SPDR S&P Health Care Services ETF (XHS) 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 XHS. Use the tables to find lower-cost options, better risk-adjusted returns, or a closer substitute for your current allocation.
Cheapest Alternatives to XHS
XHS charges 0.35% annually. There are 7 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 | XHS vs FHLC | |
| State Street Health Care Select Sector SPDR ETF | 0.08% | 41.65B | Dec 1998 | XHS vs XLV | |
| Vanguard Health Care ETF | 0.09% | 19.00B | Jan 2004 | XHS vs VHT | |
| Portfolio Building Block World Pharma and Biotech ... | 0.13% | 951.16M | Nov 2025 | XHS vs PBPH | |
| Invesco Nasdaq Biotechnology ETF | 0.19% | 74.65M | Jun 2021 | XHS vs IBBQ |
Best Risk-Adjusted Alternatives to XHS
XHS has a PortfoliosLab risk / return rank of 84. There are 14 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 | 57.56M | Dec 2014 | XHS vs BBC | |
| ALPS Medical Breakthroughs ETF | 95 | 213.08M | Dec 2014 | XHS vs SBIO | |
| SPDR S&P Biotech ETF | 94 | 11.10B | Feb 2006 | XHS vs XBI | |
| iShares U.S. Pharmaceuticals ETF | 93 | 1.34B | May 2006 | XHS vs IHE | |
| iShares Neuroscience and Healthcare ETF | 92 | 5.85M | Aug 2022 | XHS vs IBRN |
Top Performing XHS Alternatives (YTD)
XHS is at 25.69% YTD. There are 7 ETFs in the Health & Biotech Equities category with higher YTD returns, going as high as 41.70%.
| Symbol | Name | YTD Return | AUM | Inception | |
|---|---|---|---|---|---|
| ARK Genomic Revolution Multi-Sector ETF | 41.70% | 1.31B | Oct 2014 | XHS vs ARKG | |
| AdvisorShares Psychedelics ETF | 38.20% | 44.37M | Sep 2021 | XHS vs PSIL | |
| Virtus LifeSci Biotech Clinical Trials ETF | 33.75% | 57.56M | Dec 2014 | XHS vs BBC | |
| Roundhill UNH WeeklyPay ETF | 32.80% | 6.01M | Dec 2025 | XHS vs UNHW | |
| SPDR S&P Biotech ETF | 27.62% | 11.10B | Feb 2006 | XHS vs XBI |
Lowest Volatility Alternatives to XHS
XHS has 18.04% 1-year volatility. There are 23 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 | XHS vs CNCR | |
| Amplify Treatments, Testing and Advancements ETF | 0.00% | 9.68M | Jun 2020 | XHS vs GERM | |
| Horizon Kinetics SPAC Active ETF | 8.63% | 10.11M | Jun 2007 | XHS vs SPAQ | |
| State Street Health Care Select Sector SPDR Premiu... | 10.96% | 16.78M | Jul 2025 | XHS vs XLVI | |
| Milliman Healthcare Inflation Plus ETF | 11.68% | 982.35K | Apr 2026 | XHS vs MHIP |
Lowest Drawdown Alternatives to XHS
XHS has a 1-year max drawdown of -11.99%. There are 30 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 | XHS vs GERM | |
| Horizon Kinetics SPAC Active ETF | -4.32% | 10.11M | Jun 2007 | XHS vs SPAQ | |
| First Trust Nasdaq Pharmaceuticals ETF | -7.47% | 36.36M | Sep 2016 | XHS vs FTXH | |
| Invesco Nasdaq Biotechnology ETF | -8.34% | 74.65M | Jun 2021 | XHS vs IBBQ | |
| iShares U.S. Pharmaceuticals ETF | -8.47% | 1.34B | May 2006 | XHS vs IHE |
Other ETFs from State Street
The 10 most viewed State Street ETFs shown here include SPY, GLD, XLK and span 10 categories. AUM among these funds goes as high as $783B.
| Symbol | Name | Category | Risk / Return Rank | YTD Return | AUM | Inception | |
|---|---|---|---|---|---|---|---|
| State Street SPDR S&P 500 ETF | S&P 500 | 66 | 10.84% | 783.21B | Jan 1993 | XHS vs SPY | |
| SPDR Gold Shares | Gold, Precious Metals | 24 | -6.10% | 132.10B | Nov 2004 | XHS vs GLD | |
| State Street Technology Select Sector SPDR ETF | Technology Equities | 66 | 27.85% | 120.59B | Dec 1998 | XHS vs XLK | |
| State Street SPDR Portfolio S&P 500 Growth ETF | S&P 500, Large Cap Growth Equities | 49 | 12.15% | 52.75B | Sep 2000 | XHS vs SPYG | |
| State Street SPDR Portfolio S&P 500 High Dividend ... | S&P 500, Dividend | 52 | 14.61% | 7.40B | Oct 2015 | XHS vs SPYD | |
| State Street Energy Select Sector SPDR ETF | Energy Equities | 54 | 29.13% | 36.33B | Dec 1998 | XHS vs XLE | |
| State Street SPDR Portfolio S&P 500 ETF | S&P 500 | 67 | 10.90% | 158.31B | Nov 2005 | XHS vs SPYM | |
| SPDR Gold MiniShares Trust | Gold, Precious Metals | 24 | -6.00% | 27.70B | Jun 2018 | XHS vs GLDM | |
| State Street Utilities Select Sector SPDR ETF | Utilities Equities | 30 | 8.46% | 23.51B | Dec 1998 | XHS vs XLU | |
| SPDR Bloomberg 1-3 Month T-Bill ETF | Government Bonds, Ultrashort Bond | 100 | 1.89% | 46.75B | May 2007 | XHS vs BIL |
Often Compared With XHS
Investors most often compare XHS with IHF, RXL, FXAIX. These 19 comparison targets span 5 categories, based on PortfoliosLab usage data.
Compare XHS with Any Fund or Stock
Compare XHS with any ETF, mutual fund, or stock using PortfoliosLab's comparison tool.
Pair XHS with funds that move differently
SPDR S&P Health Care Services ETF alternatives help with substitution. Diversifiers are the next step when you want funds with lower historical correlation to XHS.
Explore XHS Diversifiers