FHLC vs IXJ: Grades, Fees and Holdings Compared

Fidelity MSCI Health Care Index ETF

FHLCANYSE Arca

iShares Global Healthcare ETF

IXJBNYSE Arca

Overlap

70.1%by weight

Expense ratio

FHLC −0.30pt a year

FHLC0.08%IXJ0.38%

Avg volume · 30D

FHLC 1.03×the volume

FHLC246KIXJ240K

10Y return · a year

FHLC +1.6pt

FHLC+12.4%IXJ+10.8%

FHLC vs IXJ Performance

Oct 29, 2021 – Oct 30, 2026

+42.8%FHLC+38.3%IXJ

Expense ratio: FHLC 0.08%, better; IXJ 0.38%
Fund size: FHLC $3.54B; IXJ $4.65B
1Y total return: FHLC +28.9%, better; IXJ +25.5%
Yield (12M): FHLC 1.15%; IXJ 1.28%, better
Holdings: FHLC 345; IXJ 123
Avg volume (30D): FHLC 246K sh, better; IXJ 240K sh
NAV per share: FHLC $88.53; IXJ $112.50
52W range

ETF.net Grade

Pillar letters and Scores for FHLC, IXJ, with each pillar’s weight
Pillar	FHLC	IXJ
Cost30% weight	A98Higher	B69
Mission25% weight	A81	Not scored
Risk15% weight	A79Higher	A73
Tradability15% weight	A82Higher	B66
Holdings10% weight	C54	B66Higher
Durability5% weight	A77	A88Higher

Rank among Health Care (Broad) funds

How we build Categories ›

Same Category. FHLC and IXJ 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 ›

FHLC ranks 2nd and IXJ 6th of 25 funds in the Health Care (Broad) Category.

Rank 1AXLVState Street Health Care Select Sector SPDR ETFScore 85
Rank 2AFHLCFidelity MSCI Health Care Index ETFScore 83
Rank 3AVHTVanguard Health Care ETFScore 77
Rank 5AIYHiShares U.S. Healthcare ETFScore 71
Rank 6BIXJiShares Global Healthcare ETFScore 69
Rank 7BRSPHInvesco S&P 500 Equal Weight Health Care ETFScore 68

Our read on each fund

ETF.net Research

FHLCAFidelity MSCI Health Care Index ETF

IXJBiShares Global Healthcare ETF

In short

FHLC Health care, whole market. FHLC tracks an MSCI index that runs from mega-cap pharma down to small-cap biotech and device makers, roughly 400 names, for 0.08% a year.

IXJ Most healthcare sector funds stop at the US border. IXJ tracks a global index instead: roughly 110 drugmakers, biotechs and device makers worldwide, and it has been doing it since 2001.

Stated mandate

FHLC The fund seeks to track the performance of the MSCI USA IMI Health Care Index before fees and expenses.

IXJ The fund seeks to track an index of global healthcare-sector equities, offering diversified access to pharmaceutical, biotech, and medical-device companies worldwide.

Why people hold it

FHLC Charges 0.08% a year against a 0.50% median for broad health care ETFs. Only XLV matches that sticker; VHT sits a hair above.
The IMI index it follows reaches for about 99% of US free-float market value, so smaller biotech and device names ride along with the pharma giants.msci.com
Mirrors its benchmark closely, one of the tighter tracking jobs among broad health care funds. Distributions come quarterly.
Fidelity has run it since 2013, and it has grown into a multi-billion-dollar fund with a plain vanilla index mandate.fidelity.com

IXJ Global by charter. It tracks S&P's capped global health care index, so companies listed outside the US sit in the same basket as the American giants.ishares.com
0.38% a year, below the median fee in its broad healthcare peer group, for a portfolio of about 110 pharma, biotech and medical-device names.
The word capped in the index name does real work: it limits how large any single mega-cap drugmaker can grow inside the fund.ishares.com
Running since 2001 and now a multi-billion-dollar fund. That is a long operating record, not a launch-and-see product.

Worth knowing

FHLC One sector, one country. Drug-pricing politics, patent cliffs and FDA rulings move the whole portfolio at once.
Free-float cap weighting means a handful of mega-cap insurers and drugmakers carry most of the weight; that long tail of small names counts for less than it looks.msci.com
Moderately traded rather than the category's volume leader, so spreads matter more on large or hurried orders.

IXJ The worldwide reach carries a price tag: peers XLV and FHLC (0.08%) and VHT (0.09%) charge a fraction of IXJ's 0.38%.
One sector, one storyline. Patent cliffs, trial data and drug-pricing politics tend to move the whole basket at once.
Trading is moderate rather than heavy, so bid-ask spreads are worth a glance on larger orders.

