MEDX vs. XLV

Last updated Apr 2, 2026

Compare and contrast key facts about Horizon Kinetics Medical ETF (MEDX) and State Street Health Care Select Sector SPDR ETF (XLV).

MEDX and XLV are both exchange-traded funds (ETFs), meaning they are traded on stock exchanges and can be bought and sold throughout the day. MEDX is an actively managed fund by Horizon. It was launched on Sep 30, 1999. XLV is a passively managed fund by State Street that tracks the performance of the Health Care Select Sector Index. It was launched on Dec 16, 1998.

Performance

MEDX vs. XLV - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in Horizon Kinetics Medical ETF (MEDX) and State Street Health Care Select Sector SPDR ETF (XLV). The values are adjusted to include any dividend payments, if applicable.

MEDX vs. XLV - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023
MEDX Horizon Kinetics Medical ETF	1.52%	28.62%	-4.68%	-6.22%
XLV State Street Health Care Select Sector SPDR ETF	-4.18%	14.50%	2.47%	3.97%

Returns By Period

In the year-to-date period, MEDX achieves a 1.52% return, which is significantly higher than XLV's -4.18% return.

MEDX

• 1D: 1.19%
• 1M: -3.98%
• YTD: 1.52%
• 6M: 8.07%
• 1Y: 27.44%
• 3Y*: 6.83%
• 5Y*: —
• 10Y*: —

XLV

• 1D: 0.76%
• 1M: -6.43%
• YTD: -4.18%
• 6M: 3.83%
• 1Y: 4.90%
• 3Y*: 6.25%
• 5Y*: 6.59%
• 10Y*: 9.80%

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

MEDX vs. XLV - Expense Ratio Comparison

MEDX has a 0.85% expense ratio, which is higher than XLV's 0.08% expense ratio.

MEDX

Horizon Kinetics Medical ETF

XLV

State Street Health Care Select Sector SPDR ETF

Return for Risk

MEDX vs. XLV — Risk / Return Rank

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

MEDX

MEDX Risk / Return Rank: 68
MEDX Sharpe Ratio Rank: 70
MEDX Sortino Ratio Rank: 71
MEDX Omega Ratio Rank: 61
MEDX Calmar Ratio Rank: 74
MEDX Martin Ratio Rank: 63

XLV

XLV Risk / Return Rank: 18
XLV Sharpe Ratio Rank: 19
XLV Sortino Ratio Rank: 18
XLV Omega Ratio Rank: 18
XLV Calmar Ratio Rank: 17
XLV Martin Ratio Rank: 16

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. XLV - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for Horizon Kinetics Medical ETF (MEDX) and State Street Health Care Select Sector SPDR ETF (XLV). 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	XLV	Difference
Sharpe ratio Return per unit of total volatility	1.30	0.28	+1.02
Sortino ratio Return per unit of downside risk	1.87	0.51	+1.36
Omega ratio Gain probability vs. loss probability	1.24	1.06	+0.17
Calmar ratio Return relative to maximum drawdown	2.15	0.28	+1.87
Martin ratio Return relative to average drawdown	6.85	0.58	+6.27
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. XLV - Sharpe Ratio Comparison

The current MEDX Sharpe Ratio is 1.30, which is higher than the XLV Sharpe Ratio of 0.28. The chart below compares the historical Sharpe Ratios of MEDX and XLV, offering insights into how both investments have performed under varying market conditions. These values are calculated using daily returns over the previous 12 months.

Sharpe Ratios by Period

	MEDX	XLV	Difference
Sharpe Ratio (1Y) Calculated over the trailing 1-year period	1.30	0.28	+1.02
Sharpe Ratio (5Y) Calculated over the trailing 5-year period	—	0.45	—
Sharpe Ratio (10Y) Calculated over the trailing 10-year period	—	0.59	—
Sharpe Ratio (All Time) Calculated using the full available price history	0.30	0.46	-0.16

Correlation

The correlation between MEDX and XLV is 0.78, which is considered to be high. That indicates a strong positive relationship between their price movements. Having highly-correlated positions in a portfolio may signal a lack of diversification, potentially leading to increased risk during market downturns.

Dividends

MEDX vs. XLV - Dividend Comparison

MEDX's dividend yield for the trailing twelve months is around 1.21%, less than XLV's 1.70% yield.

	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
MEDX Horizon Kinetics Medical ETF	1.21%	1.23%	1.92%	4.94%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
XLV State Street Health Care Select Sector SPDR ETF	1.70%	1.60%	1.67%	1.59%	1.47%	1.33%	1.49%	2.17%	1.57%	1.47%	1.60%	1.43%

Drawdowns

MEDX vs. XLV - Drawdown Comparison

The maximum MEDX drawdown since its inception was -23.10%, smaller than the maximum XLV drawdown of -39.17%. Use the drawdown chart below to compare losses from any high point for MEDX and XLV.

Drawdown Indicators

	MEDX	XLV	Difference
Max Drawdown Largest peak-to-trough decline	-23.10%	-39.17%	+16.07%
Max Drawdown (1Y) Largest decline over 1 year	-10.86%	-10.76%	-0.10%
Max Drawdown (5Y) Largest decline over 5 years	—	-17.11%	—
Max Drawdown (10Y) Largest decline over 10 years	—	-28.40%	—
Current Drawdown Current decline from peak	-4.91%	-7.41%	+2.50%
Average Drawdown Average peak-to-trough decline	-6.72%	-7.12%	+0.40%
Ulcer Index Depth and duration of drawdowns from previous peaks	3.40%	5.11%	-1.71%

Volatility

MEDX vs. XLV - Volatility Comparison

Horizon Kinetics Medical ETF (MEDX) has a higher volatility of 6.14% compared to State Street Health Care Select Sector SPDR ETF (XLV) at 4.79%. This indicates that MEDX's price experiences larger fluctuations and is considered to be riskier than XLV based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	MEDX	XLV	Difference
Volatility (1M) Calculated over the trailing 1-month period	6.14%	4.79%	+1.35%
Volatility (6M) Calculated over the trailing 6-month period	13.42%	10.29%	+3.13%
Volatility (1Y) Calculated over the trailing 1-year period	21.48%	17.73%	+3.75%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	16.92%	14.56%	+2.36%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	16.92%	16.53%	+0.39%