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EKG vs XLV

First Trust Nasdaq Lux Digital Health Solutions ETF

EKGDNasdaq

State Street Health Care Select Sector SPDR ETF

XLVANYSE Arca

Overlap

5.7%by weight

Expense ratio

XLV −0.57pt a year

EKG0.65%XLV0.08%

Avg volume · 30D

XLV 2094.8×the volume

EKG4.35KXLV9.1M

3Y return · a year

EKG +7.5pt

EKG+22.7%XLV+15.2%

EKG vs XLV Performance

Oct 31, 2025 – Nov 2, 2026

+27.4%EKG+30.1%XLV

Oct 31, 2025 to Nov 2, 2026. EKG +27.4%. XLV +30.1%. Use the arrow keys to read each point.−10%0%10%Oct 2025May 2026Nov 2026
Expense ratio
EKG 0.65%
XLV 0.08%, better
Fund size
EKG $10M
XLV $48.5B
1Y total return
EKG +27.4%
XLV +30.1%, better
Yield (12M)
EKG No data
XLV 1.38%
Holdings
EKG 52
XLV 64
Avg volume (30D)
EKG 4.35K sh
XLV 9.1M sh, better
NAV per share
EKG $23.95
XLV $184.09
52W range

ETF.net Grade

EKG: Cost 27, Risk 34, Mission 71, Tradability 38, Holdings 46, Durability 22. XLV: Cost 98, Risk 78, Mission 84, Tradability 100, Holdings 39, Durability 87.
Pillar letters and Scores for EKG, XLV, with each pillar’s weight
PillarEKGXLV
Cost30% weightD27A98Higher
Mission25% weightA71A84Higher
Risk15% weightD34A78Higher
Tradability15% weightD38A100Higher
Holdings10% weightC46HigherD39
Durability5% weightF22A87Higher

Rank among Health Care (Broad) funds

How we build Categories ›
Same Category. Both funds are graded against the same funds, so their Grades compare head to head.

Same Category. EKG and XLV are both graded against the same 25 Health Care (Broad) funds, so their Grades compare head to head.

Health Care (Broad)⁠

Category · 25 funds
See all 25 ›

XLV ranks 1st and EKG 19th of 25 funds in the Health Care (Broad) Category.

  1. Rank 1AXLVState Street Health Care Select Sector SPDR ETFScore 85
  2. Rank 2AFHLCFidelity MSCI Health Care Index ETFScore 83
  3. Rank 18CHEALGlobal X HealthTech ETFScore 39
  4. Rank 19DEKGFirst Trust Nasdaq Lux Digital Health Solutions ETFScore 32
  5. Rank 20DHRTSTema Heart & Health ETFScore 31

Our read on each fund

ETF.net Research

EKGDFirst Trust Nasdaq Lux Digital Health Solutions ETF

XLVAState Street Health Care Select Sector SPDR ETF

In short

EKG A ticker that spells out the mandate. EKG skips the pharma giants and tracks a Nasdaq index of health technology names: roughly 40 stocks building the digital plumbing of medicine, from diagnostics and devices to health data.

XLV Live since 1998, XLV is the original way to own health care: about 60 S&P 500 names, a 0.08% fee, and one of the busiest tickers in the sector. Big pharma and device makers, not small-cap biotech.

Stated mandate

EKG The Fund seeks to track, before fees and expenses, the price and yield performance of the Nasdaq Lux Health TechTM Index.

XLV The fund seeks to track, before expenses, the price and yield performance of the Health Care Select Sector Index, which represents the health care sector of the S&P 500 Index.

Why people hold it

  • EKG Genuinely narrow. Roughly 40 health tech names, not a broad sector fund where a few pharma megacaps set the outcome.
  • Rules-based, not a stock picker's fund. It tracks the Nasdaq Lux Health Tech Index, so holdings follow published index rules rather than manager discretion.ftportfolios.com
  • Launched in 2022, so there is a real multi-year record to inspect instead of a back-test on a brand-new theme fund.
  • XLV 0.08% a year against a cohort median of 0.50%. That ties it with FHLC as the cheapest in the group and edges VHT at 0.09%.
  • One of the most actively traded funds in its category, which generally keeps bid-ask spreads thin whether you trade 10 shares or 10,000.
  • Launched December 1998 as one of the first US sector funds, and it has tracked its S&P 500 health care index closely ever since.
  • Covers the whole sector in one line: pharma, devices, providers, biotech, life-science tools and health tech. Pays quarterly.ssga.com

Worth knowing

  • EKG 0.65% a year sits above the health care sector median, and the cohort's broad index heavyweights (VHT, XLV, FHLC) charge under a tenth of a percent.
  • A small fund that trades thinly. Wider bid-ask spreads are the usual trade-off versus the cohort's most heavily traded names.
  • One theme, about 40 stocks, no regular distribution schedule. Single names and the health tech cycle carry the weight here.
  • XLV Cap-weighted and about 60 names deep, so the largest drug and device makers carry most of the weight.ssga.com
  • S&P 500 members only. Mid- and small-cap health care names sit outside the mandate.
  • One sector, one set of headlines: drug pricing rules, patent expirations and policy shifts move the whole basket together.

Full EKG profile⁠

Full XLV profile⁠

EKG vs XLV Holdings

How EKG and XLV differ

Overlap by weight

5.7%

Shared holdings make up 44.0% of EKG and 5.7% of XLV.