Full FHLC profile⁠

Full IXJ profile⁠

FHLC vs IXJ Holdings

How FHLC and IXJ differ

Overlap by weight

70.1%

Shared holdings make up 82.6% of FHLC and 70.1% of IXJ.

Level by level

Holdings57 in both70.1%
Countryby domicile74.5%
Asset classEquity100%
Sector1 Sector100%

Sector

Sector weights in FHLC and IXJ, widest gap first
Sector	More in FHLCMore in IXJ	FHLC	IXJ
Health Care	Same weight	100.0%	100.0%

Country, concentration and asset class

Country by domicile

Country weights in FHLC and IXJ, widest gap first
Country	More in FHLCMore in IXJ	FHLC	IXJ
United States	FHLC +25.4 points	99.6%	74.2%
Switzerland	IXJ +9.7 points	0.1%	9.8%
United Kingdom	IXJ +4.5 points	0.3%	4.8%
Japan	IXJ +3.6 points	0.0%	3.6%
France	IXJ +1.9 points	0.0%	1.9%
Denmark	IXJ +1.9 points	0.0%	1.9%
Germany	IXJ +1.6 points	0.0%	1.6%
Belgium	IXJ +1.1 points	0.0%	1.1%
Other countries (3)	IXJ +0.9 points	0.1%	1.0%

Outside the US: IXJ 100% developed, 0% emerging.

Concentration

Weight in the 10 largest Holdings

FHLC52.6%
IXJ48.2%

Securities held

FHLC343
IXJ109

Asset class

FHLC: Equity
IXJ: Equity

Holdings

Only in FHLC286
In both57
Only in IXJ52

Only in FHLC

286 securities, 18.2% of FHLC by weight

Medtronic PLC1.60%
Elevance Health Inc1.18%
Securities Lending Cf0.93%
Natera Inc0.76%
Becton Dickinson & Co0.70%
Revolution Medicines Inc0.42%
Royalty Pharma PLC0.35%
Insmed Inc0.30%
Tenet Healthcare Corp0.30%
Alnylam Pharmaceuticals Inc0.30%
Guardant Health Inc0.29%
United Therapeutics Corp Del0.29%
Roivant Sciences Ltd0.25%
Halozyme Therapeutics Inc0.20%
Medpace Holdings Inc0.20%
Exelixis Inc0.20%
Neurocrine Biosciences Inc0.18%
Glaukos Corp0.17%
State Street 60 Day Money Mark0.17%
Encompass Health Corp0.17%
Jazz Pharma PLC0.16%
Penumbra Inc0.15%
Medline Inc0.15%
Elanco Animal Health Inc0.15%
Avantor Inc0.14%
Repligen0.14%
Bridgebio Pharma Inc0.14%
Ensign Group Inc0.14%
Molina Healthcare Inc0.13%
Biomarin Pharmaceutical Inc0.13%
Twist Bioscience Corp0.13%
Brightspring Hlth Services Inc0.13%
Globus Medical Inc0.12%
10X Genomics Inc0.11%
Healthequity Inc0.11%
Corcept Therapeutics Inc0.11%
Tg Therapeutics Inc0.11%
Tempus Ai Inc0.10%
Cytokinetics Inc0.10%
Vaxcyte Inc0.10%
Protagonist Therapeutics Inc0.10%
Arrowhead Pharmaceuticals Inc0.09%
Alkermes PLC0.09%
Chemed Corp0.09%
Ionis Pharmaceuticals Inc0.09%
Bio Rad Labs Class A0.09%
Krystal Biotech Inc0.09%
Praxis Precision Medicines Inc0.09%
Bruker Corp0.09%
Lantheus Hldgs Inc0.08%

Only in IXJ

52 securities, 29.5% of IXJ by weight

Roche Ps Par AG3.88%
Novartis AG3.36%
Astrazeneca PLC3.27%
Novo Nordisk Class B1.43%
Medtronic PLC1.33%
Glaxosmithkline1.13%
Sanofi SA1.08%
Elevance Health Inc1.03%
Takeda Pharmaceutical0.76%
Csl0.76%
Essilorluxottica SA0.68%
Argenx0.64%
Hoya0.63%
Bayer AG0.62%
Lonza Group AG0.62%
Becton Dickinson0.61%
Sandoz Group AG0.50%
Galderma Group N AG0.49%
Ucb SA0.43%
Haleon PLC0.42%
Genmab0.41%
Alcon AG0.40%
Otsuka Holdings0.40%
Daiichi Sankyo Ltd0.37%
Astellas Pharma0.33%
Chugai Pharmaceutical Ltd0.31%
Beone Medicines AG0.31%
Terumo0.25%
Fresenius N0.25%
Merck0.25%
Koninklijke Philips0.24%
Siemens Healthineers AG0.19%
Sonova Holding AG0.19%
Shionogi0.17%
Roche Holding AG0.16%
Straumann Holding AG0.15%
Smith and Nephew PLC0.14%
Olympus0.14%
Sigma Healthcare0.13%
Eurofins Scientific0.12%
Qiagen0.12%
Eisai0.11%
Coloplast B0.10%
Fresenius Medical Care AG0.10%
Sartorius Pref AG0.09%
Sonic Healthcare0.08%
Sartorius Stedim Biotech SA0.08%
Ono Pharmaceutical0.08%
Cochlear0.07%
Getinge B0.07%

