MEDX vs. XLVI

Last updated Jun 5, 2026

MEDX (Horizon Kinetics Medical ETF) and XLVI (State Street Health Care Select Sector SPDR Premium Income ETF) are both exchange-traded funds - MEDX is a Health & Biotech Equities fund actively managed by Horizon, while XLVI is a Derivative Income fund actively managed by State Street. Both are actively managed. Their correlation of 0.82 suggests significant overlap in exposure. MEDX charges 0.85%/yr vs 0.35%/yr for XLVI.

Performance

MEDX vs. XLVI - 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 Premium Income ETF (XLVI). 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 XLVI's 1.35% return.

MEDX

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

XLVI

• 1D: 2.03%
• 1M: 4.01%
• YTD: 1.35%
• 6M: 3.19%
• 1Y: —
• 3Y*: —
• 5Y*: —
• 10Y*: —

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

MEDX vs. XLVI - Yearly Performance Comparison

	2026 (YTD)	2025
MEDX Horizon Kinetics Medical ETF	3.90%	21.07%
XLVI State Street Health Care Select Sector SPDR Premium Income ETF	1.35%	12.79%

Correlation

The correlation between MEDX and XLVI is 0.82, indicating a strong positive relationship between their price movements. Combining them offers limited diversification - they tend to fall together during downturns.

	Correlation
Correlation (All Time) Calculated using the full available price history since Jul 31, 2025	0.82

MEDX vs. XLVI - Sectors Allocation Comparison

Sectors	MEDX	XLVI
Healthcare	100.0%	-
Basic Materials	-	-
Communication Services	-	-
Consumer Cyclical	-	-
Consumer Defensive	-	-
Energy	-	-
Financial Services	-	100.6%
Industrials	-	-
Real Estate	-	-
Technology	-	-
Utilities	-	-

Return for Risk

MEDX vs. XLVI — 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

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. XLVI - 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 Premium Income ETF (XLVI). 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	XLVI	Difference
Sharpe ratio: Return per unit of total volatility	1.78	—	—
Sortino ratio: Return per unit of downside risk	2.77	—	—
Omega ratio: Gain probability vs. loss probability	1.31	—	—
Calmar ratio: Return relative to maximum drawdown	3.06	—	—
Martin ratio: Return relative to average drawdown	8.51	—	—
Data is calculated on a 1-year rolling basis and updated daily. The trend shows the change in the indicator over the past month.

Sharpe Ratios by Period

	MEDX	XLVI	Difference
Sharpe Ratio (1Y) Calculated over the trailing 1-year period	1.78	—	—
Sharpe Ratio (All Time) Calculated using the full available price history	0.32	1.54	-1.22

Drawdowns

MEDX vs. XLVI - Drawdown Comparison

The maximum MEDX drawdown since its inception was -23.10%, which is greater than XLVI's maximum drawdown of -8.14%. Use the drawdown chart below to compare losses from any high point for MEDX and XLVI.

Drawdown Indicators

	MEDX	XLVI	Difference
Max Drawdown Largest peak-to-trough decline	-23.10%	-8.14%	-14.96%
Max Drawdown (1Y) Largest decline over 1 year	-10.54%	—	—
Max Drawdown (3Y) Largest decline over 3 years	-23.10%	—	—
Current Drawdown Current decline from peak	-2.68%	-2.08%	-0.60%
Average Drawdown Average peak-to-trough decline	-6.72%	-1.95%	-4.77%
Ulcer Index Depth and duration of drawdowns from previous peaks	3.79%	—	—

Volatility

Volatility by Period

	MEDX	XLVI	Difference
Volatility (1M) Calculated over the trailing 1-month period	5.68%	—	—
Volatility (6M) Calculated over the trailing 6-month period	13.41%	—	—
Volatility (1Y) Calculated over the trailing 1-year period	18.12%	11.12%	+7.00%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	17.04%	11.12%	+5.92%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	17.04%	11.12%	+5.92%

MEDX vs. XLVI - Expense Ratio Comparison

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

Dividends

MEDX vs. XLVI - Dividend Comparison

MEDX's dividend yield for the trailing twelve months is around 1.19%, less than XLVI's 11.30% yield.

Position	TTM	2025	2024	2023
MEDX Horizon Kinetics Medical ETF	1.19%	1.23%	1.92%	4.94%
XLVI State Street Health Care Select Sector SPDR Premium Income ETF	11.30%	5.73%	0.00%	0.00%

Frequently Asked Questions

Can I hold both MEDX and XLVI in my portfolio?

MEDX and XLVI have a correlation of 0.82, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which ETF is better, MEDX or XLVI?

On fees, XLVI is cheaper at 0.35% per year. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF is cheaper, MEDX or XLVI?

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

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

XLVI has the higher dividend yield at 11.30%, compared with 1.19% for MEDX.

What is the main difference between MEDX and XLVI?

MEDX is categorized as Health & Biotech Equities, while XLVI is Derivative Income. They also come from different issuers: Horizon and State Street. Their fees differ too: 0.85% for MEDX and 0.35% for XLVI.