XHE vs. FXH

Last updated Jun 3, 2026

XHE (SPDR S&P Health Care Equipment ETF) and FXH (First Trust Health Care AlphaDEX Fund) are both Health & Biotech Equities funds - XHE tracks the S&P Health Care Equipment Select Industry Index while FXH tracks the StrataQuant Health Care Index. Both are passively managed. Over the past 10 years, XHE returned 5.72%/yr vs 6.87%/yr for FXH. A 0.79 correlation means they provide meaningful diversification when combined. XHE charges 0.35%/yr vs 0.61%/yr for FXH.

Performance

XHE vs. FXH - Performance Comparison

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

Returns By Period

In the year-to-date period, XHE achieves a -11.59% return, which is significantly lower than FXH's -0.78% return. Over the past 10 years, XHE has underperformed FXH with an annualized return of 5.72%, while FXH has yielded a comparatively higher 6.87% annualized return.

XHE

• 1D: -0.95%
• 1M: -4.49%
• YTD: -11.59%
• 6M: -10.52%
• 1Y: -2.63%
• 3Y*: -6.57%
• 5Y*: -8.01%
• 10Y*: 5.72%

FXH

• 1D: -1.56%
• 1M: 0.25%
• YTD: -0.78%
• 6M: -2.45%
• 1Y: 12.24%
• 3Y*: 3.01%
• 5Y*: 0.39%
• 10Y*: 6.87%

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

XHE vs. FXH - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023	2022	2021	2020	2019	2018	2017
XHE SPDR S&P Health Care Equipment ETF	-11.59%	-0.23%	5.08%	-6.23%	-23.34%	3.04%	32.91%	22.30%	8.90%	30.51%
FXH First Trust Health Care AlphaDEX Fund	-0.78%	10.16%	0.96%	-4.53%	-12.24%	15.20%	28.00%	22.26%	-1.33%	21.82%

Correlation

The correlation between XHE and FXH is 0.72, which is moderate. They share some common price drivers but move independently often enough to provide real diversification benefit when combined.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	0.72
Correlation (3Y) Calculated over the trailing 3-year period	0.76
Correlation (5Y) Calculated over the trailing 5-year period	0.81
Correlation (10Y) Calculated over the trailing 10-year period	0.82
Correlation (All Time) Calculated using the full available price history since Jan 28, 2011	0.79

The correlation between XHE and FXH shifts across timeframes, from 0.72 (1 year) to 0.82 (10 years), reflecting how their relationship changes across market environments.

XHE vs. FXH - Sectors Allocation Comparison

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

Return for Risk

XHE vs. FXH — Risk / Return Rank

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

XHE

XHE Risk / Return Rank: 7
XHE Sharpe Ratio Rank: 7
XHE Sortino Ratio Rank: 7
XHE Omega Ratio Rank: 7
XHE Calmar Ratio Rank: 7
XHE Martin Ratio Rank: 6

FXH

FXH Risk / Return Rank: 22
FXH Sharpe Ratio Rank: 23
FXH Sortino Ratio Rank: 23
FXH Omega Ratio Rank: 21
FXH Calmar Ratio Rank: 22
FXH Martin Ratio Rank: 23

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.

XHE vs. FXH - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for SPDR S&P Health Care Equipment ETF (XHE) and First Trust Health Care AlphaDEX Fund (FXH). 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.

	XHE	FXH	Difference
Sharpe ratio Return per unit of total volatility	-0.12	0.78	-0.91
Sortino ratio Return per unit of downside risk	-0.03	1.25	-1.28
Omega ratio Gain probability vs. loss probability	1.00	1.14	-0.15
Calmar ratio Return relative to maximum drawdown	-0.21	0.97	-1.18
Martin ratio Return relative to average drawdown	-0.48	2.98	-3.46
Data is calculated on a 1-year rolling basis and updated daily. The trend shows the change in the indicator over the past month.