Weight gaps

All 57 Holdings in both funds, largest gap first.

Holding weights in FHLC and IXJ, widest gap first
Holding	More in FHLCMore in IXJ	FHLC	IXJ
Eli Lilly & CoLLY	FHLC +2.54 points	14.17%	11.63%
Johnson & JohnsonJNJ	FHLC +1.79 points	8.54%	6.75%
AbbVie IncABBV	FHLC +1.28 points	6.62%	5.34%
UnitedHealth Group IncUNH	FHLC +0.69 points	4.81%	4.12%
Merck & Co Inc NewMRK	FHLC +0.51 points	4.66%	4.15%
Thermo Fisher Scientific IncTMO	FHLC +0.49 points	3.40%	2.91%
Amgen IncAMGN	FHLC +0.36 points	3.20%	2.84%
Intuitive Surgical IncISRG	FHLC +0.33 points	2.05%	1.72%
Danaher CorpDHR	FHLC +0.31 points	1.95%	1.64%
Abbott LaboratoriesABT	FHLC +0.28 points	2.35%	2.07%
Gilead Sciences IncGILD	FHLC +0.26 points	2.65%	2.39%
Pfizer IncPFE	FHLC +0.24 points	2.20%	1.96%
Stryker CorpSYK	FHLC +0.24 points	1.39%	1.15%
Cvs Health CorpCVS	FHLC +0.19 points	1.49%	1.30%
Bristol-Myers Squibb CoBMY	FHLC +0.18 points	1.62%	1.44%
Mckesson CorpMCK	FHLC +0.17 points	1.48%	1.31%
Hca Healthcare IncHCA	FHLC +0.17 points	0.96%	0.79%
Vertex Pharmaceuticals IncVRTX	FHLC +0.17 points	1.77%	1.60%
Illumina IncILMN	FHLC +0.15 points	0.55%	0.40%
Boston Scientific CorpBSX	FHLC +0.13 points	0.82%	0.69%
Cigna Group (The)CI	FHLC +0.13 points	1.02%	0.89%
Edwards Lifesciences CorpEW	FHLC +0.10 points	0.70%	0.60%
Agilent Technologies IncA	FHLC +0.10 points	0.66%	0.56%
Cardinal Health IncCAH	FHLC +0.10 points	0.76%	0.66%
Idexx Labs IncIDXX	FHLC +0.10 points	0.59%	0.49%
Resmed IncRMD	FHLC +0.10 points	0.47%	0.37%
Iqvia Holdings IncIQV	FHLC +0.09 points	0.59%	0.50%
Waters CorpWAT	FHLC +0.10 points	0.61%	0.51%
Humana IncHUM	FHLC +0.09 points	0.65%	0.56%
Cencora IncCOR	FHLC +0.08 points	0.79%	0.71%
Mettler-Toledo Intl IncMTD	FHLC +0.07 points	0.45%	0.38%
Regeneron Pharmaceuticals IncREGN	FHLC +0.07 points	1.09%	1.02%
Labcorp Holdings IncLH	FHLC +0.06 points	0.39%	0.33%
Ge Healthcare Technologies IncGEHC	FHLC +0.06 points	0.45%	0.39%
Veeva Sys Inc Class AVEEV	FHLC +0.05 points	0.58%	0.53%
Zoetis Inc Class AZTS	FHLC +0.06 points	0.43%	0.37%
Centene CorpCNC	FHLC +0.06 points	0.44%	0.38%
West Pharmaceutical Svcs IncWST	FHLC +0.05 points	0.38%	0.33%
Biogen IncBIIB	FHLC +0.06 points	0.47%	0.42%
Dexcom IncDXCM	FHLC +0.05 points	0.40%	0.35%
Quest Diagnostics IncDGX	FHLC +0.05 points	0.36%	0.31%
Viatris IncVTRS	FHLC +0.04 points	0.29%	0.25%
Steris PLCSTE	FHLC +0.04 points	0.29%	0.25%
Revvity IncRVTY	FHLC +0.04 points	0.24%	0.20%
Zimmer Biomet Hldgs IncZBH	FHLC +0.04 points	0.24%	0.20%
Moderna IncMRNA	FHLC +0.04 points	0.97%	0.93%
Charles River Labs Intl IncCRL	FHLC +0.04 points	0.23%	0.19%
Solventum CorpSOLV	FHLC +0.03 points	0.16%	0.13%
Incyte CorpINCY	FHLC +0.03 points	0.26%	0.23%
Align Technology IncALGN	FHLC +0.02 points	0.13%	0.11%
Baxter Intl IncBAX	FHLC +0.03 points	0.16%	0.13%
Insulet CorpPODD	FHLC +0.02 points	0.14%	0.12%
Cooper Companies IncCOO	FHLC +0.02 points	0.15%	0.13%
Bio Techne CorpTECH	FHLC +0.02 points	0.15%	0.13%
Henry Schein IncHSIC	FHLC +0.02 points	0.11%	0.09%
Universal Health Svcs Inc Class BUHS	FHLC +0.02 points	0.12%	0.10%
Davita IncDVA	FHLC +0.01 points	0.08%	0.07%

