XLVvsXLVIETF Comparison
VS
ETF 2
XLVI
State Street Health Care Select Sector SPDR Premium Income Fund
This fund is part of
Options Strategies
-0.07%
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 down -5.14% year-to-date (YTD) with +$1.14B in YTD flows. XLVI performs better with -2.45% YTD performance, and +$2M 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
Cumulative Flows
Historic performance and flows
Data as of 04/23/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | XLV XLVI | +1.01%+1.89% | -6.76%-4.12% | -5.14%-2.45% | +9.65%n/a | +13.83%n/a | +28.17%n/a |
| Flows | XLV XLVI | +$56M+$501K | -$417M+$2M | +$1.14B+$2M | +$1.11B- | -$4.42B- | +$7.08B- |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | XLV XLVI | +15.03%+12.91% | +15.78%n/a | +13.70%n/a | +14.57%n/a |
| Max drawdown | XLV XLVI | -10.19%-8.21% | -10.19%n/a | -17.05%n/a | -17.05%n/a |
| Max drawdown duration | XLV XLVI | 53d53d | 53dn/a | 444dn/a | 444dn/a |
Trading data
XLV | XLVI | |
Last sale 4/24/2026 at 1:30 PM | $144.18 | $24.64 |
| Previous close 04/23/2026 | $146.24 | $24.90 |
| Consolidated volume 04/23/2026 | ||
| 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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XLVI
is actively managed and doesn’t replicate an indexXLV | 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 4/24/2026 at 1:30 PM
Live
Closed
XLV | XLVI | |
|---|---|---|
| Last price | $144.18 | $24.64 |
| 1D performance | -1.41% | -1.02% |
| AuM | $38.57 B | $13.20 M |
| E/R | 0.08% | 0.35% |
Characteristics
XLV | XLVI | |
|---|---|---|
| Management strategy | Passive | Active |
| Provider | State Street Investment Management | State Street Investment Management |
| Benchmark | S&P Health Care Select Sector Index | - |
| N° of holdings | 56 | 56 |
| Asset class | Equities | - |
| Trailing 12m distribution yield | Join | Join |
| Inception date | December 16, 1998 | July 30, 2025 |
| ESG | No | No |
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Exposure
Countries
XLV
USA
97.26%
Other
2.74%
XLVI
USA
96.44%
Other
3.56%
Sectors
XLV
Health Care
98.29%
Other
1.71%
XLVI
Health Care
97.46%
Other
2.54%
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Diversification
XLV
Total weight of top 15 holdings out of 15
70.96%
XLVI
Total weight of top 15 holdings out of 15
70.36%
Top 15 holdings
Data as of March 31, 2026
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%
XLVI
LILLY
13.62%
JOHNSON&JOHNSON
11.01%
ABBVIE
7.19%
MERCK & CO INC
5.58%
UNITEDHEALTH GRP
4.58%
AMGEN-T
3.54%
THERMO FISHER SCIENTIFIC
3.45%
ABBOTT LABS
3.34%
GILEAD SCIENCES
3.23%
INTUITIVE SURGICAL
3.06%
PFIZER
2.98%
BRISTOL-MYERS SQUIBB
2.31%
DANAHER
2.23%
VERTEX PHARMACEUTICALS
2.12%
STRYKER
2.12%
Frequently asked questions about XLV and XLVI
How have the XLV and XLVI ETFs performed in 2026?
As of April 23, 2026, XLV is down -5.14% year-to-date (YTD), while XLVI has lost -2.45%. 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 +$1.14B in flows, compared to +$2M for XLVI.
Which ETF is bigger: XLV or XLVI?
As of April 23, 2026, XLV holds $38.57 B in assets under management (AUM), while XLVI manages $13.20 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 59 securities with 70.96% of its assets in the top 15. XLVI has 59 securities and a top 15 weight of 70.36%.
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