IXJ vs XLV: Grades, Fees and Holdings Compared

iShares Global Healthcare ETF

IXJBNYSE Arca

State Street Health Care Select Sector SPDR ETF

XLVANYSE Arca

Overlap

73.1%by weight

Expense ratio

XLV −0.30pt a year

IXJ0.38%XLV0.08%

Avg volume · 30D

XLV 38.0×the volume

IXJ240KXLV9.1M

10Y return · a year

XLV +1.7pt

IXJ+10.8%XLV+12.5%

IXJ vs XLV Performance

Oct 29, 2021 – Oct 30, 2026

+38.3%IXJ+49.8%XLV

Expense ratio: IXJ 0.38%; XLV 0.08%, better
Fund size: IXJ $4.65B; XLV $48.5B
1Y total return: IXJ +25.5%; XLV +30.3%, better
Yield (12M): IXJ 1.28%; XLV 1.38%, better
Holdings: IXJ 123; XLV 64
Avg volume (30D): IXJ 240K sh; XLV 9.1M sh, better
NAV per share: IXJ $112.50; XLV $184.09
52W range

ETF.net Grade

Pillar letters and Scores for IXJ, XLV, with each pillar’s weight
Pillar	IXJ	XLV
Cost30% weight	B69	A98Higher
Mission25% weight	Not scored	A84
Risk15% weight	A73	A78Higher
Tradability15% weight	B66	A100Higher
Holdings10% weight	B66Higher	D39
Durability5% weight	A88Higher	A87

Rank among Health Care (Broad) funds

How we build Categories ›

Same Category. IXJ 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 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 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

IXJBiShares Global Healthcare ETF

XLVAState Street Health Care Select Sector SPDR ETF

In short

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.

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

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

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

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.

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

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.

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 IXJ profile⁠

Full XLV profile⁠

IXJ vs XLV Holdings

How IXJ and XLV differ

Overlap by weight

73.1%

Shared holdings make up 99.8% of XLV and 73.1% of IXJ.

Level by level

Holdings60 in both73.1%
Countryby domicile74.2%
Sector2 Sectors99.3%
Asset classEquity100%

Sector

Sector weights in IXJ and XLV, widest gap first
Sector	More in IXJMore in XLV	IXJ	XLV
Health Care	IXJ +0.7 points	100.0%	99.3%
Technology	XLV +0.7 points	0.0%	0.7%

Country, concentration and asset class

Country by domicile

Country weights in IXJ and XLV, widest gap first
Country	More in IXJMore in XLV	IXJ	XLV
United States	XLV +25.8 points	74.2%	100.0%
Switzerland	IXJ +9.8 points	9.8%	0.0%
United Kingdom	IXJ +4.8 points	4.8%	0.0%
Japan	IXJ +3.6 points	3.6%	0.0%
France	IXJ +1.9 points	1.9%	0.0%
Denmark	IXJ +1.9 points	1.9%	0.0%
Germany	IXJ +1.6 points	1.6%	0.0%
Belgium	IXJ +1.1 points	1.1%	0.0%
Australia	IXJ +1.0 points	1.0%	0.0%

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

Concentration

Weight in the 10 largest Holdings

IXJ48.2%
XLV61.0%

Securities held

IXJ109
XLV62

Asset class

IXJ: Equity
XLV: Equity

Holdings

Only in IXJ49
In both60
Only in XLV2

Only in IXJ

49 securities, 26.6% of IXJ by weight

Roche Ps Par AG3.88%
Novartis AG3.36%
Astrazeneca PLC3.27%
Novo Nordisk Class B1.43%
Glaxosmithkline1.13%
Sanofi SA1.08%
Takeda Pharmaceutical0.76%
Csl0.76%
Essilorluxottica SA0.68%
Argenx0.64%
Hoya0.63%
Bayer AG0.62%
Lonza Group AG0.62%
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%
Rede Dor Sao Luiz SA0.07%
Hologic Inc0.00%

Only in XLV

2 securities, 0.0% of XLV by weight

Xav Health Care DEC260.02%
Contra Hologic Incorpo0.00%

Weight gaps

All 60 Holdings in both funds, largest gap first.