All 365 FHLC holdings⁠All 109 IXJ 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.

FHLC vs IXJ Cost

Overpaying IXJ vs FHLC

$5,933

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

FHLC 0.084%
$1,773
IXJ 0.38%
$7,706

Amount$10,000

Years30 years

Cost over time

FHLC 0.084%
IXJ 0.38%
Overpaying

Year by year

Year	FHLC	IXJ	Overpaying
10	$154	$688	$534
20	$603	$2,658	$2,055
30	$1,773	$7,706	$5,933

Expense ratio

0.08%FHLC, cheaper
0.38%IXJ

FHLC0.08%IXJ0.38%

0.08%0.85%

Middle half of Health Care (Broad) funds
Median 0.50%

FHLC 2nd cheapest of 25 funds

IXJ 10th cheapest of 25 funds

FHLC vs IXJ Dividends

Last 12 months to Oct 30, 2026

Yield (12M): FHLC 1.15%; IXJ 1.28%, better
Payout (12M): FHLC $1.02; IXJ $1.44
Last payment: FHLC $0.25; IXJ $0.85
Ex-dividend: FHLC Sep 18, 2026; IXJ Jun 15, 2026
Paid on: FHLC Sep 22, 2026; IXJ Jun 18, 2026
Frequency: FHLC Quarterly; IXJ Twice a year

Distribution history

Per share, 2017 to 2026, same scale for both

FHLCQuarterly · 40 paymentsAll FHLC payments⁠

IXJTwice a year · 20 paymentsAll IXJ payments⁠

FHLC vs IXJ Risk

Fall from peak · 5 years

FHLC
IXJ

Risk facts

VolatilityStd dev, 3 years: FHLC 14.5%IXJ 14.2%, better
Return per unit of riskSharpe ratio, 3 years: FHLC 0.83, betterIXJ 0.69
Worst fallMax drawdown, 5 years: FHLC −17.7%, betterIXJ −18.1%
Market sensitivityBeta, 5 years: FHLC 0.59IXJ 0.55; Market = 1

FHLC and IXJ in the news

All news⁠

Category Review
Health care funds trail the S&P 500 this year
Updated Oct 7, 2026FHLCIXJ
Deep Dive
Health care's 1.8% week was four large caps, not a biotech rally
Sep 19, 2026FHLC
News
Artisan Partners calls for Novartis board changes after back-to-back trial failures
Sep 10, 2026IXJ

Popular comparisons

FHLCAvsXLVA
Fidelity MSCI Health Care Index ETF · State Street Health Care Select Sector SPDR ETF
Expense ratio
0.08% · 0.08%
Category
IXJBvsXLVA
iShares Global Healthcare ETF · State Street Health Care Select Sector SPDR ETF
Expense ratio
0.38% · 0.08%
Category
FHLCAvsVHTA
Fidelity MSCI Health Care Index ETF · Vanguard Health Care ETF
Expense ratio
0.08% · 0.09%
Category
IXJBvsVHTA
iShares Global Healthcare ETF · Vanguard Health Care ETF
Expense ratio
0.38% · 0.09%
Category
FHLCAvsXHSA
Fidelity MSCI Health Care Index ETF · State Street SPDR S&P Health Care Services ETF
Expense ratio
0.08% · 0.35%
Category
IXJBvsXHSA
iShares Global Healthcare ETF · State Street SPDR S&P Health Care Services ETF
Expense ratio
0.38% · 0.35%
Category