VanEck Healthcare TruSector ETF (TRUH) 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 TRUH. Use the tables to find lower-cost options, better risk-adjusted returns, or a closer substitute for your current allocation.
Cheapest Alternatives to TRUH
Among 63 ETFs in the Health & Biotech Equities category with expense-ratio data, the lowest-cost alternatives shown here go as low as 0.08%.
| Symbol | Name | Expense Ratio | AUM | Inception | |
|---|---|---|---|---|---|
| State Street Health Care Select Sector SPDR ETF | 0.08% | 39.60B | Dec 1998 | TRUH vs XLV | |
| Fidelity MSCI Health Care Index ETF | 0.08% | 2.99B | Oct 2013 | TRUH vs FHLC | |
| Vanguard Health Care ETF | 0.09% | 19.00B | Jan 2004 | TRUH vs VHT | |
| Portfolio Building Block World Pharma and Biotech ... | 0.13% | 9.98M | Nov 2025 | TRUH vs PBPH | |
| GSK plc ADRhedged ETF | 0.19% | 793.18K | Jan 2025 | TRUH vs GSKH |
Best Risk-Adjusted Alternatives to TRUH
Among 56 ETFs in the Health & Biotech Equities category with risk / return rank data, the top risk-adjusted alternatives shown here go as high as 97.
| Symbol | Name | Risk / Return Rank | AUM | Inception | |
|---|---|---|---|---|---|
| Virtus LifeSci Biotech Clinical Trials ETF | 97 | 47.07M | Dec 2014 | TRUH vs BBC | |
| ALPS Medical Breakthroughs ETF | 95 | 184.61M | Dec 2014 | TRUH vs SBIO | |
| SPDR S&P Biotech ETF | 95 | 10.25B | Feb 2006 | TRUH vs XBI | |
| iShares U.S. Pharmaceuticals ETF | 94 | 1.11B | May 2006 | TRUH vs IHE | |
| iShares Neuroscience and Healthcare ETF | 94 | 5.75M | Aug 2022 | TRUH vs IBRN |
Top Performing TRUH Alternatives (YTD)
Among 63 ETFs in the Health & Biotech Equities category with YTD return data, the top-performing alternatives shown here go as high as 46.22%.
| Symbol | Name | YTD Return | AUM | Inception | |
|---|---|---|---|---|---|
| ARK Genomic Revolution Multi-Sector ETF | 46.22% | 1.31B | Oct 2014 | TRUH vs ARKG | |
| AdvisorShares Psychedelics ETF | 43.74% | 41.44M | Sep 2021 | TRUH vs PSIL | |
| Virtus LifeSci Biotech Clinical Trials ETF | 36.28% | 47.07M | Dec 2014 | TRUH vs BBC | |
| Roundhill UNH WeeklyPay ETF | 30.73% | 5.60M | Dec 2025 | TRUH vs UNHW | |
| SPDR S&P Biotech ETF | 29.96% | 10.25B | Feb 2006 | TRUH vs XBI |
Lowest Volatility Alternatives to TRUH
TRUH has 16.87% 1-year volatility. There are 18 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 | TRUH vs CNCR | |
| Amplify Treatments, Testing and Advancements ETF | 0.00% | 9.68M | Jun 2020 | TRUH vs GERM | |
| Horizon Kinetics SPAC Active ETF | 8.57% | 10.09M | Jun 2007 | TRUH vs SPAQ | |
| State Street Health Care Select Sector SPDR Premiu... | 11.06% | 15.88M | Jul 2025 | TRUH vs XLVI | |
| Global X Aging Population ETF | 13.71% | 85.09M | May 2016 | TRUH vs AGNG |
Lowest Drawdown Alternatives to TRUH
Among 57 ETFs in the Health & Biotech Equities category with 1-year drawdown data, the lowest-drawdown alternatives shown here go as shallow as 0.00%.
| Symbol | Name | Max Drawdown 1Y | AUM | Inception | |
|---|---|---|---|---|---|
| Amplify Treatments, Testing and Advancements ETF | 0.00% | 9.68M | Jun 2020 | TRUH vs GERM | |
| Horizon Kinetics SPAC Active ETF | -4.60% | 10.09M | Jun 2007 | TRUH vs SPAQ | |
| First Trust Nasdaq Pharmaceuticals ETF | -7.47% | 36.32M | Sep 2016 | TRUH vs FTXH | |
| Invesco Nasdaq Biotechnology ETF | -8.34% | 71.84M | Jun 2021 | TRUH vs IBBQ | |
| iShares U.S. Pharmaceuticals ETF | -8.47% | 1.11B | May 2006 | TRUH vs IHE |
Other ETFs from VanEck
The 10 most viewed VanEck ETFs shown here include SMH, GDX, NLR and span 12 categories. AUM among these funds goes as high as $71B.
| Symbol | Name | Category | Risk / Return Rank | YTD Return | AUM | Inception | |
|---|---|---|---|---|---|---|---|
| VanEck Semiconductor ETF | Semiconductors, Technology Equities | 95 | 75.49% | 70.88B | Dec 2011 | TRUH vs SMH | |
| VanEck Gold Miners ETF | Gold, Precious Metals | 30 | -11.76% | 23.08B | May 2006 | TRUH vs GDX | |
| VanEck Uranium and Nuclear ETF | Uranium, Alternative Energy Equities | 12 | -5.84% | 4.24B | Aug 2007 | TRUH vs NLR | |
| VanEck Junior Gold Miners ETF | Gold, Precious Metals | 30 | -13.06% | 7.16B | Nov 2009 | TRUH vs GDXJ | |
| VanEck Morningstar Wide Moat ETF | Large Cap Blend Equities | 24 | 0.14% | 11.57B | Apr 2012 | TRUH vs MOAT | |
| VanEck Fabless Semiconductor ETF | Semiconductors, Technology Equities | 86 | 62.50% | 278.14M | Aug 2024 | TRUH vs SMHX | |
| VanEck Rare Earth and Strategic Metals ETF | Rare Earth & Strategic Metals | 77 | 16.86% | 2.65B | Oct 2010 | TRUH vs REMX | |
| VanEck BDC Income ETF | Financials Equities | 5 | -7.15% | 1.59B | Feb 2013 | TRUH vs BIZD | |
| VanEck Bitcoin Trust | Cryptocurrency | 2 | -30.97% | 967.50M | Jan 2024 | TRUH vs HODL | |
| VanEck IG Floating Rate ETF | Corporate Bonds, Ultrashort Bond | 99 | 2.27% | 2.83B | Apr 2011 | TRUH vs FLTR |
Compare TRUH with Any Fund or Stock
Compare TRUH with any ETF, mutual fund, or stock using PortfoliosLab's comparison tool.
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Pair TRUH with funds that move differently
VanEck Healthcare TruSector ETF alternatives help with substitution. Diversifiers are the next step when you want funds with lower historical correlation to TRUH.
Explore TRUH Diversifiers