XLV — XLV | S&P 500 Health Care Sector ETF 13F holdings and portfolio analysis

Directly following the baseline means accepting a concentrated health care portfolio with meaningful single-name exposure and benchmark lag risk. The baseline holds 100.01% in Health Care in the strategy artifact, with top 5 concentration at 41.34% and top 10 at 58.55%. Eli Lilly alone is 15.23%, followed by JNJ at 8.90% and ABBV at 7.21%. Performance is respectable in absolute terms at 9.08% annualized return and 136.36% total return, but alpha is -0.38 and the baseline summary explicitly notes persistent underperformance versus SPY.

The clearest recent examples are the strong rebound months with high turnover and the sharp weak stretches in 2025. In period performance, October 2025 posted 9.49% return versus 0.20% for the benchmark, a +9.29% excess return, but turnover was still 1.72 with 60 trades. July 2025 also outperformed by +3.14% with 5.19% return. On the downside, April 2025 returned -5.73% while the benchmark gained 6.28%, a -12.02% excess gap, and August 2025 lagged by -4.54%. These periods show the trade-off clearly: the baseline can win in sector-led rallies, but concentrated health care exposure creates large opportunity-cost periods when SPY leadership comes from elsewhere.

A user should inspect concentration, sector dependency, and how recent performance was achieved. The baseline artifact already flags top 10 concentration at 58.5% and max drawdown at -28.55%, despite a lower 0.73 beta. It also shows monthly turnover spikes such as 2.29 in September 2025 and 1.90 in November 2025, which matter if the user cares about implementation realism. On holdings, LLY at 15.23%, JNJ at 8.90%, and ABBV at 7.21% are big enough that a few names can drive most results. If the user is comfortable with a health care-heavy, top-heavy portfolio and negative alpha to SPY, the baseline may still be acceptable as a lower-beta exposure tool.