MEDX vs. XHE

Last updated Jun 5, 2026

MEDX (Horizon Kinetics Medical ETF) and XHE (SPDR S&P Health Care Equipment ETF) are both Health & Biotech Equities funds. MEDX is actively managed, while XHE is passively managed. Over the past 3 years, MEDX returned 6.55%/yr vs -5.07%/yr for XHE. A 0.51 correlation means they provide meaningful diversification when combined. MEDX charges 0.85%/yr vs 0.35%/yr for XHE.

Performance

MEDX vs. XHE - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in Horizon Kinetics Medical ETF (MEDX) and SPDR S&P Health Care Equipment ETF (XHE). The values are adjusted to include any dividend payments, if applicable.

Returns By Period

In the year-to-date period, MEDX achieves a 3.90% return, which is significantly higher than XHE's -7.82% return.

MEDX

• 1D: 3.04%
• 1M: 5.53%
• YTD: 3.90%
• 6M: 3.58%
• 1Y: 32.14%
• 3Y*: 6.55%
• 5Y*: —
• 10Y*: —

XHE

• 1D: 4.19%
• 1M: 1.33%
• YTD: -7.82%
• 6M: -8.99%
• 1Y: 0.22%
• 3Y*: -5.07%
• 5Y*: -7.43%
• 10Y*: 6.06%

*Multi-year figures are annualized to reflect compound growth (CAGR)

MEDX vs. XHE - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023
MEDX Horizon Kinetics Medical ETF	3.90%	28.62%	-4.68%	-6.22%
XHE SPDR S&P Health Care Equipment ETF	-7.82%	-0.23%	5.08%	-11.92%

Correlation

The correlation between MEDX and XHE is 0.45, which is low. Their price movements are largely independent, making them effective diversification partners.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	0.45
Correlation (3Y) Calculated over the trailing 3-year period	0.50
Correlation (All Time) Calculated using the full available price history since Feb 1, 2023	0.51

The correlation between MEDX and XHE has been stable across timeframes, ranging from 0.45 to 0.51 - a consistent structural relationship.

MEDX vs. XHE - Sectors Allocation Comparison

Sectors	MEDX	XHE
Healthcare	100.0%	98.4%
Basic Materials	-	-
Communication Services	-	1.4%
Consumer Cyclical	-	-
Consumer Defensive	-	-
Energy	-	-
Financial Services	-	1.6%
Industrials	-	1.7%
Real Estate	-	-
Technology	-	-
Utilities	-	-

Return for Risk

MEDX vs. XHE — Risk / Return Rank

Compare risk-adjusted metric ranks to identify better-performing investments over the past 12 months.

MEDX

MEDX Risk / Return Rank: 55
MEDX Sharpe Ratio Rank: 53
MEDX Sortino Ratio Rank: 59
MEDX Omega Ratio Rank: 50
MEDX Calmar Ratio Rank: 63
MEDX Martin Ratio Rank: 51

XHE

XHE Risk / Return Rank: 9
XHE Sharpe Ratio Rank: 9
XHE Sortino Ratio Rank: 10
XHE Omega Ratio Rank: 9
XHE Calmar Ratio Rank: 9
XHE Martin Ratio Rank: 9

The rank (0–100) shows how this investment's returns compare to the risk taken. Higher = better. Based on the past 12 months of data, combining Sharpe, Sortino, and other metrics used by quantitative funds and institutional investors.

MEDX vs. XHE - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for Horizon Kinetics Medical ETF (MEDX) and SPDR S&P Health Care Equipment ETF (XHE). Risk-adjusted metrics are performance indicators that assess an investment's returns in relation to its risk, enabling a more accurate comparison of different investment options.

	MEDX	XHE	Difference
Sharpe ratio: Return per unit of total volatility	1.78	0.01	+1.77
Sortino ratio: Return per unit of downside risk	2.77	0.17	+2.59
Omega ratio: Gain probability vs. loss probability	1.31	1.02	+0.29
Calmar ratio: Return relative to maximum drawdown	3.06	0.01	+3.05
Martin ratio: Return relative to average drawdown	8.51	0.03	+8.48
Data is calculated on a 1-year rolling basis and updated daily. The trend shows the change in the indicator over the past month.

