XHE vs. IHI

Last updated Aug 4, 2026

XHE (SPDR S&P Health Care Equipment ETF) and IHI (iShares U.S. Medical Devices ETF) are both Health & Biotech Equities funds - XHE tracks the S&P Health Care Equipment Select Industry Index while IHI tracks the Dow Jones U.S. Select Medical Equipment Index. Both are passively managed. Over the past 10 years, XHE returned 6.33%/yr vs 8.87%/yr for IHI. Their correlation of 0.84 means they have usually moved in the same direction. XHE charges 0.35%/yr vs 0.38%/yr for IHI.

Performance

XHE vs. IHI - Performance Comparison

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

Returns By Period

In the year-to-date period, XHE achieves a 5.60% return, which is significantly higher than IHI's -12.58% return. Over the past 10 years, XHE has underperformed IHI with an annualized return of 6.33%, while IHI has yielded a comparatively higher 8.87% annualized return.

XHE

• 1D: 4.05%
• 1M: 6.04%
• 6M: 7.88%
• YTD: 5.60%
• 1Y: 21.90%
• 3Y*: -0.09%
• 5Y*: -6.21%
• 10Y*: 6.33%
• ALL TIME*: 9.68%

IHI

• 1D: 3.24%
• 1M: 4.49%
• 6M: -8.90%
• YTD: -12.58%
• 1Y: -8.74%
• 3Y*: 0.55%
• 5Y*: -2.67%
• 10Y*: 8.87%
• ALL TIME*: 10.19%

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

Liquidity Comparison

Position	Avg. Volume Value (2W)	Avg. Volume Value (1M)	Avg. Volume Value (3M)
IHI iShares U.S. Medical Devices ETF	$149.25M	$165.21M	$149.27M
XHE SPDR S&P Health Care Equipment ETF	$2.26M	$2.20M	$2.39M

XHE vs. IHI - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023	2022	2021	2020	2019	2018	2017
XHE SPDR S&P Health Care Equipment ETF	5.60%	-0.23%	5.08%	-6.23%	-23.34%	3.04%	32.91%	22.30%	8.90%	30.51%
IHI iShares U.S. Medical Devices ETF	-12.58%	6.88%	8.62%	3.24%	-19.80%	21.03%	24.17%	32.75%	15.45%	30.81%

Correlation

The correlation between XHE and IHI is 0.86, meaning they have usually moved in the same direction, including during past declines.

	Correlation
Correlation (1Y) Focuses on recent behavior, but can change the most.	0.86
Correlation (3Y) Balances recent behavior with more history.	0.85
Correlation (5Y) Shows whether the relationship held over a longer period.	0.86
Correlation (10Y) Provides a long-term view across more market conditions.	0.86
Correlation (All Time) Calculated using the full available price history since Jan 27, 2011	0.84

The correlation between XHE and IHI has been stable across timeframes, ranging from 0.84 to 0.86 - a consistent structural relationship.

XHE vs. IHI - Sectors Allocation Comparison

Sectors	XHE	IHI
Healthcare	98.8%	100.0%
Technology	1.7%	0.3%
Industrials	1.7%	0.2%
Communication Services	1.5%	-
Financial Services	1.2%	-
Basic Materials	-	-
Consumer Cyclical	-	-
Consumer Defensive	-	-
Energy	-	-
Real Estate	-	-
Utilities	-	-

Return for Risk

XHE vs. IHI — Risk / Return Rank

Compare historical risk-adjusted metric ranks over the past 12 months.

XHE

XHE Risk / Return Rank: 35
XHE Sharpe Ratio Rank: 38
XHE Sortino Ratio Rank: 40
XHE Omega Ratio Rank: 35
XHE Calmar Ratio Rank: 35
XHE Martin Ratio Rank: 29

IHI

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

The rank (0–100) uses a weighted average of the Sharpe, Sortino, Omega, Calmar, and Martin percentile ranks for the trailing 12 months. Higher means stronger historical risk-adjusted performance within the peer group.

XHE vs. IHI - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for SPDR S&P Health Care Equipment ETF (XHE) and iShares U.S. Medical Devices ETF (IHI). 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.

Values are calculated on a 1-year rolling basis and updated daily. Risk-adjusted metrics are more stable over longer periods — use the period switch above to explore them.

