At a glance
FHLC charges 0.08% a year, below the 0.42% average of the 8 funds most like it (the 2nd cheapest of 9). It has $3.29B in assets, the 5th largest of that group; it paid 1.17% of its price in distributions over the past 12 months, quarterly. Over the past year it returned +23.8% with distributions reinvested (S&P 500: +11.5%), 5th of those 9 funds; over three years it returned +16.0% a year. At its worst it fell 28.7% in the 2020 crash (S&P 500: 33.7%) and 16.9% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 3 months and 19 months after the lows. Its ten largest positions make up 51.9% of the fund, out of 334 in all.
The short version
Fidelity MSCI Health Care Index ETF (FHLC) tracks the MSCI USA IMI Health Care 25/50 Index. That means it holds U.S. drugmakers, biotech firms, insurers, device makers and service providers. Its expense ratio of 0.084% is close to XLV's 0.08% and VHT's 0.09%. The average for similar funds is 0.42%. The fund held 334 companies as of July 31, 2026, but the top 10 made up about 52% of assets.
Price history
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FHLC +23.8% over the year to Oct 27, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| FHLC official prospectus, to Nov 29, 2025 | — | +2.60% | — | +7.17% | +8.79% | — |
| IXWN0 index, same period | — | +2.68% | — | +7.26% | +8.89% | — |
| S&P 001 index, same period | — | +25.02% | — | +14.53% | +13.10% | — |
| FHLC price data to Oct 27, 2026 | +17.0% | +23.8% | +16.0% | +7.2% | +11.8% | +11.6% |
- Over the year to Oct 27, 2026, FHLC returned +23.8%, 5th of 9 among similar funds.
- Its 5-year annualized return was +7.2% and its 10-year +11.8%.
- In the 2020 COVID crash it fell 28.7% and regained its old high 2.5 months after the low.
- Its worst full calendar year was 2022 (-5.5%); its best was 2014 (+25.1%).
- The deepest fall in its price history was 28.7% (Feb 19, 2020 to Mar 23, 2020), recovered by Jun 8, 2020.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +17.1% | — |
| 2025 | +15.4% | — |
| 2024 | +2.5% | +2.60% |
| 2023 | +2.6% | +2.48% |
| 2022 | -5.5% | -5.45% |
| 2021 | +20.4% | +20.37% |
| 2020 | +18.1% | +18.13% |
| 2019 | +21.9% | +21.94% |
| 2018 | +5.5% | +5.52% |
| 2017 | +23.4% | +23.31% |
| 2016 | -3.4% | -3.33% |
| 2015 | +7.1% | +7.04% |
| 2014 | +25.1% | — |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 28.7% over that stretch · deepest drop along the way 28.7%, back to its old high 2.5 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 14.2% over that stretch · deepest drop along the way 16.9%, back to its old high 18.8 months after the low |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2026 (to date) | $0.7400 | |
| 2025 | $1.0400 | +5.1% |
| 2024 | $0.9900 | +10.0% |
| 2023 | $0.9000 | +8.4% |
| 2022 | $0.8300 | +5.1% |
| 2021 | $0.7900 | -4.8% |
| 2020 | $0.8300 | +43.1% |
| 2019 | $0.5800 | -34.5% |
| 2018 | $0.8860 | +58.2% |
| 2017 | $0.5600 | +21.7% |
| 2016 | $0.4600 | -36.1% |
| 2015 | $0.7200 | +110.5% |
| 2014 | $0.3420 |
What's inside
As of Jul 31, 2026, the fund held 334 securities; the ten largest made up 51.94% of assets.
| Holding | Weight | |
|---|---|---|
| Eli Lilly & Co | 13.35% | |
| Johnson & Johnson | 8.93% | |
| AbbVie Inc | 6.42% | |
| UnitedHealth Group Inc | 5.44% | |
| Merck & Co Inc | 4.66% | |
| Thermo Fisher Scientific Inc | 3.09% | |
| Amgen Inc | 3.00% | |
| Abbott Laboratories | 2.66% | |
| Gilead Sciences Inc | 2.34% | |
| Pfizer Inc | 2.06% | |
| Bristol-Myers Squibb Co | 1.93% | |
| CVS Health Corp | 1.92% | |
| Intuitive Surgical Inc | 1.82% | |
| Danaher Corp | 1.80% | |
| Vertex Pharmaceuticals Inc | 1.76% |
By country
United States 96.35%Ireland 2.24%United Kingdom 0.45%Bermuda 0.24%Canada 0.17%By asset type
Stocks 99.71%By sector
Sectors of the companies held, for the 76.3% of the fund in companies that have a stock page here; other holdings and cash aren't classified. Source: N-PORT holdings report as of Jul 31, 2026. Cash, money-market funds and derivatives are shown separately from the securities list.What changed recently
- Over the three months to Jul 31, 2026, investors added a net $88.7M (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +2.70%, +7.31%, +1.90%.
How it works
FHLC aims to match the performance of the MSCI USA IMI Health Care 25/50 Index, before fees and expenses. The index covers U.S. companies in the health care sector under GICS (the Global Industry Classification Standard, a widely used system for sorting companies by industry). The sector has two parts. One is companies that make equipment and supplies or provide health care services, including distributors and hospital operators. The other is companies that research, make and sell drugs and biotech products.
Fidelity uses "representative sampling." The fund keeps at least 80% of its assets in index stocks but may not own every one. Instead, it picks a sample that resembles the index in company size, industry mix, yield and price swings. Bigger companies carry more weight. As of July 31, 2026, the fund held 334 companies. Eli Lilly made up 13.3% of assets, Johnson & Johnson 8.9%, AbbVie 6.4%, UnitedHealth Group 5.4% and Merck 4.7%. The fund is legally "non-diversified," so a few stocks can drive its results.
