VHT vs XLV: Differences, Fees and Returns
XLV is cheaper: it charges 0.08% a year against 0.09% for VHT. That is €1 less a year per 10,000 invested; over a plan of 10,000 up front plus 200 a month for 30 years, the accumulated cost gap comes to about €708.
They do not track the same thing: VHT follows the MSCI US Investable Market Health Care 25/50 Index and XLV the Health Care Select Sector Index. Any difference in returns will come mainly from that exposure, not from the fee.
Over the last 10 years, VHT and XLV returned practically the same, around 10.79% a year.
Head-to-head comparison
| VHT | XLV | |
|---|---|---|
| Name | Vanguard Health Care ETF | Health Care Select Sector SPDR Fund |
| Provider | Vanguard | State Street |
| Index | MSCI US Investable Market Health Care 25/50 Index | Health Care Select Sector Index |
| TER | 0.09% | 0.08% |
| Type | ETF | ETF |
| Domicile | United States | United States |
| Dividends | Distributing | Distributing |
| Launch date | January 26, 2004 | December 16, 1998 |
| Fund size | $22B | $44B |
| ISIN | — | — |
| Available to EU retail investors | No | No |
| Tax-free switch (Spain) | No | No |
Historical returns: VHT vs XLV (Aug 2016 – Aug 2026)
10,000 invested in Aug 2016 would be worth $27,854 in VHT and $27,710 in XLV today.
| VHT | XLV | |
|---|---|---|
| Annualised return | 10.79% | 10.73% |
| Total return | 178.54% | 177.10% |
| Annual volatility | 14.68% | 14.54% |
| Maximum drawdown | -15.21% | -15.62% |
| Monthly correlation | 0.99 | |
Calendar-year returns
| Year | VHT | XLV |
|---|---|---|
| 2026* | 11.95% | 11.10% |
| 2025 | 15.46% | 14.50% |
| 2024 | 2.67% | 2.47% |
| 2023 | 2.51% | 2.06% |
| 2022 | -5.62% | -2.09% |
| 2021 | 20.56% | 26.04% |
| 2020 | 18.27% | 13.34% |
| 2019 | 21.86% | 20.45% |
| 2018 | 5.58% | 6.28% |
| 2017 | 23.26% | 21.77% |
* Current year, to Aug 2026.
Month-end closing prices adjusted for dividends and net of fund costs. Broker fees and taxes are not included. Past performance does not guarantee future results.