RSPHvsXLVETF Comparison
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Invesco S&P 500® Equal Weight Health Care ETF (RSPH) and State Street Health Care Select Sector SPDR ETF (XLV) belong to the same industry segment: US Health Care. Both ETFs have the same top 3 sector exposures: and Health Care. RSPH is more expensive with a Total Expense Ratio (TER) of 0.4%, versus 0.08% for XLV. RSPH is down -3.91% year-to-date (YTD) with -$24M in YTD flows. XLV performs worse with -6.44% YTD performance, and +$1.23B in YTD flows. Run a side-by-side ETF comparison of RSPH 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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RSPH vs XLV performance and flow charts
Performance
Cumulative Flows
Historic performance and flows
Data as of 04/24/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | RSPH XLV | +1.26%-0.41% | -7.61%-8.42% | -3.91%-6.44% | +8.85%+6.83% | +3.16%+12.26% | +10.64%+26.85% |
| Flows | RSPH XLV | -$11M-$74M | -$24M-$228M | -$24M+$1.23B | -$107M+$1.16B | -$335M-$4.33B | -$180M+$7.32B |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | RSPH XLV | +15.94%+15.20% | +16.25%+15.80% | +14.83%+13.72% | +16.23%+14.58% |
| Max drawdown | RSPH XLV | -10.87%-10.19% | -10.87%-10.19% | -17.06%-17.05% | -21.91%-17.05% |
| Max drawdown duration | RSPH XLV | 54d54d | 54d54d | 192d444d | 817d444d |
Trading data
RSPH | XLV | |
Last sale 4/27/2026 at 1:30 PM | $30.57 | $143.46 |
| Previous close 04/24/2026 | $30.54 | $144.18 |
| Consolidated volume 04/24/2026 | ||
| Average volume 30 days | ||
| Average discount or premium 30 days | ||
| Average Bid/Ask spread 30 days |
Replication quality
Data as of March 31, 2026
1-year trailing difference
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RSPH | 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 4/27/2026 at 1:30 PM
Live
Closed
RSPH | XLV | |
|---|---|---|
| Last price | $30.57 | $143.46 |
| 1D performance | +0.10% | -0.50% |
| AuM | $697.68 M | $38.13 B |
| E/R | 0.4% | 0.08% |
Characteristics
RSPH | XLV | |
|---|---|---|
| Management strategy | Passive | Passive |
| Provider | Invesco | State Street Investment Management |
| Benchmark | S&P 500 Equal Weight Health Care Index | S&P Health Care Select Sector Index |
| N° of holdings | 56 | 56 |
| Asset class | Equities | Equities |
| Trailing 12m distribution yield | Join | Join |
| Inception date | November 1, 2006 | December 16, 1998 |
| ESG | No | No |
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Exposure
Countries
RSPH
USA
96.48%
Other
3.52%
XLV
USA
97.26%
Other
2.74%
Sectors
RSPH
Health Care
93.2%
Other
6.8%
XLV
Health Care
98.29%
Other
1.71%
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Diversification
RSPH
Total weight of top 15 holdings out of 15
26.72%
XLV
Total weight of top 15 holdings out of 15
70.96%
Top 15 holdings
Data as of March 31, 2026
RSPH
MERCK & CO INC
1.84%
WEST PHARM SVCS
1.83%
CIGNA
1.80%
HOLOGIC
1.79%
METTLER TOLEDO
1.79%
DAVITA INC
1.78%
BOSTON SCIENTIFIC
1.78%
PFIZER
1.77%
STERIS
1.77%
JOHNSON&JOHNSON
1.77%
HUMANA
1.77%
ELEVANCE HEALTH INC
1.77%
UNIVERSAL HEALTH SERVICES
1.77%
MEDTRONIC PLC
1.75%
US5049221055
1.75%
XLV
LILLY
13.74%
JOHNSON&JOHNSON
11.10%
ABBVIE
7.25%
MERCK & CO INC
5.63%
UNITEDHEALTH GRP
4.62%
AMGEN-T
3.57%
THERMO FISHER SCIENTIFIC
3.48%
ABBOTT LABS
3.37%
GILEAD SCIENCES
3.26%
INTUITIVE SURGICAL
3.09%
PFIZER
3.01%
BRISTOL-MYERS SQUIBB
2.33%
DANAHER
2.25%
VERTEX PHARMACEUTICALS
2.14%
STRYKER
2.13%
Frequently asked questions about RSPH and XLV
How have the RSPH and XLV ETFs performed in 2026?
As of April 24, 2026, RSPH is down -3.91% year-to-date (YTD), while XLV has lost -6.44%. That puts RSPH better performer ahead so far this year.
Which ETF is attracting more investor money: RSPH or XLV?
Year-to-date, the RSPH ETF saw -$24M in flows, compared to +$1.23B for XLV.
Which ETF is more volatile: RSPH or XLV?
Over the past year, RSPH had a volatility of 16.25%, while XLV experienced 15.8%.
Which ETF is bigger: RSPH or XLV?
As of April 24, 2026, RSPH holds $697.68 M in assets under management (AUM), while XLV manages $38.13 B.
What sectors do the RSPH and XLV ETFs invest in?
RSPH leans toward sectors like Health Care. Meanwhile, XLV focuses on Health Care.
What are the top holdings of the RSPH ETF and XLV ETF?
RSPH top holdings include MERCK & CO INC, WEST PHARM SVCS and CIGNA. XLV holds in its top three: LILLY, JOHNSON&JOHNSON and ABBVIE.
Which ETF is more diversified: RSPH or XLV?
RSPH holds 59 securities with 26.72% of its assets in the top 15. XLV has 59 securities and a top 15 weight of 70.96%.
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