rose 4.5%. With every distribution reinvested, the fund returned +18.6%. Health care sector (XLV) returned +25.6% over the same days, so a holder was behind by 7.0 pts. At its price on Oct 28, 2026 the latest distribution annualizes to 13.8%, paid monthly. State Street estimates that 71% of the distribution paid Oct 5, 2026 was a return of capital (its 19a-1 notice). That is a tax label, not a measure of erosion.
Questions people ask
- Are XLV and XLVI in the same category?
- XLV is a stock ETF and XLVI is an option-income ETF, so they do different jobs. The table compares what both publish: return, cost and holdings.
- Which returned more over the last year, XLV or XLVI?
- In the year to Oct 28, 2026, with distributions reinvested, XLV returned +25.6% and XLVI +18.6%.
- Which is cheaper, XLV or XLVI?
- XLV is cheaper, by 0.27 percentage points a year. That is about $27 on $10,000 held for a year. Fees come from each fund's prospectus.
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.
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ETFIQ, XLV against XLVI, data as of Oct 28, 2026. https://etfiq.com/compare/any/xlv-vs-xlvi
ETFIQ. (Oct 28, 2026). XLV against XLVI. Retrieved from https://etfiq.com/compare/any/xlv-vs-xlvi
[XLV against XLVI (ETFIQ, Oct 28, 2026)](https://etfiq.com/compare/any/xlv-vs-xlvi)
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