XLV vs IHI Stock Comparison: AI Score, Valuation, Performance and Upside
XLV (Health Care Select Sector SPDR) provides broad S&P 500 healthcare exposure across pharma, biotech, managed care, and devices at ultra-low cost, while IHI (iShares US Medical Devices) concentrates purely in medical device companies at higher cost. XLV is the standard broad healthcare allocation tool; IHI is a subsector bet on medical technology innovation and aging demographics driving surgical procedure demand.
XLV vs IHI is broad healthcare sector diversification (all S&P 500 healthcare subsectors at 0.09%) versus medical device subsector concentration (pure-play devices, robotics, and diagnostics at 0.40%) — the tradeoff between comprehensive healthcare coverage and targeted medical technology exposure.
XLV holds the edge across 5 of 5 key metrics in this comparison. XLV has delivered stronger 1-year price return (+29.39% vs -12.55% for IHI).
- Want comprehensive healthcare sector exposure at ultra-low cost (0.09%) — pharmaceuticals, biotech, managed care, medical devices, and healthcare technology in one ETF
- Value healthcare's defensive characteristics during economic slowdowns — healthcare spending is relatively inelastic and XLV provides broad sector diversification without overweighting any single healthcare subsector
- Use XLV as a sector rotation tool or to overweight defensive sectors during market uncertainty without taking subsector concentration risk
- Want pure-play medical device and equipment exposure — concentrated in companies like Intuitive Surgical, Abbott, Medtronic, and Boston Scientific that benefit from aging demographics and surgical technology innovation
- Value the aging population tailwind for elective procedures, cardiac devices, orthopedic implants, and diabetes monitoring devices that is more directly expressed in IHI than in broad XLV
- Accept the higher expense ratio (0.40%) and subsector concentration risk in exchange for more targeted medical technology exposure without managed care or pharmaceutical company weights
| Metric | XLV | IHI |
|---|---|---|
| ETF scorei | 81.0 | 23.0 |
| Latest closei | $170.70 | $51.60 |
| 1M returni | -1.26% | -6.70% |
| 6M returni | +20.14% | -2.67% |
| 1Y returni | +29.39% | -12.55% |
The ETF score weights long-term returns and risk-adjusted performance most heavily, but still rewards low expense ratios, larger fund size, and broader diversification — so it can favor low-cost, broad, mega-cap funds over smaller thematic or actively-managed funds even when the latter have delivered stronger returns.
How much would $10,000 be worth today if invested at the start of each period, with all dividends reinvested?
| Period | XLV | IHI |
|---|---|---|
| 1Y ago | $13.16K (+31.6%) started 2025-09-25 | $8.79K (-12.1%) started 2025-09-25 |
| 5Y ago | $15.48K (+54.8%) started 2021-09-27 | $8.36K (-16.4%) started 2021-09-27 |
| 10Y ago | $33.49K (+234.9%) started 2016-09-26 | $23.37K (+133.7%) started 2016-09-26 |
Hypothetical — past performance does not guarantee future results.
| Metric | XLV | IHI |
|---|---|---|
| Expense ratioi | 0.08% | 0.37% |
| Total assets (AUM)i | $43.91B | $3.47B |
| Dividend yieldi | 1.49% | 0.44% |
| Trailing P/Ei | 30.50 | 29.12 |
| Betai | 0.55 | 0.82 |
| 52-week change | 29.39% | -12.55% |
| Metric | XLV | IHI |
|---|---|---|
| 1Y returni | +29.39% | -12.55% |
| 6M returni | +20.14% | -2.67% |
| 1M returni | -1.26% | -6.70% |
| 1Y Sharpe ratio | 1.41 | -0.79 |
| Betai | 0.55 | 0.82 |
| Dividend yieldi | 1.49% | 0.44% |
| 5Y CAGR | +7.32% | -3.98% |
Over the past year, XLV and IHI have moved moderately in the same direction (correlation of 0.66), based on daily returns.
