FXHvsXLVETF Comparison
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First Trust Health Care AlphaDEX Fund ETF (FXH) and State Street Health Care Select Sector SPDR ETF (XLV) belong to the same industry segment: US Health Care. FXH's top 1 sector exposures are Healthcare. In contrast, XLV's top sector exposures are Healthcare and Consumer Non-Cyclicals. FXH is more expensive with a Total Expense Ratio (TER) of 0.61%, versus 0.08% for XLV. FXH is up 13.36% year-to-date (YTD) with +$32M in YTD flows. XLV performs worse with 5.57% YTD performance, and +$419M in YTD flows. Run a side-by-side ETF comparison of FXH and XLV below, and assess how they stack up in performance, liquidity, risk, exposure, holdings, and more, helping you select the best ETF for your investments.
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FXH vs XLV performance and flow charts
Performance
Cumulative Flows
Historic performance and flows
Data as of 08/04/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | FXH XLV | +2.38%+0.02% | +14.38%+12.42% | +13.36%+5.57% | +29.25%+23.92% | +24.97%+28.71% | +5.83%+31.47% |
| Flows | FXH XLV | +$57M+$190M | +$88M-$272M | +$32M+$419M | +$1M+$2.05B | -$594M-$4.88B | -$464M+$2.37B |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | FXH XLV | +15.84%+18.49% | +15.82%+15.60% | +15.52%+14.42% | +16.88%+15.01% |
| Max drawdown | FXH XLV | -3.81%-3.83% | -12.07%-10.51% | -17.66%-17.05% | -29.40%-17.05% |
| Max drawdown duration | FXH XLV | 20d20d | 168d116d | 395d444d | 1759d444d |
Trading data
FXH | XLV | |
Last sale 8/5/2026 at 1:30 PM | $128.30 | $164.15 |
| Previous close 08/04/2026 | $128.40 | $162.10 |
| Consolidated volume 08/04/2026 | ||
| Average volume 30 days | ||
| Average discount or premium 30 days | ||
| Average Bid/Ask spread 30 days |
Replication quality
Data as of July 31, 2026
1-year trailing difference
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FXH | XLV | |
|---|---|---|
| Tracking error | ||
| Tracking difference | ||
| 1 year cumulative return difference | ||
| Best | ||
| Worst | ||
| Daily return difference | ||
| Average | ||
| Worst | ||
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Main metrics
Last update 8/5/2026 at 1:30 PM
Live
Closed
FXH | XLV | |
|---|---|---|
| Last price | $128.30 | $164.15 |
| 1D performance | -0.08% | +1.26% |
| AuM | $1.09 B | $41.87 B |
| E/R | 0.61% | 0.08% |
Characteristics
FXH | XLV | |
|---|---|---|
| Management strategy | Passive | Passive |
| Provider | First Trust | State Street Investment Management |
| Benchmark | StrataQuant Health Care Index | S&P Health Care Select Sector Index |
| N° of holdings | 75 | 59 |
| Asset class | Equities | Equities |
| Trailing 12m distribution yield | Join | Join |
| Inception date | May 8, 2007 | December 16, 1998 |
| ESG | No | No |
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Exposure
Countries
FXH
USA
96.02%
Other
3.98%
XLV
USA
97.92%
Other
2.08%
Sectors
FXH
Healthcare
99.85%
Other
0.15%
XLV
Healthcare
97.73%
Other
2.27%
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Diversification
FXH
Total weight of top 15 holdings out of 15
38.89%
XLV
Total weight of top 15 holdings out of 15
72.82%
Top 15 holdings
Data as of June 30, 2026
FXH
Humana, Inc.
4.74%
Organon & Co.
3.63%
DaVita, Inc.
2.98%
Elevance Health, Inc.
2.86%
Molina Healthcare, Inc.
2.80%
Exelixis, Inc.
2.53%
Incyte Corp.
2.43%
Solventum Corp.
2.41%
Biogen, Inc.
2.30%
Cardinal Health, Inc.
2.26%
Bio-Rad Laboratories, Inc.
2.14%
The Cigna Group
2.09%
Chemed Corp.
2.05%
Zimmer Biomet Holdings, Inc.
1.87%
Illumina, Inc.
1.80%
XLV
Eli Lilly & Co.
16.57%
Johnson & Johnson
10.68%
AbbVie, Inc.
7.76%
UnitedHealth Group, Inc.
6.59%
Merck & Co., Inc.
5.54%
Amgen, Inc.
3.41%
Thermo Fisher Scientific, Inc.
3.25%
Abbott Laboratories
2.76%
Gilead Sciences, Inc.
2.74%
Intuitive Surgical, Inc.
2.46%
Pfizer Inc.
2.40%
CVS Health Corp.
2.31%
Vertex Pharmaceuticals, Inc.
2.20%
Danaher Corp.
2.10%
Bristol Myers Squibb Co.
2.05%
Frequently asked questions about FXH and XLV
How have the FXH and XLV ETFs performed in 2026?
As of August 4, 2026, FXH is up 13.36% year-to-date (YTD), while XLV has returned 5.57%. That puts FXH better performer ahead so far this year.
Which ETF is attracting more investor money: FXH or XLV?
Year-to-date, the FXH ETF saw +$32M in flows, compared to +$419M for XLV.
Which ETF is more volatile: FXH or XLV?
Over the past year, FXH had a volatility of 15.82%, while XLV experienced 15.6%.
Which ETF is bigger: FXH or XLV?
As of August 4, 2026, FXH holds $1.09 B in assets under management (AUM), while XLV manages $41.87 B.
What sectors do the FXH and XLV ETFs invest in?
FXH leans toward sectors like Healthcare. Meanwhile, XLV focuses on Healthcare.
What are the top holdings of the FXH ETF and XLV ETF?
FXH top holdings include Humana, Inc., Organon & Co. and DaVita, Inc.. XLV holds in its top three: Eli Lilly & Co., Johnson & Johnson and AbbVie, Inc..
Which ETF is more diversified: FXH or XLV?
FXH holds 75 securities with 38.89% of its assets in the top 15. XLV has 59 securities and a top 15 weight of 72.82%.
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