Health Care Select Sector SPDR Fund (XLV) Top 25 Holdings

The Health Care Select Sector SPDR Fund (XLV) is the go-to ETF for investors looking to capture the performance of America’s health care giants. With low fees and massive liquidity, it’s a staple in countless portfolios. XLV offers targeted exposure to one of the most resilient and essential sectors of the U.S. economy.

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Health care has long been a defensive play. People need treatments, drugs, devices, and insurance regardless of the economic cycle, which makes XLV less volatile than many other sector funds. It combines pharma leaders like Eli Lilly and Johnson & Johnson with insurers, biotech innovators, and medical equipment makers.

Still, like other sector ETFs, XLV is concentrated at the top. The biggest names account for a significant share of the fund, and their performance drives overall returns. Let’s take a closer look at the 25 largest holdings and then dive deeper into Eli Lilly, Johnson & Johnson, and AbbVie, which anchor the portfolio.

1. Eli Lilly (LLY)

Eli Lilly is the crown jewel of XLV right now. Its breakthroughs in obesity and diabetes treatments, such as Mounjaro and Zepbound, have transformed it into the most valuable pharmaceutical company in the world. These drugs are expanding at a pace rarely seen in health care, addressing one of the largest global markets.

But Lilly’s story doesn’t end there. Its Alzheimer’s pipeline is advancing, and oncology efforts are showing promise, meaning future growth drivers are already lined up. For XLV investors, this matters because Lilly’s 11.9% weighting means one company has an outsized influence; when Lilly moves, XLV moves.

Financially, Lilly generates massive cash flow, fueling continued R&D investments while rewarding shareholders with returns. If you believe in health care innovation as an investment thesis, Eli Lilly is XLV’s headline act.

2. Johnson & Johnson (JNJ)

Johnson & Johnson brings stability to the ETF. With businesses in pharmaceuticals, medical devices, and consumer health, it’s one of the most diversified players in the sector. That makes it less vulnerable to any single setback, whether it’s a patent expiration or regulatory delay.

JNJ has faced challenges, including talc litigation and increased generic competition, but its pharmaceutical pipeline and device business remain strong growth drivers. Investors often view J&J as a bond-like stock in the health care space, with consistent dividends, steady growth, and broad exposure.

For XLV, J&J’s 8.6% weighting makes it the second-largest driver of returns. It may not move as dramatically as Eli Lilly, but its resilience and income profile provide ballast to the fund. Over the long term, that blend of safety and stability is precisely why J&J remains a cornerstone of XLV.

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3. AbbVie (ABBV)

AbbVie is the income workhorse of the group. While Humira’s decline after losing exclusivity was a major headline, AbbVie has proven it can adapt. Its newer immunology drugs, Skyrizi and Rinvoq, have already become multi-billion-dollar products and are expected to keep growing for years.

For investors, AbbVie offers one of the more attractive dividend yields in XLV. That makes it popular with income-focused portfolios, especially in a sector where payouts vary widely. AbbVie’s 7.7% share of XLV ensures that its mix of income and growth is baked directly into the ETF’s returns.

AbbVie’s story illustrates the sector’s resilience: even as blockbuster drugs age, new therapies emerge to take their place. That cycle of innovation keeps the health care sector, and by extension XLV, moving forward.

What XLV Really Owns

XLV might have over 60 holdings, but the top names dominate it. Nearly half of the fund is concentrated in 10 companies, with Eli Lilly alone accounting for almost 12%. That level of concentration means fund performance is closely tied to a handful of healthcare giants.

The upside is that those giants are leaders in their respective fields. Whether it’s pharmaceutical breakthroughs, medical devices, or managed care, XLV provides investors with exposure to the most influential companies in the healthcare sector. The trade-off is that smaller innovators play a limited role in returns, even if their pipelines are promising.

Key Insights

• Concentration in leaders: Nearly 30% of the fund is in just three companies, Eli Lilly, J&J, and AbbVie.
• Defensive and stable: Health care is less tied to economic cycles, offering downside protection during market turbulence.
• Growth meets income: Investors get exposure to blockbuster drug growth while also benefiting from steady dividends and cash flows.
• Innovation pipeline: Biotech breakthroughs and new therapies continue to refresh long-term growth opportunities.

Why XLV Is Right For Healthcare Investment

XLV remains one of the most efficient ways to invest in U.S. health care. With a rock-bottom expense ratio, broad sector coverage, and massive daily liquidity, it’s a core building block in many portfolios. The ETF’s design ensures that investors get both the growth potential of blockbuster drugs and the stability of diversified insurers and device makers.

But concentration risk is real. With Eli Lilly, Johnson & Johnson, and AbbVie making up nearly 30% of the portfolio, XLV’s success leans heavily on just a few companies. For most investors, that’s an acceptable trade-off, given their scale, innovation pipelines, and financial strength.

In short, XLV is a bet on the durability of health care demand and the continued leadership of its top players. For long-term investors, it provides a straightforward, cost-effective means to capture both resilience and innovation in a single package.

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Disclaimer:

Please note that the articles on TIKR are not intended to serve as investment or financial advice from TIKR or our content team, nor are they recommendations to buy or sell any stocks. We create our content based on TIKR Terminal’s investment data and analysts’ estimates. Our analysis might not include recent company news or important updates. TIKR has no position in any stocks mentioned. Thank you for reading, and happy investing!