ETF Evaluator: First Trust Health Care AlphaDEX® ETF (FXH) Follow This ETF

First Trust Health Care AlphaDEX® ETF Overview

First Trust Health Care AlphaDEX® ETF (FXH) is a passively managed Sector Equity Health exchange-traded fund (ETF). First Trust launched the ETF in 2007.

The investment seeks investment results that correspond generally to the price and yield (before the fund's fees and expenses) of an equity index called the StrataQuant® Health Care Index. The fund will normally invest at least 90% of its net assets (including investment borrowings) in the securities that comprise the index. The index is a modified equal-dollar weighted index to objectively identify and select stocks from the Russell 1000® Index in the health care sector that may generate positive alpha relative to traditional passive-style indices through the use of the AlphaDEX® selection methodology.

About First Trust Health Care AlphaDEX® ETF (FXH)

There are 7 members of the management team with an average tenure of 15.94 years: Daniel Lindquist (2007), Jon Erickson (2007), David McGarel (2007), Stan Ueland (2007), Chris Peterson (2016), Erik Russo (2020) and Roger Testin (2007). Management tenure is more important for actively managed ETFs than passive index ETFs.

The ETF has 2 primary benchmarks: Russell 1000 TR USD index with a weighting of 100% and StrataQuant Health Care TR USD index with a weighting of 100%. First Trust Health Care AlphaDEX® ETF has 76 securities in its portfolio. The top 10 holdings constitute 28.8% of the ETF’s assets. The ETF meets the SEC requirement of being classified as a diversified fund. The ETF is not considered to have an ESG focus with its investment selection and management.

First Trust Health Care AlphaDEX® ETF is part of the Equity global asset class and is within the Sector Equity ETF group. First Trust Health Care AlphaDEX® ETF has 0.0% of its portfolio invested in foreign issues. The overall assets allocated to domestic stock is 100.0% There is 0.0% allocated to foreign stock, and 0.0% is allocated to preferred stocks. The bond allocation as a percentage of total assets is 0.0% (0.0% domestic bond, 0.0% foreign bond and 0.0% convertible bond). First Trust Health Care AlphaDEX® ETF has 0.1% of the portfolio in cash.

Assets Under Management

The fund has $959 million in total assets, which is below the $1 billion average for the Health category. Normally, lower assets under management translates to higher average expense ratios, and greater total assets are desired. However, for some investment categories, such as small-cap investing, it may be difficult for the manager to fully employ the desired active strategy if assets grow too large or too quickly.

FXH Performance and Fees

The expense ratio measures how much of a fund’s assets are used for administrative expenses and operating expenses, including adviser fees and fees for the transfer agent and custodial services. The First Trust Health Care AlphaDEX® ETF expense ratio is above average compared to funds in the Health category. First Trust Health Care AlphaDEX® ETF has an expense ratio of 0.61%, which is 18% higher than its category average, making the fund expense ratio grade a D. While it is difficult to predict returns, it is known that high annual expense ratios reduce your rate of return, and excessive fees are difficult to overcome. Active management normally comes with higher expense ratios than passive index management. Certain investment categories such as small company and foreign also normally have higher expense ratios. It is best to compare fund expense ratios against the category averages for meaningful assessments.

High portfolio turnover can translate to higher expenses and lower aftertax returns. First Trust Health Care AlphaDEX® ETF has a portfolio turnover rate of 85%, which indicates that it holds its assets around / 0.0 years. By way of comparison, the average portfolio turnover is 40% for the Health category.

Recently, in the month of June 2026, First Trust Health Care AlphaDEX® ETF returned 6.3%, which earned it a grade of D, as the Health category had an average return of 8.7%. The letter grades of A, B, C, D and F are based upon relative rankings within the investment category. A grade of A, for example, would indicate that the return is in the highest 20% for that time period compared to all ETFs in that category.

First Trust Health Care AlphaDEX® ETF has a trailing yield of 0.84%, which is below the 1.12% category average. The fund normally distributes its income quarterly and its capital gains annually.

It’s natural to seek the best-performing investments, but you must consider the relationship between risk and return and the impact of costs and taxes on your realized returns.

First Trust Health Care AlphaDEX® ETF Grades

Year to date, the ETF has returned 7.7%, 2.4 percentage points worse than the category, which translates into a grade of C. The fund has returned 18.8% over the past year (grade of D), 4.7% over the past three years (grade of D) and 1.2% per year over the past five years (grade of D) and 7.8% per year over the past 10 years (grade of F).

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