# XLV alternatives: 5 similar ETFs compared

> ETFs similar to XLV, closest first, with each fund's fee, what it tracks, and returns and worst drops on the same dates as XLV. Updated daily.

The ETFs most like XLV are VHT, USMV and VDC. VHT holds US drug makers, medical device makers and health insurers, like XLV.

Written by [the Tactfolio research team](https://tactfolio.com/about/editorial-policy). Fund facts checked October 17, 2026. Prices through October 16, 2026.

## Key points

- 5 funds can stand in for XLV: 1 of the same kind and 4 related funds.
- XLV charges 0.08% a year (about $8 on $10,000).
- VHT moved most like XLV: a daily correlation of 0.99 over about the last five years.
- Returns and drops for each pair use the same dates for both funds.

## 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.

| ETF | How close | Yearly fee | Fee on $10,000 | Tracks |
| --- | --- | --- | --- | --- |
| **XLV** | This fund | 0.08% | $8 | Health Care Select Sector Index |
| [VHT](https://tactfolio.com/etf/VHT.md) | Same kind of fund | 0.09% | $9 | MSCI US Investable Market Health Care 25/50 Index |
| [USMV](https://tactfolio.com/etf/USMV.md) | Related fund | 0.15% | $15 | MSCI USA Minimum Volatility Index |
| [VDC](https://tactfolio.com/etf/VDC.md) | Related fund | 0.09% | $9 | MSCI US Investable Market Consumer Staples 25/50 Index |
| [QUAL](https://tactfolio.com/etf/QUAL.md) | Related fund | 0.15% | $15 | MSCI USA Sector Neutral Quality Index |
| [XLP](https://tactfolio.com/etf/XLP.md) | Related fund | 0.08% | $8 | Consumer Staples Select Sector Index |

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.

| ETF | Moves with XLV | Per year | XLV per year | Worst drop | XLV worst drop | Since |
| --- | --- | --- | --- | --- | --- | --- |
| [VHT](https://tactfolio.com/etf/VHT.md) | 0.99 | 10.1% | 9.8% | −39.1% | −39.2% | January 2004 |
| [USMV](https://tactfolio.com/etf/USMV.md) | 0.78 | 11.7% | 13.9% | −33.1% | −28.4% | October 2011 |
| [VDC](https://tactfolio.com/etf/VDC.md) | 0.63 | 9.5% | 9.8% | −34.2% | −39.2% | January 2004 |
| [QUAL](https://tactfolio.com/etf/QUAL.md) | 0.63 | 13.6% | 11.8% | −34.1% | −28.4% | July 2013 |
| [XLP](https://tactfolio.com/etf/XLP.md) | 0.62 | 6.9% | 8.9% | −35.9% | −39.2% | December 1998 |

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](https://tactfolio.com/etf/VHT.md) 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](https://tactfolio.com/etf/USMV.md) 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](https://tactfolio.com/etf/VDC.md) 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](https://tactfolio.com/etf/QUAL.md) 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](https://tactfolio.com/etf/XLP.md) 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](https://tactfolio.com/etf/VHT.md), Vanguard Health Care ETF (same kind of fund, 0.09% a year)
- **iShares (BlackRock):** [USMV](https://tactfolio.com/etf/USMV.md), 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](https://www.irs.gov/publications/p550).

## 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](https://tactfolio.com/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](https://tactfolio.com/docs/backtests.md) for more on these measures.

## Research and test it

- [Sector rotation](https://tactfolio.com/learn/sector-rotation): Sector rotation explained: the 11 GICS sectors and their ETFs, business-cycle vs momentum rotation, and a classic rule with dated backtest figures.
- [S&P 500 index](https://tactfolio.com/learn/sp500-index): The S&P 500 tracks about 500 large US companies. Learn how stocks get in, how the index is weighted, how to invest in it, and how far it has fallen before.
- [What is an ETF](https://tactfolio.com/learn/what-is-an-etf): An ETF is a fund that trades like a stock. Learn how ETFs work, what they cost, the main types, and the risks, with SEC sources.
- [ETF screener](https://tactfolio.com/screener.md): A free ETF screener for 162 US-listed funds. Filter by type, issuer and fee, sort by returns or worst drop, and compare funds side by side.
- [ETF expense ratio](https://tactfolio.com/learn/etf-expense-ratio): What an ETF expense ratio is, how the fund charges it, and how 0.03% vs 1% adds up over 10 and 30 years, with real fund examples.
- [Backtest a portfolio](https://tactfolio.com/trading-tools/backtest-portfolio): Backtest a portfolio of US stocks and ETFs. Enter tickers and shares, pick when to rebalance, and get the results with a link to share.

## Common questions

### What ETF is most similar to XLV?

VHT is the closest. 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. Over about the last five years they moved almost exactly together.

### Is there a cheaper alternative to XLV?

Not among the funds here. XLV charges 0.08% a year, about $8 on $10,000, which is as low as or lower than each alternative listed.

### Is XLV or VHT better?

Neither is better for everyone. From January 2004 to October 2026, XLV returned about 9.8% a year and VHT returned about 10.1% a year. XLV charges 0.08% a year and VHT charges 0.09%. Past returns do not tell you what comes next.

### What if I had put $10,000 in XLV 10 years ago?

It would have grown to about $29,994 by October 16, 2026, with dividends reinvested. That is about 11.6% a year. Past returns do not tell you what comes next.

## Sources

- [SPDR (State Street): State Street Health Care Select Sector SPDR ETF fund page](https://www.ssga.com/us/en/intermediary/etfs/state-street-health-care-select-sector-spdr-etf-xlv)
- [Vanguard: Vanguard Health Care ETF fund page](https://investor.vanguard.com/investment-products/etfs/profile/vht)
- [iShares (BlackRock): iShares MSCI USA Min Vol Factor ETF fund page](https://www.ishares.com/us/products/239695/ishares-msci-usa-min-vol-factor-etf)
- [Vanguard: Vanguard Consumer Staples ETF fund page](https://investor.vanguard.com/investment-products/etfs/profile/vdc)
- [iShares (BlackRock): iShares MSCI USA Quality Factor ETF fund page](https://www.ishares.com/us/products/256101/ishares-msci-usa-quality-factor-etf)
- [SPDR (State Street): State Street Consumer Staples Select Sector SPDR ETF fund page](https://www.ssga.com/us/en/intermediary/etfs/state-street-consumer-staples-select-sector-spdr-etf-xlp)
- [IRS Publication 550: wash sales](https://www.irs.gov/publications/p550)

> Not financial advice. Tactfolio is a research and automation tool. It is not a broker or a financial adviser. This page is for education only. Backtests are hypothetical. They show how rules would have done on past prices, not how they will do. All investing involves risk, including losing the money you put in.