XLV alternatives and similar ETFs

XLV alternatives at a glance#

Each fund below can stand in for XLV, closest first. “Same kind” funds hold the same kind of stocks through a different index. “Related” funds make a different bet that often moves the same way.

Fees come from each fund company, checked on the dates shown on each fund’s page.

How XLV and its alternatives did over the same dates#

Each row measures the alternative and XLV on the days both traded, so neither gets a head start. Correlation shows how closely their daily moves matched over about the last five years. A value of 1 means they always moved together.

Prices through October 16, 2026. Figures use daily closing prices adjusted for splits, with dividends reinvested. They do not include taxes or the cost of buying and selling. Past results do not tell you what will happen next.

Each XLV alternative, compared#

VHT: Vanguard Health Care ETF#

VHT also holds US drug makers, medical device makers and health insurers. It tracks the MSCI US Investable Market Health Care 25/50 Index, while XLV tracks the Health Care Select Sector Index.

It charges 0.09% a year, about $9 on $10,000, against $8 for XLV. It held 412 stocks, against 61 for XLV.

From January 2004 to October 2026, VHT returned about 10.1% a year and XLV returned about 9.8% a year. Over about the last five years they moved almost exactly together (correlation 0.99).

Read the VHT fund page for its returns by year and worst drop.

USMV: iShares MSCI USA Min Vol Factor ETF#

USMV is a looser match. It holds US stocks picked by rules for steady profits or smaller price swings, while XLV holds US drug makers, medical device makers and health insurers.

It charges 0.15% a year, about $15 on $10,000, against $8 for XLV. It held 174 stocks, against 61 for XLV.

From October 2011 to October 2026, USMV returned about 11.7% a year and XLV returned about 13.9% a year. Over about the last five years they often moved together, but not always (correlation 0.78).

Read the USMV fund page for its returns by year and worst drop.

VDC: Vanguard Consumer Staples ETF#

VDC is a looser match. It holds US companies that sell things people buy in good times and bad, such as food and soap, while XLV holds US drug makers, medical device makers and health insurers.

It charges 0.09% a year, about $9 on $10,000, against $8 for XLV. It held 103 stocks, against 61 for XLV.

From January 2004 to October 2026, VDC returned about 9.5% a year and XLV returned about 9.8% a year. Over about the last five years they often moved together, but not always (correlation 0.63).

Read the VDC fund page for its returns by year and worst drop.

QUAL: iShares MSCI USA Quality Factor ETF#

QUAL is a looser match. It holds US stocks picked by rules for steady profits or smaller price swings, while XLV holds US drug makers, medical device makers and health insurers.

It charges 0.15% a year, about $15 on $10,000, against $8 for XLV. It held 118 stocks, against 61 for XLV.

From July 2013 to October 2026, QUAL returned about 13.6% a year and XLV returned about 11.8% a year. Over about the last five years they often moved together, but not always (correlation 0.63).

Read the QUAL fund page for its returns by year and worst drop.

XLP: State Street Consumer Staples Select Sector SPDR ETF#

XLP is a looser match. It holds US companies that sell things people buy in good times and bad, such as food and soap, while XLV holds US drug makers, medical device makers and health insurers.

It charges 0.08% a year, about $8 on $10,000, against $8 for XLV. It held 35 stocks, against 61 for XLV.

From December 1998 to October 2026, XLP returned about 6.9% a year and XLV returned about 8.9% a year. Over about the last five years they often moved together, but not always (correlation 0.62).

Read the XLP fund page for its returns by year and worst drop.

XLV versions from other fund companies#

Some people keep all their funds with one company. Here is the closest fund to XLV from each other company on this page:

• Vanguard: VHT, Vanguard Health Care ETF (same kind of fund, 0.09% a year)
• iShares (BlackRock): USMV, iShares MSCI USA Min Vol Factor ETF (related fund, 0.15% a year)

Most brokers let you buy any ETF, whoever runs it. Mutual fund versions, such as a fund company’s index mutual fund, are not listed here.

How to choose between XLV and its alternatives#

• What it tracks. A fund on the same index holds the same stocks. A different index can mean different weights, more or fewer holdings, or a different mix.
• The fee. The difference is often small. On $10,000, XLV costs about $8 a year.
• History. An older fund has been through more bad markets, so you can see how far it fell.
• What you already own. Two funds that move together add little variety. A fund with a low correlation behaves more on its own.

Swapping XLV to harvest a tax loss#

Some investors sell a fund at a loss to lower their taxes, then buy a similar fund so they stay invested. This is called tax-loss harvesting.

The IRS wash sale rule blocks the loss if you buy a “substantially identical” security within 30 days before or after the sale. The IRS has not said exactly when two funds count. Funds on the same index are more likely to. Funds on a different index, such as VHT, USMV or VDC, are less likely to.

Ask a tax professional before you rely on this. Read the IRS rules in Publication 550.

Test XLV and its alternatives in a backtest#

Tactfolio is a platform where you build rules-based investing strategies, backtest them on decades of real prices, share them, and run them automatically in your own Alpaca account. Open the builder, add XLV and VHT, and see how each would have done on the same dates, or how a mix of both would have done.

The details#

Alternatives are picked from facts, not from returns. First come funds that track the same index as XLV. Then come funds that hold the same kind of stocks through another index. Last come funds from a close category that make a different bet. Leveraged funds are only listed as alternatives to other leveraged funds.

Within each group, the funds whose daily returns moved most like XLV over about the last five years come first. Returns and worst drops use Tactfolio’s stored daily prices, adjusted for splits, with dividends reinvested. Each alternative is measured with XLV only on days both traded. Read what a backtest simulates for more on these measures.