Holding weights in IXJ and XLV, widest gap first
Holding	More in IXJMore in XLV	IXJ	XLV
Eli LillyLLY	XLV +4.83 points	11.63%	16.46%
Johnson & JohnsonJNJ	XLV +3.18 points	6.75%	9.93%
AbbVieABBV	XLV +2.36 points	5.34%	7.70%
UnitedHealth GroupUNH	XLV +1.40 points	4.12%	5.52%
Merck & Co IncMRK	XLV +1.26 points	4.15%	5.41%
Thermo Fisher ScientificTMO	XLV +1.02 points	2.91%	3.93%
Amgen IncAMGN	XLV +0.89 points	2.84%	3.73%
Gilead SciencesGILD	XLV +0.69 points	2.39%	3.08%
Intuitive SurgicalISRG	XLV +0.65 points	1.72%	2.37%
Abbott LaboratoriesABT	XLV +0.64 points	2.07%	2.71%
PfizerPFE	XLV +0.60 points	1.96%	2.56%
DanaherDHR	XLV +0.58 points	1.64%	2.22%
StrykerSYK	XLV +0.48 points	1.15%	1.63%
Vertex PharmaceuticalsVRTX	XLV +0.45 points	1.60%	2.05%
Medtronic PLCMDT	XLV +0.45 points	1.33%	1.78%
Bristol Myers SquibbBMY	XLV +0.44 points	1.44%	1.88%
Cvs HealthCVS	XLV +0.43 points	1.30%	1.73%
Mckesson CorpMCK	XLV +0.40 points	1.31%	1.71%
Elevance Health IncELV	XLV +0.34 points	1.03%	1.37%
ModernaMRNA	XLV +0.31 points	0.93%	1.24%
CignaCI	XLV +0.29 points	0.89%	1.18%
Hca HealthcareHCA	XLV +0.26 points	0.79%	1.05%
Illumina IncILMN	XLV +0.26 points	0.40%	0.66%
Boston ScientificBSX	XLV +0.24 points	0.69%	0.93%
CencoraCOR	XLV +0.23 points	0.71%	0.94%
Cardinal HealthCAH	XLV +0.21 points	0.66%	0.87%
Edwards LifesciencesEW	XLV +0.22 points	0.60%	0.82%
Agilent Technologies IncA	XLV +0.21 points	0.56%	0.77%
Becton DickinsonBDX	XLV +0.20 points	0.61%	0.81%
Waters CorpWAT	XLV +0.20 points	0.51%	0.71%
Idexx LaboratoriesIDXX	XLV +0.19 points	0.49%	0.68%
HumanaHUM	XLV +0.19 points	0.56%	0.75%
Iqvia Holdings IncIQV	XLV +0.18 points	0.50%	0.68%
Regeneron PharmaceuticalsREGN	XLV +0.18 points	1.02%	1.20%
ResmedRMD	XLV +0.18 points	0.37%	0.55%
Veeva Systems Class AVEEV	XLV +0.16 points	0.53%	0.69%
Mettler ToledoMTD	XLV +0.14 points	0.38%	0.52%
BiogenBIIB	XLV +0.13 points	0.42%	0.55%
Ge Healthcare TechnologiesGEHC	XLV +0.13 points	0.39%	0.52%
Centene CorpCNC	XLV +0.13 points	0.38%	0.51%
Labcorp HoldingsLH	XLV +0.12 points	0.33%	0.45%
Zoetis Inc Class AZTS	XLV +0.11 points	0.37%	0.48%
West Pharmaceutical ServicesWST	XLV +0.11 points	0.33%	0.44%
Quest Diagnostics IncDGX	XLV +0.11 points	0.31%	0.42%
Dexcom IncDXCM	XLV +0.10 points	0.35%	0.45%
SterisSTE	XLV +0.09 points	0.25%	0.34%
ViatrisVTRS	XLV +0.08 points	0.25%	0.33%
RevvityRVTY	XLV +0.08 points	0.20%	0.28%
Charles River Laboratories InternaCRL	XLV +0.08 points	0.19%	0.27%
Zimmer Biomet HoldingsZBH	XLV +0.08 points	0.20%	0.28%
Incyte CorpINCY	XLV +0.07 points	0.23%	0.30%
SolventumSOLV	XLV +0.05 points	0.13%	0.18%
Baxter InternationalBAX	XLV +0.05 points	0.13%	0.18%
CooperCOO	XLV +0.05 points	0.13%	0.18%
InsuletPODD	XLV +0.04 points	0.12%	0.16%
Bio TechneTECH	XLV +0.04 points	0.13%	0.17%
Align TechnologyALGN	XLV +0.04 points	0.11%	0.15%
Universal Health Services Class BUHS	XLV +0.04 points	0.10%	0.14%
Henry ScheinHSIC	XLV +0.03 points	0.09%	0.12%
Davita IncDVA	XLV +0.03 points	0.07%	0.10%

All 109 IXJ 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.

