First Trust Health Care AlphaDEX Fund (FXH) belongs to the Health & Biotech Equities category. Below you'll find alternative ETFs from the same category, ranked by key criteria, plus funds that investors commonly compare with FXH. Use the tables to find lower-cost options, better risk-adjusted returns, or a closer substitute for your current allocation.
Cheapest Alternatives to FXH
FXH charges 0.61% annually. There are 42 ETFs in the Health & Biotech Equities category with lower expense ratios, going as low as 0.08%.
| Symbol | Name | Expense Ratio | AUM | Inception | |
|---|---|---|---|---|---|
| Fidelity MSCI Health Care Index ETF | 0.08% | 3.22B | Oct 2013 | FXH vs FHLC | |
| State Street Health Care Select Sector SPDR ETF | 0.08% | 42.10B | Dec 1998 | FXH vs XLV | |
| Vanguard Health Care ETF | 0.09% | 20.40B | Jan 2004 | FXH vs VHT | |
| VanEck Healthcare TruSector ETF | 0.10% | 850.50K | Apr 2026 | FXH vs TRUH | |
| Portfolio Building Block World Pharma and Biotech ... | 0.13% | 933.15M | Nov 2025 | FXH vs PBPH |
Best Risk-Adjusted Alternatives to FXH
FXH has a PortfoliosLab risk / return rank of 74. There are 25 ETFs in the Health & Biotech Equities category with higher risk-adjusted ranks, going as high as 96.
| Symbol | Name | Risk / Return Rank | AUM | Inception | |
|---|---|---|---|---|---|
| Virtus LifeSci Biotech Clinical Trials ETF | 96 | 47.80M | Dec 2014 | FXH vs BBC | |
| iShares U.S. Pharmaceuticals ETF | 95 | 1.65B | May 2006 | FXH vs IHE | |
| First Trust Nasdaq Pharmaceuticals ETF | 95 | 911.09M | Sep 2016 | FXH vs FTXH | |
| ALPS Medical Breakthroughs ETF | 95 | 201.57M | Dec 2014 | FXH vs SBIO | |
| Invesco Dynamic Pharmaceuticals ETF | 94 | 472.10M | Jun 2005 | FXH vs PJP |
Top Performing FXH Alternatives (YTD)
FXH is at 12.75% YTD. There are 25 ETFs in the Health & Biotech Equities category with higher YTD returns, going as high as 36.76%.
| Symbol | Name | YTD Return | AUM | Inception | |
|---|---|---|---|---|---|
| ARK Genomic Revolution Multi-Sector ETF | 36.76% | 1.73B | Oct 2014 | FXH vs ARKG | |
| AdvisorShares Psychedelics ETF | 36.69% | 48.53M | Sep 2021 | FXH vs PSIL | |
| Roundhill UNH WeeklyPay ETF | 28.89% | 7.27M | Dec 2025 | FXH vs UNHW | |
| Virtus LifeSci Biotech Clinical Trials ETF | 27.03% | 47.80M | Dec 2014 | FXH vs BBC | |
| SPDR S&P Health Care Services ETF | 25.67% | 206.72M | Sep 2011 | FXH vs XHS |
Lowest Volatility Alternatives to FXH
FXH has 16.25% 1-year volatility. There are 15 ETFs in the Health & Biotech Equities category with lower 1-year volatility, going as low as 0.00%.
| Symbol | Name | Volatility 1Y | AUM | Inception | |
|---|---|---|---|---|---|
| Loncar Cancer Immunotherapy ETF | 0.00% | 12.73M | Oct 2015 | FXH vs CNCR | |
| Amplify Treatments, Testing and Advancements ETF | 0.00% | 9.68M | Jun 2020 | FXH vs GERM | |
| Horizon Kinetics SPAC Active ETF | 8.66% | 10.09M | Jun 2007 | FXH vs SPAQ | |
| State Street Health Care Select Sector SPDR Premiu... | 10.75% | 21.55M | Jul 2025 | FXH vs XLVI | |
| Milliman Healthcare Inflation Plus ETF | 10.92% | 982.35K | Apr 2026 | FXH vs MHIP |
Lowest Drawdown Alternatives to FXH
FXH has a 1-year max drawdown of -12.20%. There are 33 ETFs in the Health & Biotech Equities category with shallower 1-year drawdowns, going as shallow as 0.00%.
| Symbol | Name | Max Drawdown 1Y | AUM | Inception | |
|---|---|---|---|---|---|
| Amplify Treatments, Testing and Advancements ETF | 0.00% | 9.68M | Jun 2020 | FXH vs GERM | |
| Horizon Kinetics SPAC Active ETF | -4.20% | 10.09M | Jun 2007 | FXH vs SPAQ | |
| First Trust Nasdaq Pharmaceuticals ETF | -7.47% | 911.09M | Sep 2016 | FXH vs FTXH | |
| State Street Health Care Select Sector SPDR Premiu... | -8.14% | 21.55M | Jul 2025 | FXH vs XLVI | |
| Invesco Nasdaq Biotechnology ETF | -8.34% | 75.06M | Jun 2021 | FXH vs IBBQ |
Other ETFs from First Trust
The 10 most viewed First Trust ETFs shown here include CIBR, GRID, AIRR and span 16 categories. AUM among these funds goes as high as $25B.
Often Compared With FXH
Investors most often compare FXH with IHF, FBT, MDEV. These 20 comparison targets span 10 categories, based on PortfoliosLab usage data.
Compare FXH with Any Fund or Stock
Compare FXH with any ETF, mutual fund, or stock using PortfoliosLab's comparison tool.
Pair FXH with funds that move differently
First Trust Health Care AlphaDEX Fund alternatives help with substitution. Diversifiers are the next step when you want funds with lower historical correlation to FXH.
Explore FXH Diversifiers