Better Health Care ETF: Fidelity's FHLC vs. State Street's XLV
The article compares healthcare ETFs XLV (State Street Health Care Select Sector SPDR) and FHLC (Fidelity MSCI Health Care Index). XLV holds about 60 S&P 500 healthcare stocks, with over 25% concentrated in Eli Lilly and Johnson & Johnson, making results dependent on those firms. FHLC holds 300+ stocks, including mid/small caps, offering broader diversification but higher volatility, according to the article.
How this was made
The 30-second read
Why it matters
While there is no new fundamental catalyst for the companies, the article implies that XLV’s risk/return will be more sensitive to LLY and JNJ than FHLC, which is more diversified.
Market read
Useful for traders managing healthcare ETF factor exposure (concentration vs diversification) and for interpreting relative moves between XLV and FHLC.
What to watch
Liquidity, tracking error, and how each ETF’s underlying index methodology rebalances could matter more than the headline concentration for short-term trading.
Background
The piece compares two healthcare ETFs—XLV (S&P 500 healthcare, ~60 holdings, heavy top-name concentration) versus FHLC (MSCI healthcare, 300+ holdings, more mid/small-cap exposure).
Ticker impact
XLV is over 25% concentrated in Eli Lilly, so fund performance is highly dependent on LLY’s healthcare outlook.
Moderate correlation with LLY; volatility in LLY can amplify XLV swings.
The article explicitly cites XLV’s >25% concentration in LLY, making LLY a key driver of XLV returns.
XLV’s performance is highly reliant on Johnson & Johnson because the ETF holds a large concentration in JNJ.
If JNJ underperforms, XLV likely underperforms; if JNJ strengthens, XLV likely benefits.
The article states XLV is >25% concentrated solely on Eli Lilly and Johnson & Johnson, implying JNJ is a major factor.
Market effects
Highlights that healthcare ETF risk profiles differ: XLV concentration can increase single-name sensitivity versus FHLC diversification.
Limited—both ETFs are US-focused (S&P 500 for XLV; broader US healthcare exposure for FHLC).
Low—article is about US-listed healthcare sector exposure rather than global policy or cross-border events.
Counterpoint
The article’s focus on concentration may overstate near-term impact; ETF returns can still be driven by broader sector moves and index constituents beyond the top names.
Key entities
- ETFState Street Health Care Select Sector SPDR ETF (XLV)
S&P 500 healthcare exposure with ~60 holdings and >25% concentration in Eli Lilly and Johnson & Johnson.
- ETFFidelity MSCI Health Care Index ETF (FHLC)
More diversified MSCI healthcare exposure with 300+ holdings, including mid/small-cap names.
- CompanyEli Lilly
Major concentration holding within XLV, making it a key driver of XLV performance.
- CompanyJohnson & Johnson
Major concentration holding within XLV, making it a key driver of XLV performance.