IXJ vs XLV Cost

Overpaying IXJ vs XLV

$6,017

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

IXJ 0.38%
$7,706
XLV 0.08%
$1,689

Amount$10,000

Years30 years

Cost over time

IXJ 0.38%
XLV 0.08%
Overpaying

Year by year

Year	IXJ	XLV	Overpaying
10	$688	$147	$541
20	$2,658	$575	$2,083
30	$7,706	$1,689	$6,017

Expense ratio

0.38%IXJ
0.08%XLV, cheaper

XLV0.08%IXJ0.38%

0.08%0.85%

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

XLV cheapest of 25 funds

IXJ 10th cheapest of 25 funds

IXJ vs XLV Dividends

Last 12 months to Oct 30, 2026

Yield (12M): IXJ 1.28%; XLV 1.38%, better
Payout (12M): IXJ $1.44; XLV $2.55
Last payment: IXJ $0.85; XLV $0.64
Ex-dividend: IXJ Jun 15, 2026; XLV Sep 21, 2026
Paid on: IXJ Jun 18, 2026; XLV Sep 23, 2026
Frequency: IXJ Twice a year; XLV Quarterly

Distribution history

Per share, 2017 to 2026, same scale for both

IXJTwice a year · 20 paymentsAll IXJ payments⁠

XLVQuarterly · 40 paymentsAll XLV payments⁠

IXJ vs XLV Risk

Fall from peak · 5 years

Risk facts

VolatilityStd dev, 3 years: IXJ 14.2%, betterXLV 14.8%
Return per unit of riskSharpe ratio, 3 years: IXJ 0.69XLV 0.78, better
Worst fallMax drawdown, 5 years: IXJ −18.1%XLV −17.1%, better
Market sensitivityBeta, 5 years: IXJ 0.55XLV 0.56; Market = 1

IXJ and XLV in the news

All news⁠

Category Review
Health care funds trail the S&P 500 this year
Updated Oct 7, 2026IXJXLV
The Big Picture
Two-year Treasury yield fell 11 basis points alongside the AI share selloff
Oct 31, 2026XLV
Top Movers
Alphabet fell 12.6%, but the average stock rose
Oct 29, 2026XLV
Closing Bell
Alphabet falls 12.6% - dragging SPY into negative territory for the day
Oct 29, 2026XLV
Deep Dive
Moderna fell 18% on cancer-vaccine data, and genomics ETFs fell 4%
Oct 23, 2026XLV
Opening Bell
Nasdaq futures rise as SpaceX posts its first public profit
Oct 21, 2026XLV

Popular comparisons

IXJBvsFHLCA
iShares Global Healthcare ETF · Fidelity MSCI Health Care Index ETF
Expense ratio
0.38% · 0.08%
Category
XLVAvsFHLCA
State Street Health Care Select Sector SPDR ETF · Fidelity MSCI Health Care Index ETF
Expense ratio
0.08% · 0.08%
Category
IXJBvsVHTA
iShares Global Healthcare ETF · Vanguard Health Care ETF
Expense ratio
0.38% · 0.09%
Category
XLVAvsVHTA
State Street Health Care Select Sector SPDR ETF · Vanguard Health Care ETF
Expense ratio
0.08% · 0.09%
Category
IXJBvsXHSA
iShares Global Healthcare ETF · State Street SPDR S&P Health Care Services ETF
Expense ratio
0.38% · 0.35%
Category
XLVAvsXHSA
State Street Health Care Select Sector SPDR ETF · State Street SPDR S&P Health Care Services ETF
Expense ratio
0.08% · 0.35%
Category

IXJ vs XLV

In short

Stated mandate

Why people hold it