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XLVvsXLVIETF Comparison

ETF 1
XLV

State Street Health Care Select Sector SPDR ETF

This fund is part of
US Health Care
+1.38%
VS
ETF 2
XLVI

State Street Health Care Select Sector SPDR Premium Income Fund

This fund is part of
Options Strategies
-0.18%

State Street Health Care Select Sector SPDR ETF (XLV) belongs to the US Health Care segment. State Street Health Care Select Sector SPDR Premium Income Fund (XLVI) is part of the Options Strategies segment. Both ETFs have the same top 3 sector exposures: and Health Care. XLV is less expensive with a Total Expense Ratio (TER) of 0.08%, versus 0.35% for XLVI. XLV is up 0.3% year-to-date (YTD) with -$222M in YTD flows. XLVI performs better with 2.13% YTD performance, and +$4M in YTD flows. Run a side-by-side ETF comparison of XLV and XLVI 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 XLVI performance and flow charts

Performance

0.02.04.06.08.0%May 11May 18May 26Jun 2Jun 9

Cumulative Flows

-1,000 M-800 M-600 M-400 M-200 M0 M200 MMay 11May 18May 26Jun 2Jun 9

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Historic performance and flows
Data as of 06/09/2026
1M3MYTD1Y3Y5Y
Perf.
XLV
XLVI
+8.11%+6.44%
+0.61%+1.06%
+0.30%+2.13%
+17.25%n/a
+24.75%n/a
+35.83%n/a
Flows
XLV
XLVI
-$664M+$2M
-$1.40B+$2M
-$222M+$4M
-$239M-
-$7.31B-
+$4.81B-
Volatility and drawdown
3M1Y3Y5Y
Volatility
XLV
XLVI
+16.20%+13.59%
+14.99%n/a
+13.96%n/a
+14.73%n/a
Max drawdown
XLV
XLVI
-7.08%-6.06%
-10.51%n/a
-17.05%n/a
-17.05%n/a
Max drawdown duration
XLV
XLVI
91d86d
100dn/a
444dn/a
444dn/a
Trading data

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XLV
XLVI
Last sale
6/10/2026 at 7:41 PM
$152.89
$25.53
Previous close
06/09/2026
$154.57
$25.60
Consolidated volume
06/09/2026
Average volume
30 days
Average discount or premium
30 days
Average Bid/Ask spread
30 days
Replication quality
Data as of May 29, 2026
1-year trailing difference

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XLVI
is actively managed and doesn’t replicate an index

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XLV
XLVI
Tracking error
Tracking difference
1 year cumulative return difference
Best
Worst
Daily return difference
Average
Worst
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Main metrics
Last update 6/10/2026 at 7:41 PM
Live
Closed
XLV
XLVI
Last price
$152.89
$25.53
1D performance
-1.09%
-0.27%
AuM$39.34 B$14.84 M
E/R0.08%0.35%
Characteristics
XLV
XLVI
Management strategyPassiveActive
ProviderState Street Investment ManagementState Street Investment Management
BenchmarkS&P Health Care Select Sector Index-
N° of holdings5555
Asset classEquities-
Trailing 12m distribution yield
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Inception dateDecember 16, 1998July 30, 2025
ESGNoNo
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Exposure

Countries

XLV
USA
97.39%
Other
2.61%
XLVI
USA
96.67%
Other
3.33%

Sectors

XLV
Health Care
98.41%
Other
1.59%
XLVI
Health Care
97.69%
Other
2.31%
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Diversification

XLV

Total weight of top 15 holdings out of 15

70.92%
XLVI

Total weight of top 15 holdings out of 15

70.39%

Top 15 holdings

Data as of April 30, 2026
XLV
LILLY
14.09%
JOHNSON&JOHNSON
10.54%
ABBVIE
7.10%
UNITEDHEALTH GRP
6.38%
MERCK & CO INC
5.15%
AMGEN-T
3.55%
THERMO FISHER SCIENTIFIC
3.42%
INTUITIVE SURGICAL
3.09%
GILEAD SCIENCES
3.09%
ABBOTT LABS
3.00%
PFIZER
2.89%
BRISTOL-MYERS SQUIBB
2.35%
DANAHER
2.14%
VERTEX PHARMACEUTICALS
2.06%
STRYKER
2.06%
XLVI
LILLY
13.98%
JOHNSON&JOHNSON
10.46%
ABBVIE
7.05%
UNITEDHEALTH GRP
6.34%
MERCK & CO INC
5.12%
AMGEN-T
3.52%
THERMO FISHER SCIENTIFIC
3.40%
INTUITIVE SURGICAL
3.07%
GILEAD SCIENCES
3.06%
ABBOTT LABS
2.98%
PFIZER
2.87%
BRISTOL-MYERS SQUIBB
2.33%
DANAHER
2.13%
VERTEX PHARMACEUTICALS
2.05%
STRYKER
2.05%
Frequently asked questions about XLV and XLVI

How have the XLV and XLVI ETFs performed in 2026?

As of June 9, 2026, XLV is up 0.3% year-to-date (YTD), while XLVI has returned 2.13%. That puts XLVI better performer ahead so far this year.

Which ETF is attracting more investor money: XLV or XLVI?

Year-to-date, the XLV ETF saw -$222M in flows, compared to +$4M for XLVI.

Which ETF is bigger: XLV or XLVI?

As of June 9, 2026, XLV holds $39.34 B in assets under management (AUM), while XLVI manages $14.84 M.

What sectors do the XLV and XLVI ETFs invest in?

XLV leans toward sectors like Health Care. Meanwhile, XLVI focuses on Health Care.

What are the top holdings of the XLV ETF and XLVI ETF?

XLV top holdings include LILLY, JOHNSON&JOHNSON and ABBVIE. XLVI holds in its top three: LILLY, JOHNSON&JOHNSON and ABBVIE.

Which ETF is more diversified: XLV or XLVI?

XLV holds 58 securities with 70.92% of its assets in the top 15. XLVI has 58 securities and a top 15 weight of 70.39%.

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