XHE vs. FXH - Sharpe Ratio Comparison

The current XHE Sharpe Ratio is -0.12, which is lower than the FXH Sharpe Ratio of 0.78. The chart below compares the historical Sharpe Ratios of XHE and FXH, 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

	XHE	FXH	Difference
Sharpe Ratio (1Y) Calculated over the trailing 1-year period	-0.12	0.78	-0.91
Sharpe Ratio (5Y) Calculated over the trailing 5-year period	-0.33	0.02	-0.35
Sharpe Ratio (10Y) Calculated over the trailing 10-year period	0.25	0.37	-0.12
Sharpe Ratio (All Time) Calculated using the full available price history	0.40	0.51	-0.11

Drawdowns

XHE vs. FXH - Drawdown Comparison

The maximum XHE drawdown since its inception was -49.92%, which is greater than FXH's maximum drawdown of -43.70%. Use the drawdown chart below to compare losses from any high point for XHE and FXH.

Drawdown Indicators

	XHE	FXH	Difference
Max Drawdown Largest peak-to-trough decline	-49.92%	-43.70%	-6.22%
Max Drawdown (1Y) Largest decline over 1 year	-18.29%	-12.20%	-6.09%
Max Drawdown (3Y) Largest decline over 3 years	-32.62%	-17.53%	-15.09%
Max Drawdown (5Y) Largest decline over 5 years	-49.92%	-29.49%	-20.43%
Max Drawdown (10Y) Largest decline over 10 years	-49.92%	-30.61%	-19.31%
Current Drawdown Current decline from peak	-41.39%	-10.40%	-30.99%
Average Drawdown Average peak-to-trough decline	-13.26%	-9.46%	-3.80%
Ulcer Index Depth and duration of drawdowns from previous peaks	8.00%	3.99%	+4.01%

Volatility

XHE vs. FXH - Volatility Comparison

SPDR S&P Health Care Equipment ETF (XHE) has a higher volatility of 5.82% compared to First Trust Health Care AlphaDEX Fund (FXH) at 3.89%. This indicates that XHE's price experiences larger fluctuations and is considered to be riskier than FXH based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	XHE	FXH	Difference
Volatility (1M) Calculated over the trailing 1-month period	5.82%	3.89%	+1.93%
Volatility (6M) Calculated over the trailing 6-month period	15.38%	11.18%	+4.20%
Volatility (1Y) Calculated over the trailing 1-year period	21.39%	15.69%	+5.70%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	24.40%	16.51%	+7.89%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	22.93%	18.47%	+4.46%

XHE vs. FXH - Expense Ratio Comparison

XHE has a 0.35% expense ratio, which is lower than FXH's 0.61% expense ratio.

Dividends

XHE vs. FXH - Dividend Comparison

XHE's dividend yield for the trailing twelve months is around 0.09%, less than FXH's 0.86% yield.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
FXH First Trust Health Care AlphaDEX Fund	0.86%	0.75%	0.41%	0.24%	0.20%	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 XHE and FXH in my portfolio?

XHE and FXH have a correlation of 0.72, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, XHE or FXH?

XHE has higher volatility (5.82%) compared to FXH (3.89%). In terms of maximum drawdown, XHE dropped -49.92% vs FXH's -43.70%.

Which ETF is better, XHE or FXH?

On 10-year performance, FXH leads with 6.87% vs 5.72% for XHE. On fees, XHE is cheaper at 0.35% per year. On volatility, FXH has been the lower-risk option at 3.89%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, XHE or FXH?

Over the 10-year period, FXH has performed better with a 6.87% return vs 5.72%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, XHE or FXH?

XHE is cheaper with a 0.35% expense ratio, compared with 0.61% for FXH.

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

FXH has the higher dividend yield at 0.86%, compared with 0.09% for XHE.

What is the main difference between XHE and FXH?

XHE tracks S&P Health Care Equipment Select Industry Index, while FXH tracks StrataQuant Health Care Index. They also come from different issuers: State Street and First Trust. Their fees differ too: 0.35% for XHE and 0.61% for FXH.

Which has better risk-adjusted returns?

FXH currently has the higher Sharpe Ratio (0.78 vs -0.12), 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.