XLVvsRSPHETF Comparison
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State Street Health Care Select Sector SPDR ETF (XLV) and Invesco S&P 500® Equal Weight Health Care ETF (RSPH) belong to the same industry segment: US Health Care. Both ETFs have the same top 2 sector exposures: Healthcare and Consumer Non-Cyclicals. XLV is less expensive with a Total Expense Ratio (TER) of 0.08%, versus 0.4% for RSPH. XLV is up 15.55% year-to-date (YTD) with +$934M in YTD flows. RSPH performs better with 22.43% YTD performance, and +$43M in YTD flows. Run a side-by-side ETF comparison of XLV and RSPH 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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XLV vs RSPH performance and flow charts
Performance
Cumulative Flows
Historic performance and flows
Data as of 10/16/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | XLV RSPH | +5.73%+5.63% | +9.60%+13.16% | +15.55%+22.43% | +26.19%+30.50% | +41.57%+45.76% | +50.78%+35.64% |
| Flows | XLV RSPH | +$312M+$44M | +$779M+$90M | +$934M+$43M | +$1.65B+$37M | -$3.95B-$249M | +$4.02B-$228M |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | XLV RSPH | +17.08%+18.96% | +16.12%+16.73% | +14.90%+15.93% | +15.22%+16.80% |
| Max drawdown | XLV RSPH | -5.81%-5.57% | -10.51%-10.87% | -17.05%-16.96% | -17.05%-21.91% |
| Max drawdown duration | XLV RSPH | 56d55d | 116d116d | 444d434d | 444d817d |
Trading data
XLV | RSPH | |
Last sale 10/19/2026 at 1:30 PM | $175.65 | $38.68 |
| Previous close 10/16/2026 | $176.71 | $38.79 |
| Consolidated volume 10/16/2026 | ||
| Average volume 30 days | ||
| Average discount or premium 30 days | ||
| Average Bid/Ask spread 30 days |
Replication quality
Data as of September 30, 2026
1-year trailing difference
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XLV | RSPH | |
|---|---|---|
| Tracking error | ||
| Tracking difference | ||
| 1 year cumulative return difference | ||
| Best | ||
| Worst | ||
| Daily return difference | ||
| Average | ||
| Worst | ||
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Main metrics
Last update 10/19/2026 at 1:30 PM
Live
Closed
XLV | RSPH | |
|---|---|---|
| Last price | $175.65 | $38.68 |
| 1D performance | -0.60% | -0.28% |
| AuM | $46.19 B | $942.18 M |
| E/R | 0.08% | 0.4% |
Characteristics
XLV | RSPH | |
|---|---|---|
| Management strategy | Passive | Passive |
| Provider | State Street Investment Management | Invesco |
| Benchmark | S&P Health Care Select Sector Index | S&P 500 Equal Weight Health Care Index |
| N° of holdings | 59 | 59 |
| Asset class | Equities | Equities |
| Trailing 12m distribution yield | Join | Join |
| Inception date | December 16, 1998 | November 1, 2006 |
| ESG | No | No |
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Exposure
Countries
XLV
USA
97.52%
Other
2.48%
RSPH
USA
96.79%
Other
3.21%
Sectors
XLV
Healthcare
97.84%
Other
2.16%
RSPH
Healthcare
98.64%
Other
1.36%
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Diversification
XLV
Total weight of top 15 holdings out of 15
71.32%
RSPH
Total weight of top 15 holdings out of 15
31.58%
Top 15 holdings
Data as of August 31, 2026
XLV
Eli Lilly & Co.
14.88%
Johnson & Johnson
10.41%
AbbVie, Inc.
7.37%
Merck & Co., Inc.
5.93%
UnitedHealth Group, Inc.
5.75%
Amgen, Inc.
3.77%
Thermo Fisher Scientific, Inc.
3.73%
Abbott Laboratories
3.13%
Gilead Sciences, Inc.
2.95%
Pfizer Inc.
2.64%
Vertex Pharmaceuticals, Inc.
2.25%
Bristol Myers Squibb Co.
2.22%
Danaher Corp.
2.19%
Intuitive Surgical, Inc.
2.17%
CVS Health Corp.
1.95%
RSPH
Moderna, Inc.
4.45%
Veeva Systems, Inc.
2.47%
Charles River Laboratories International, Inc.
2.28%
IQVIA Holdings, Inc.
2.07%
Bio-Techne Corp.
1.98%
Regeneron Pharmaceuticals, Inc.
1.92%
Thermo Fisher Scientific, Inc.
1.88%
Amgen, Inc.
1.85%
Revvity, Inc.
1.83%
Baxter International, Inc.
1.83%
Becton, Dickinson & Co.
1.82%
Vertex Pharmaceuticals, Inc.
1.80%
Merck & Co., Inc.
1.80%
Abbott Laboratories
1.79%
Labcorp Holdings, Inc.
1.79%
Frequently asked questions about XLV and RSPH
How have the XLV and RSPH ETFs performed in 2026?
As of October 16, 2026, XLV is up 15.55% year-to-date (YTD), while RSPH has returned 22.43%. That puts RSPH better performer ahead so far this year.
Which ETF is attracting more investor money: XLV or RSPH?
Year-to-date, the XLV ETF saw +$934M in flows, compared to +$43M for RSPH.
Which ETF is more volatile: XLV or RSPH?
Over the past year, XLV had a volatility of 16.12%, while RSPH experienced 16.73%.
Which ETF is bigger: XLV or RSPH?
As of October 16, 2026, XLV holds $46.19 B in assets under management (AUM), while RSPH manages $942.18 M.
What sectors do the XLV and RSPH ETFs invest in?
XLV leans toward sectors like Healthcare. Meanwhile, RSPH focuses on Healthcare.
What are the top holdings of the XLV ETF and RSPH ETF?
XLV top holdings include Eli Lilly & Co., Johnson & Johnson and AbbVie, Inc.. RSPH holds in its top three: Moderna, Inc., Veeva Systems, Inc. and Charles River Laboratories International, Inc..
Which ETF is more diversified: XLV or RSPH?
XLV holds 59 securities with 71.32% of its assets in the top 15. RSPH has 59 securities and a top 15 weight of 31.58%.
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