MEDX vs. XHE - Sharpe Ratio Comparison

The current MEDX Sharpe Ratio is 1.78, which is higher than the XHE Sharpe Ratio of 0.01. The chart below compares the historical Sharpe Ratios of MEDX and XHE, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Sharpe Ratios by Period

	MEDX	XHE	Difference
Sharpe Ratio (1Y) Calculated over the trailing 1-year period	1.78	0.01	+1.77
Sharpe Ratio (5Y) Calculated over the trailing 5-year period	—	-0.31	—
Sharpe Ratio (10Y) Calculated over the trailing 10-year period	—	0.26	—
Sharpe Ratio (All Time) Calculated using the full available price history	0.32	0.42	-0.09

Drawdowns

MEDX vs. XHE - Drawdown Comparison

The maximum MEDX drawdown since its inception was -23.10%, smaller than the maximum XHE drawdown of -49.92%. Use the drawdown chart below to compare losses from any high point for MEDX and XHE.

Drawdown Indicators

	MEDX	XHE	Difference
Max Drawdown Largest peak-to-trough decline	-23.10%	-49.92%	+26.82%
Max Drawdown (1Y) Largest decline over 1 year	-10.54%	-18.29%	+7.75%
Max Drawdown (3Y) Largest decline over 3 years	-23.10%	-32.62%	+9.52%
Max Drawdown (5Y) Largest decline over 5 years	—	-49.92%	—
Max Drawdown (10Y) Largest decline over 10 years	—	-49.92%	—
Current Drawdown Current decline from peak	-2.68%	-38.89%	+36.21%
Average Drawdown Average peak-to-trough decline	-6.72%	-13.27%	+6.55%
Ulcer Index Depth and duration of drawdowns from previous peaks	3.79%	8.10%	-4.31%

Volatility

MEDX vs. XHE - Volatility Comparison

The current volatility for Horizon Kinetics Medical ETF (MEDX) is 5.68%, while SPDR S&P Health Care Equipment ETF (XHE) has a volatility of 7.09%. This indicates that MEDX experiences smaller price fluctuations and is considered to be less risky than XHE based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	MEDX	XHE	Difference
Volatility (1M) Calculated over the trailing 1-month period	5.68%	7.09%	-1.41%
Volatility (6M) Calculated over the trailing 6-month period	13.41%	15.89%	-2.48%
Volatility (1Y) Calculated over the trailing 1-year period	18.12%	21.70%	-3.58%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	17.04%	24.47%	-7.43%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	17.04%	22.96%	-5.92%

MEDX vs. XHE - Expense Ratio Comparison

MEDX has a 0.85% expense ratio, which is higher than XHE's 0.35% expense ratio.

Dividends

MEDX vs. XHE - Dividend Comparison

MEDX's dividend yield for the trailing twelve months is around 1.19%, more than XHE's 0.09% yield.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
MEDX Horizon Kinetics Medical ETF	1.19%	1.23%	1.92%	4.94%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
XHE SPDR S&P Health Care Equipment ETF	0.09%	0.08%	0.04%	0.03%	0.04%	0.00%	0.00%	0.05%	0.09%	0.78%	0.17%	7.22%

Frequently Asked Questions

Can I hold both MEDX and XHE in my portfolio?

MEDX and XHE have a correlation of 0.45, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, MEDX or XHE?

XHE has higher volatility (7.09%) compared to MEDX (5.68%). In terms of maximum drawdown, MEDX dropped -23.10% vs XHE's -49.92%.

Which ETF is better, MEDX or XHE?

On 3-year performance, MEDX leads with 6.55% vs -5.07% for XHE. On fees, XHE is cheaper at 0.35% per year. On volatility, MEDX has been the lower-risk option at 5.68%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, MEDX or XHE?

Over the 3-year period, MEDX has performed better with a 6.55% return vs -5.07%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, MEDX or XHE?

XHE is cheaper with a 0.35% expense ratio, compared with 0.85% for MEDX.

Which ETF pays a higher dividend yield, MEDX or XHE?

MEDX has the higher dividend yield at 1.19%, compared with 0.09% for XHE.

What is the main difference between MEDX and XHE?

They also come from different issuers: Horizon and State Street. Their fees differ too: 0.85% for MEDX and 0.35% for XHE.

Which has better risk-adjusted returns?

MEDX currently has the higher Sharpe Ratio (1.78 vs 0.01), meaning it's delivered slightly more return per unit of risk over the trailing 12 months. However, this ranking shifts over time - use the Risk/Return Score above for a more comprehensive view that combines Sharpe, Sortino, and other measures used by quantitative funds.