Trading is light: portfolio turnover was 3%. From December 11, 2025, derivatives can count toward the 80% rule. As of July 31, 2026, the fund's futures positions were tiny and cash was 0.15% of assets. Fees, sampling and trading costs mean returns can differ slightly from the index.
What it really costs
- FHLC charges 0.084% a year, versus an average of 0.42% for the similar funds below (2nd of 9, cheapest first).
- Using the prospectus's standard example, $10,000 invested would cost about $9 in the first year and $108 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| FHLC | $9 | $27 | $47 | $108 |
In a retirement portfolio
It is a low-cost but single-sector, non-diversified fund in which one stock, Eli Lilly, was 13.3% of assets as of July 31, 2026.
FHLC launched in October 2013, so it has no record from the 2008 crisis. Its deepest drop came in the 2020 COVID crash. It fell 28.7% from February 19 to March 23, 2020, then recovered by June 8, about 2.5 months later. The 2022 decline was smaller, at 16.9%, but recovery took 18.8 months, until January 2024. Its worst calendar year was 2022, at -5.45%. A retiree selling shares for spending during a slow recovery like that would lock in losses.
Income is modest. The trailing yield was 1.17% as of October 27, 2026, paid quarterly. Costs are low: the SEC's standard example works out to $9 in the first year and $108 over 10 years on $10,000. Past results don't predict the future, and a plan should look at the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Investors wanting U.S. health care stocks at low cost: a 0.084% expense ratio, compared with a 0.42% average among similar funds.
- Holders comfortable with a big tilt to drugmakers: Eli Lilly, Johnson & Johnson and AbbVie made up nearly 29% of assets as of July 31, 2026.
- Those wanting a sector that has moved less with the market: a one-year beta (how much it follows the market) of 0.26 as of October 27, 2026.
Look elsewhere if
- Investors wanting broad diversification: the prospectus shows a 10-year return of 8.79% a year, versus 13.1% for its broad-market comparison index.
- Income seekers: the trailing yield was 1.17% as of October 27, 2026, paid quarterly, which is modest for anyone relying on payouts.
- Those wanting non-U.S. health care firms: about 96% of assets are U.S.-based. The global iShares Global Healthcare ETF (IXJ) costs more, at 0.41%.
Close alternatives
Matched by holdings overlap from the latest N-PORT reports.
| Fund | Overlap | Cost | Net assets | 1 yr | 3 yr |
|---|---|---|---|---|---|
| FHLC this fund | — | 0.084% | $3.29B | +23.8% | +16.0% |
| VHT Vanguard Health Care ETF | 96% | 0.09% | $22.04B | +28.9% | +16.9% |
| IYH iShares U.S. Healthcare ETF | 87% | 0.39% | $3.56B | +23.8% | +15.0% |
| XLV Health Care Select Sector SPDR Fund | 85% | 0.08% | $40.60B | +30.2% | +16.2% |
| IXJ iShares Global Healthcare ETF | 71% | 0.41% | $3.84B | +19.5% | +13.4% |
| JDOC JPMorgan Healthcare Leaders ETF | 54% | 0.65% | $9.1M | +15.7% | — |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 49% | 0.4% | $766.9M | +28.4% | +16.6% |
| FTXH First Trust Nasdaq Pharmaceuticals ETF | 45% | 0.6% | $36.2M | +46.9% | +23.4% |
Questions investors ask
What's the difference between FHLC and VHT?
Very little in holdings: about 96% of their portfolios overlap. That makes the Vanguard Health Care ETF (VHT) the closest similar fund. FHLC's expense ratio is 0.084% and VHT's is 0.09%, so FHLC costs slightly less. VHT is much bigger. It had about $22.0 billion in net assets as of August 31, 2026. FHLC had about $3.3 billion as of July 31, 2026. Both are worth comparing on cost, trading volume and tracking.
Does FHLC pay dividends?
Yes, FHLC pays dividends quarterly. Over the 12 months to October 27, 2026, it paid $1.01 per share, a trailing yield of 1.17%. That income comes from dividends paid by the health care companies it holds, such as Johnson & Johnson, AbbVie and Merck. The yield is modest, so the fund is mainly a growth holding rather than an income source.
What is FHLC's expense ratio?
FHLC's expense ratio is 0.084% a year, according to its prospectus filed November 24, 2025. In the SEC's standard example of $10,000 earning 5% a year, costs come to about $9 after one year and $108 after 10 years. It ranks 2nd-cheapest of 9 similar health care funds, where the average is 0.42%. The Health Care Select Sector SPDR Fund (XLV) costs 0.08%.
What are FHLC's top holdings?
As of July 31, 2026, FHLC's largest holdings were Eli Lilly (13.3% of assets), Johnson & Johnson (8.9%), AbbVie (6.4%), UnitedHealth Group (5.4%) and Merck (4.7%). Thermo Fisher Scientific, Amgen, Abbott Laboratories, Gilead Sciences and Pfizer complete the top 10. Altogether, the top 10 made up about 52% of the fund, even though it held 334 companies.
How has FHLC performed over the long term?
FHLC returned 8.79% a year over 10 years and 7.17% a year over five years, according to its prospectus filed November 24, 2025. Its index returned 8.89% and 7.26% over the same periods, so the fund tracked it closely. Both trailed the prospectus's broad-market comparison index, at 13.1% over 10 years. Based on prices, the fund was up 17.05% in 2026 through October 27.