Lower drawdown and smaller single-period drops generally indicate a smoother ride, though they do not guarantee lower future risk.
| Period | Metric | XLV | IHI |
|---|---|---|---|
| 1Y | Growthi | +29.39% | -12.55% |
| CAGRi | +29.41% | -12.55% | |
| Volatilityi | 16.07% | 20.21% | |
| Sharpe ratioi | 1.41 | -0.79 | |
| Sortino ratioi | 2.37 | -1.09 | |
| Max drawdowni | 10.47% | 26.11% | |
| Current drawdowni | 2.46% | 19.57% | |
| Avg drawdowni | 3.33% | 12.06% | |
| Ulcer Indexi | 4.48% | 14.67% | |
| Max daily dropi | 2.52% | 4.13% | |
| Max wkly dropi | 4.68% | 6.47% | |
| 5Y | Growthi | +42.32% | -18.37% |
| CAGRi | +7.32% | -3.98% | |
| Volatilityi | 15.19% | 19.71% | |
| Sharpe ratioi | 0.25 | -0.34 | |
| Sortino ratioi | 0.35 | -0.46 | |
| Max drawdowni | 17.11% | 32.39% | |
| Current drawdowni | 2.46% | 20.44% | |
| Avg drawdowni | 5.80% | 14.02% | |
| Ulcer Indexi | 7.08% | 15.85% | |
| Max daily dropi | 5.48% | 6.38% | |
| Max wkly dropi | 8.36% | 10.41% | |
| 10Y | Growthi | +179.26% | +123.96% |
| CAGRi | +10.82% | +8.40% | |
| Volatilityi | 16.72% | 20.09% | |
| Sharpe ratioi | 0.43 | 0.28 | |
| Sortino ratioi | 0.61 | 0.39 | |
| Max drawdowni | 28.40% | 33.25% | |
| Current drawdowni | 2.46% | 21.30% | |
| Avg drawdowni | 4.63% | 9.12% | |
| Ulcer Indexi | 6.11% | 12.33% | |
| Max daily dropi | 9.86% | 10.57% | |
| Max wkly dropi | 13.20% | 13.64% |
| Category | XLV | IHI |
|---|---|---|
| Fund name | State Street Health Care Select Sector SPDR ETF | iShares U.S. Medical Devices ETF |
| Type | ETF | ETF |
| Expense ratioi | 0.08% | 0.37% |
| Total assets (AUM)i | $43.91B | $3.47B |
| Dividend yieldi | 1.49% | 0.44% |
- Comprehensive healthcare sector coverage — XLV provides one-stop exposure to pharmaceuticals, biotechnology, medical devices, healthcare services, and managed care in a single low-cost ETF
- Ultra-low expense ratio (0.09%) from State Street makes XLV one of the cheapest sector ETFs available
- Healthcare's defensive characteristics — drug and insurance demand is relatively inelastic to economic cycles, making XLV a common defensive allocation in equity portfolios
- Pure-play medical device exposure — IHI concentrates in the segment of healthcare most tied to surgical volume recovery post-COVID, elective procedure demand, and innovative device adoption (robotic surgery, minimally invasive)
- Aging demographics are a powerful structural tailwind — orthopedic implants, cardiac devices, diabetes management, and diagnostic imaging demand grows with an aging population
- Technology innovation within devices — Intuitive Surgical's robotic surgery, continuous glucose monitors (Abbott FreeStyle Libre), and structural heart devices represent high-growth subsegments within IHI
- Pharmaceutical and managed care concentration — top holdings in UnitedHealth, Eli Lilly, Johnson & Johnson, and AbbVie often represent 40%+ of XLV, concentrating exposure in a few companies
- Drug pricing political risk affects the entire healthcare sector — any legislative action on pharmaceutical pricing, Medicare negotiation, or healthcare reform can impact XLV broadly
- Large managed care components (UnitedHealth, Humana, CVS) behave differently from pharma and biotech — XLV's sector blend means subsector dynamics are mixed
- Higher expense ratio (0.40%) versus XLV's 0.09% — investors pay more for IHI's subsector concentration
- Subsector volatility — IHI can be more volatile than broad XLV as it lacks the defensive buffer of managed care and pharmaceuticals during device-specific headwinds
- Hospital procedure volume sensitivity — IHI companies rely on hospitals performing elective surgeries; COVID-era procedure deferrals significantly impacted medical device revenue in 2020
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