	XHE	IHI	Difference
Sharpe ratio: Return per unit of total volatility	0.96	-0.44	+1.40
Sortino ratio: Return per unit of downside risk	1.52	-0.51	+2.03
Omega ratio: Gain probability vs. loss probability	1.17	0.94	+0.23
Calmar ratio: Return relative to maximum drawdown	1.20	-0.34	+1.54
Martin ratio: Return relative to average drawdown	2.55	-0.66	+3.21

XHE vs. IHI - Sharpe Ratio Comparison

The current XHE Sharpe Ratio is 0.96, which is higher than the IHI Sharpe Ratio of -0.44. The chart below compares the historical Sharpe Ratios of XHE and IHI, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Drawdowns

XHE vs. IHI - Drawdown Comparison

The maximum XHE drawdown since its inception was -49.92%, roughly equal to the maximum IHI drawdown of -49.65%. Use the drawdown chart below to compare losses from any high point for XHE and IHI.

Drawdown Indicators

	XHE	IHI	Difference
Max Drawdown Largest peak-to-trough decline	-49.92%	-49.65%	-0.27%
Max Drawdown (1Y) Largest decline over 1 year	-18.29%	-26.11%	+7.82%
Max Drawdown (3Y) Largest decline over 3 years	-28.66%	-26.64%	-2.02%
Max Drawdown (5Y) Largest decline over 5 years	-49.92%	-33.12%	-16.80%
Max Drawdown (10Y) Largest decline over 10 years	-49.92%	-33.25%	-16.67%
Current Drawdown Current decline from peak	-29.99%	-17.45%	-12.54%
Average Drawdown Average peak-to-trough decline	-13.50%	-8.43%	-5.07%
Ulcer Index Depth and duration of drawdowns from previous peaks	8.61%	13.30%	-4.69%

Volatility

XHE vs. IHI - Volatility Comparison

The current volatility for SPDR S&P Health Care Equipment ETF (XHE) is 8.23%, while iShares U.S. Medical Devices ETF (IHI) has a volatility of 9.39%. This indicates that XHE experiences smaller price fluctuations and is considered to be less risky than IHI based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	XHE	IHI	Difference
Volatility (1M) Calculated over the trailing 1-month period	8.23%	9.39%	-1.16%
Volatility (6M) Calculated over the trailing 6-month period	18.07%	16.87%	+1.20%
Volatility (1Y) Calculated over the trailing 1-year period	23.01%	20.02%	+2.99%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	24.83%	19.61%	+5.22%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	23.14%	20.05%	+3.09%

XHE vs. IHI - Expense Ratio Comparison

XHE has a 0.35% expense ratio, which is lower than IHI's 0.38% expense ratio.

Dividends

XHE vs. IHI - Dividend Comparison

XHE's dividend yield for the trailing twelve months is around 0.06%, less than IHI's 0.45% yield.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
IHI iShares U.S. Medical Devices ETF	0.45%	0.34%	0.46%	0.53%	0.45%	0.25%	0.25%	0.33%	0.26%	0.37%	0.55%	1.28%
XHE SPDR S&P Health Care Equipment ETF	0.06%	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 IHI in my portfolio?

XHE and IHI have a correlation of 0.86, 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 IHI?

IHI has higher volatility (9.39%) compared to XHE (8.23%). In terms of maximum drawdown, XHE dropped -49.92% vs IHI's -49.65%.

Which ETF is better, XHE or IHI?

On 10-year performance, IHI leads with 8.87% vs 6.33% for XHE. On fees, XHE is cheaper at 0.35% per year. On volatility, XHE has been the lower-risk option at 8.23%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, XHE or IHI?

Over the 10-year period, IHI has performed better with a 8.87% return vs 6.33%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, XHE or IHI?

XHE is cheaper with a 0.35% expense ratio, compared with 0.38% for IHI.

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

IHI has the higher dividend yield at 0.45%, compared with 0.06% for XHE.

What is the main difference between XHE and IHI?

XHE tracks S&P Health Care Equipment Select Industry Index, while IHI tracks Dow Jones U.S. Select Medical Equipment Index. They also come from different issuers: State Street and iShares. Their fees differ too: 0.35% for XHE and 0.38% for IHI.

Which has better risk-adjusted returns?

XHE currently has the higher Sharpe Ratio (0.96 vs -0.44), 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.