Level by level

  • Holdings8 in both5.7%
  • Sector2 Sectors92.1%
  • Asset classEquity100%
  • Countryby domicile100%

Sector

Sector weights in EKG and XLV, widest gap first
SectorMore in EKGMore in XLV
Health CareXLV +8.0 points
TechnologyEKG +8.0 points

Country, concentration and asset class

Country by domicile

Country weights in EKG and XLV, widest gap first
CountryMore in EKGMore in XLV
United StatesSame weight

Concentration

Weight in the 10 largest Holdings

  • EKG58.6%
  • XLV61.0%

Securities held

  • EKG51
  • XLV62

Asset class

EKG
Equity
XLV
Equity

Holdings

  • Only in EKG43
  • In both8
  • Only in XLV54

Only in EKG

43 securities, 55.9% of EKG by weight

  • Natera, Inc.9.47%
  • Guardant Health, Inc.4.14%
  • Qiagen N.v.3.46%

Only in XLV

54 securities, 94.1% of XLV by weight

  • Eli Lilly & Co16.46%
  • Johnson & Johnson9.93%
  • AbbVie Inc7.70%

Weight gaps

All 8 Holdings in both funds, largest gap first.

Holding weights in EKG and XLV, widest gap first
HoldingMore in EKGMore in XLV
Veeva Systems Inc. (Class A)VEEVEKG +7.36 points
IQVIA Holdings Inc.IQVEKG +6.85 points
DexCom, Inc.DXCMEKG +6.20 points
Intuitive Surgical, Inc.ISRGEKG +6.07 points
Illumina, Inc.ILMNEKG +3.40 points
ResMed Inc.RMDEKG +2.97 points
Insulet CorporationPODDEKG +2.88 points
Align Technology, Inc.ALGNEKG +2.60 points

All 51 EKG holdings⁠All 61 XLV holdings⁠

How we measure overlap

Each holding counts at its smaller weight in the two funds, summed over the full Holdings. Sector, country and asset class use the same rule on each fund’s split. Cash, FX and derivative lines stay out of the counts. Two bond funds get no overlap figure.

EKG vs XLV Cost

Overpaying EKG vs XLV

$11,028

On $10,000 over 30 years. 7% growth a year before fees, expense ratio only.

  • EKG 0.65%

    $12,717

  • XLV 0.08%

    $1,689

$10,000
30 years

Cost over time

  • EKG 0.65%
  • XLV 0.08%
  • Overpaying
One line per fund, from year 0 to year 30. Use the arrow keys to read each point.$0$5K$10K$15K051015202530EKG $12,717XLV $1,689

Year by year

YearEKGXLVOverpaying
10$1,163$147$1,016
20$4,440$575$3,865
30$12,717$1,689$11,028

Expense ratio

  • 0.65%EKG
  • 0.08%XLV, cheaper
  • Middle half of Health Care (Broad) funds
  • Median 0.50%

XLV cheapest of 25 funds

EKG 18th cheapest of 25 funds

EKG vs XLV Dividends

Last 12 months to Nov 2, 2026
Yield (12M)
EKG No data
XLV 1.38%
Payout (12M)
EKG None
XLV $2.55
Last payment
EKG No data
XLV $0.64
Ex-dividend
EKG No data
XLV Sep 21, 2026
Paid on
EKG No data
XLV Sep 23, 2026
Frequency
EKG No data
XLV Quarterly

Distribution history

Per share, 2017 to 2026, same scale for both

EKGAll EKG payments⁠

No distribution history available.

XLVQuarterly · 40 paymentsAll XLV payments⁠
One bar per payment. 40 payments from 2017 to 2026 YTD. Mar 17, 2017 $0.27; Jun 16, 2017 $0.31; Sep 15, 2017 $0.30; Dec 15, 2017 $0.33; Mar 16, 2018 $0.30; Jun 15, 2018 $0.32; Sep 21, 2018 $0.37; Dec 21, 2018 $0.38; Mar 15, 2019 $0.34; Jun 21, 2019 $0.40; Sep 20, 2019 $0.38; Dec 20, 2019 $0.42; Dec 30, 2019 $0.67; Mar 23, 2020 $0.38; Jun 22, 2020 $0.42; Sep 21, 2020 $0.42; Dec 21, 2020 $0.46; Mar 22, 2021 $0.40; Jun 21, 2021 $0.48; Sep 20, 2021 $0.47; Dec 20, 2021 $0.53; Mar 21, 2022 $0.43; Jun 21, 2022 $0.50; Sep 19, 2022 $0.51; Dec 19, 2022 $0.56; Mar 20, 2023 $0.49; Jun 20, 2023 $0.54; Sep 18, 2023 $0.54; Dec 18, 2023 $0.60; Mar 18, 2024 $0.52; Jun 24, 2024 $0.57; Sep 23, 2024 $0.58; Dec 23, 2024 $0.62; Mar 24, 2025 $0.56; Jun 23, 2025 $0.63; Sep 22, 2025 $0.62; Dec 22, 2025 $0.66; Mar 23, 2026 $0.59; Jun 22, 2026 $0.66; Sep 21, 2026 $0.64. Use the arrow keys to read each point.$0$0.502017202020232026YTD

EKG vs XLV Risk

Fall from peak · 5 years

This chart needs five years of history for both funds.

Risk facts

VolatilityStd dev, 3 years
EKG 22.1%XLV 14.8%, better
Return per unit of riskSharpe ratio, 3 years
EKG 0.92, betterXLV 0.78
Worst fallMax drawdown, 5 years
EKG −43.8%since Mar 2022XLV −17.1%
Market sensitivityBeta, 5 years
EKG 1.43XLV 0.56

EKG and XLV in the news

All news⁠

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