VS
First Trust AlphaDEX U.S. Health Care Sector Index ETF (FHH) and BMO SPDR Health Care Select Sector Index ETF (ZXLV) offer distinct profiles for Canadian ETF investors. A direct comparison shows that FHH focuses its top 3 sector exposures on Health Care, while ZXLV leans towards Health Care. When evaluating costs, FHH features a management fee (MER) of 0.7%, compared to 0.21% for ZXLV. Performance-wise, FHH has returned 0.21% year-to-date with -$0 M in net flows, whereas ZXLV is at 5.66% with +$3 M. Use the comparison tool below to benchmark these funds across top 10 holdings, yield, sector weights and historical returns.
NAV Performance and Flows
Key Data
Compare
FHH
ZXLV
| AuM | $6.31 M | $16.23 M |
| Management Fees | 0.70% | 0.21% |
| Exp. ratio | 0.76% | 0.21% |
| Tracking Difference | -0.98% | - |
Historical performance and flows
As of May 12, 2026
| 1M | 3M | YTD | 1Y | 3Y | ||
|---|---|---|---|---|---|---|
| Perf. | FHH | +0.17% | +1.49% | +0.21% | +9.47% | +9.17% |
ZXLV | -2.07% | -5.61% | -5.66% | +6.49% | - | |
| Flows | FHH | +$0 M | +$0 M | -$0 M | -$4 M | -$6 M |
ZXLV | -$0 M | -$1 M | +$3 M | +$16 M | - |
FHH vs ZXLV exposure
Countries
FHH
USA
95.47%
ZXLV
USA
97.26%
Sectors
FHH
Health Care
93.76%
ZXLV
Health Care
98.29%
As of May 12, 2026
Top 10 Holdings
FHH
ACADIA HEALTHCARE COMPANY
3.83%
APELLIS PHARMACEUTICALS
2.95%
PFIZER
2.63%
BIOGEN INC
2.40%
CARDINAL HEALTH
2.37%
HCA HEALTHCARE
2.33%
INCYTE
2.19%
IONIS PHARMACEUTICALS INC
2.18%
INSMED
2.17%
UTD THERAPEUT
2.15%
ZXLV
LILLY
13.74%
JOHNSON&JOHNSON
11.10%
ABBVIE
7.25%
MERCK & CO INC
5.63%
UNITEDHEALTH GRP
4.62%
AMGEN-T
3.57%
THERMO FISHER SCIENTIFIC
3.48%
ABBOTT LABS
3.37%
GILEAD SCIENCES
3.26%
INTUITIVE SURGICAL
3.09%
Diversification
FHH
Total weight of top 10 holdings out of 75 total
25.20%
ZXLV
Total weight of top 10 holdings out of 59 total
59.10%
Characteristics
Compare
FHH
ZXLV
| Provider | First Trust | BMO |
| Management | Passively managed | Passively managed |
| Benchmark | StrataQuant Health Care CAD Total Return Index - CAD | S&P Health Care Select Sector Total Return Index - USD |
| Replication Method | Direct (Physical) | |
| Asset Class | Equity | Equity |
| Dividend Policy | Distributing | Distributing |
| Trailing 12m distribution yield | 0.33% | 0.53% |
| Meets ESG criteria | No | No |
| Inception Date | October 30, 2014 | February 2, 2025 |
Frequently asked questions about FHH and ZXLV
Which ETF has performed better year to date: FHH or ZXLV?
As of May 12, 2026, FHH has returned 0.21% year to date, while ZXLV has returned -5.66%. FHH is ahead on YTD performance.
Which ETF is larger by assets under management: FHH or ZXLV?
As of May 12, 2026, FHH manages $6.31 M in assets, while ZXLV manages $16.23 M. ZXLV is the larger fund by AUM.
How are FHH and ZXLV managed?
FHH is passively managed by First Trust. It tracks the StrataQuant Health Care CAD Total Return Index - CAD benchmark. ZXLV is passively managed by BMO. It tracks the S&P Health Care Select Sector Total Return Index - USD benchmark.
What sectors do FHH and ZXLV emphasize?
FHH is most exposed to Health Care. ZXLV is most exposed to Health Care.
Which ETF is attracting more investor flows: FHH or ZXLV?
Year to date, FHH has seen -$0.00 M in net flows, compared with +$3.13 M for ZXLV. ZXLV has attracted more net investor money so far.
How do the fees of FHH and ZXLV compare?
FHH has an expense ratio of 0.76%, while ZXLV has an expense ratio of 0.21%.
What are the top holdings of FHH and ZXLV?
FHH's largest holdings include ACADIA HEALTHCARE COMPANY and APELLIS PHARMACEUTICALS. ZXLV's top holdings include LILLY, JOHNSON&JOHNSON, and ABBVIE.
Which ETF is more diversified: FHH or ZXLV?
FHH holds 71 securities, while ZXLV holds 56. On holdings count, FHH is the more diversified portfolio.
The ETF Market Canada is brought to you by Cboe in partnership with Trackinsight SA who is providing all the data, analysis and editorial content on this site. Unless explicitly stated as such, any information that you receive is not real-time.
All content on the ETF Market Canada is for your general information use only, Cboe is not responsible for any use of content by you outside this scope. In particular, the content does not constitute any form of advice, recommendation, representation, endorsement or arrangement by Cboe and is not intended to be relied upon by users in making (or refraining from making) any specific investment or other decisions.
All content on the ETF Market Canada is for your general information use only, Cboe is not responsible for any use of content by you outside this scope. In particular, the content does not constitute any form of advice, recommendation, representation, endorsement or arrangement by Cboe and is not intended to be relied upon by users in making (or refraining from making) any specific investment or other decisions.