XLVvsTRUHETF Comparison
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State Street Health Care Select Sector SPDR ETF (XLV) belongs to the US Health Care segment. VanEck Healthcare TruSector ETF (TRUH) is part of the Uncategorized Equities segment. 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 0.1% for TRUH. Run a side-by-side ETF comparison of XLV and TRUH 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 TRUH performance and flow charts
Performance
Cumulative Flows
Historic performance and flows
Data as of 09/08/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | XLV TRUH | -0.80%-0.80% | +9.95%+9.90% | +8.89%n/a | +23.43%n/a | +33.03%n/a | +33.25%n/a |
| Flows | XLV TRUH | -$312M- | +$483M-$21K | +$566M- | +$1.74B- | -$5.28B- | +$1.93B- |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | XLV TRUH | +19.71%+19.67% | +16.28%n/a | +14.74%n/a | +15.20%n/a |
| Max drawdown | XLV TRUH | -4.84%-4.85% | -10.51%n/a | -17.05%n/a | -17.05%n/a |
| Max drawdown duration | XLV TRUH | 20d20d | 116dn/a | 444dn/a | 444dn/a |
Trading data
XLV | TRUH | |
Last sale 9/8/2026 at 1:30 PM | $167.13 | $29.14 |
| Previous close 09/08/2026 | $171.45 | $29.89 |
| Consolidated volume 09/08/2026 | ||
| Average volume 30 days | ||
| Average discount or premium 30 days | ||
| Average Bid/Ask spread 30 days |
Replication quality
Data as of August 31, 2026
1-year trailing difference
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TRUH
is actively managed and doesn’t replicate an indexXLV | TRUH | |
|---|---|---|
| Tracking error | ||
| Tracking difference | ||
| 1 year cumulative return difference | ||
| Best | ||
| Worst | ||
| Daily return difference | ||
| Average | ||
| Worst | ||
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Main metrics
Last update 9/8/2026 at 1:30 PM
Live
Closed
XLV | TRUH | |
|---|---|---|
| Last price | $167.13 | $29.14 |
| 1D performance | -2.52% | -2.51% |
| AuM | $43.35 B | $0.58 M |
| E/R | 0.08% | 0.1% |
Characteristics
XLV | TRUH | |
|---|---|---|
| Management strategy | Passive | Active |
| Provider | State Street Investment Management | VanEck |
| Benchmark | S&P Health Care Select Sector Index | - |
| N° of holdings | 59 | 59 |
| Asset class | Equities | - |
| Trailing 12m distribution yield | Join | Join |
| Inception date | December 16, 1998 | April 1, 2026 |
| ESG | No | No |
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Exposure
Countries
XLV
USA
97.53%
Other
2.47%
TRUH
USA
97.81%
Other
2.19%
Sectors
XLV
Healthcare
97.51%
Other
2.49%
TRUH
Healthcare
97.78%
Other
2.22%
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Diversification
XLV
Total weight of top 15 holdings out of 15
71.77%
TRUH
Total weight of top 15 holdings out of 15
72.03%
Top 15 holdings
Data as of July 31, 2026
XLV
Eli Lilly & Co.
15.48%
Johnson & Johnson
10.51%
AbbVie, Inc.
7.55%
UnitedHealth Group, Inc.
6.41%
Merck & Co., Inc.
5.48%
Thermo Fisher Scientific, Inc.
3.64%
Amgen, Inc.
3.54%
Abbott Laboratories
3.14%
Gilead Sciences, Inc.
2.75%
Pfizer Inc.
2.43%
Bristol Myers Squibb Co.
2.27%
CVS Health Corp.
2.27%
Intuitive Surgical, Inc.
2.13%
Danaher Corp.
2.09%
Vertex Pharmaceuticals, Inc.
2.06%
TRUH
Eli Lilly & Co.
15.53%
Johnson & Johnson
10.55%
AbbVie, Inc.
7.58%
UnitedHealth Group, Inc.
6.43%
Merck & Co., Inc.
5.50%
Thermo Fisher Scientific, Inc.
3.65%
Amgen, Inc.
3.53%
Abbott Laboratories
3.14%
Gilead Sciences, Inc.
2.77%
Pfizer Inc.
2.44%
CVS Health Corp.
2.28%
Bristol Myers Squibb Co.
2.28%
Intuitive Surgical, Inc.
2.16%
Danaher Corp.
2.11%
Vertex Pharmaceuticals, Inc.
2.08%
Frequently asked questions about XLV and TRUH
Which ETF is bigger: XLV or TRUH?
As of September 8, 2026, XLV holds $43.35 B in assets under management (AUM), while TRUH manages $0.58 M.
What sectors do the XLV and TRUH ETFs invest in?
XLV leans toward sectors like Healthcare. Meanwhile, TRUH focuses on Healthcare.
What are the top holdings of the XLV ETF and TRUH ETF?
XLV top holdings include Eli Lilly & Co., Johnson & Johnson and AbbVie, Inc.. TRUH holds in its top three: Eli Lilly & Co., Johnson & Johnson and AbbVie, Inc..
Which ETF is more diversified: XLV or TRUH?
XLV holds 59 securities with 71.77% of its assets in the top 15. TRUH has 59 securities and a top 15 weight of 72.03%.
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