MEDX vs VOO
Horizon Kinetics Medical ETF vs Vanguard S&P 500 ETF
Which is better, MEDX or VOO?
VOO has been ahead.
VOO has a lower expense ratio. VOO led over 1Y, 3Y and the full window.
MarketXLS is not an investment adviser. This comparison is generated automatically from market data and is for information only. A Best mark means the better reading on that one measure, not a recommendation to buy.
Side-by-Side Comparison
| Metric | MEDX | VOO |
|---|---|---|
| Expense Ratio | 0.85% | 0.03%Best |
| AUM | $17M | $1.0T |
| Dividend Yield | 1.12% | 1.04% |
| Holdings | 68 | 506 |
| YTD Return | +4.43% | +13.59%Best |
| 1Y Return | +11.27% | +16.33%Best |
| 3Y Return (annualized) | +10.39% | +23.81%Best |
| 5Y Return (annualized) | - | +14.02% |
| Volatility (annualized) | 14.3% | 12.3%Best |
| Max Drawdown | -21.6% | -18.7%Best |
| $10,000 over 3.7 years | $12,358 | $20,035Best |
| Fund Family | Horizon Kinetics LLC | Vanguard (US) |
| Category | Equity | Equity |
| Style | Large Cap Blend | Large Cap Blend |
| Inception | Jan 27, 2023 | Sep 7, 2010 |
Not shown on this pair: Top 10 Weight.
Volatility and max drawdown, and the $10,000 over 3.7 years row, are measured over the window both funds cover: Jan 31, 2023 to Oct 2, 2026 (3.7 years).
MEDX vs VOO growth
Month-end closes. Both lines start at 0% in the first month shown, so the gap between them is the difference in growth across that window. The full view covers the 3.7 years both funds cover.
MEDX vs VOO Performance
Horizon Kinetics Medical ETF (MEDX) is an ETF from Horizon Kinetics LLC and Vanguard S&P 500 ETF (VOO) is an ETF from Vanguard (US). Over the past year MEDX returned +11.27% while VOO returned +16.33%. Year to date, MEDX is up 4.43% versus a gain of 13.59% for VOO.
Over three years, MEDX compounded at +10.39% per year against +23.81% for VOO. Across the full 4-year window we track, VOO has the edge at +20.66% annualized vs +5.89%.
Past performance does not guarantee future results.
Risk: Volatility and Drawdowns
MEDX has been the more volatile fund, with annualized monthly volatility of 14.3% compared with 12.3% for VOO. Lower volatility generally means a smoother ride, though it often comes with lower long-run returns.
The deepest peak-to-trough decline in our data was -21.6% for MEDX and -18.7% for VOO. Drawdown depth is what each fund did in the worst stretch of the window measured above.
The two funds' monthly returns correlate at 0.40. They move together some of the time, and apart the rest.
Fees and Cost Over Time
MEDX charges 0.85% per year while VOO charges 0.03%. On a $10,000 position that is $85 vs $3 annually, a gap of $82 per year that compounds over a long holding period. On income, MEDX currently yields 1.12% against 1.04% for VOO.
Holdings Overlap
At least 4.6% of VOO's money is in holdings MEDX also owns.
Stated as a floor: for MEDX, our book for it covers 91.5% of that fund, so a holding it does not list is one we cannot count as shared. The real figure is this or higher.
VOO and MEDX share little of their money.
The two holdings books were reported 47 days apart, MEDX as of Sep 16, 2026 and VOO as of Jul 31, 2026, so some of the difference between them is the time between the two reports rather than the funds.
11 positions in common, counted across the 31 positions we hold weights for in MEDX and 494 in VOO, against full books of 68 and 506.
Top Shared Holdings
| Stock | Weight in MEDX | Weight in VOO | Difference |
|---|---|---|---|
| LLYEli Lilly & Co. | 18.38% | 1.41% | 16.97% |
| ABBVAbbvie Inc. | 9.70% | 0.69% | 9.01% |
| JNJJohnson & Johnson - Common | 6.18% | 0.96% | 5.22% |
| MRKMerck & Company Inc | 4.68% | 0.50% | 4.18% |
| BMYBristol-Myers Squibb Co. | 4.62% | 0.21% | 4.41% |
| AMGNAmgen Inc. | 4.27% | 0.32% | 3.95% |
| PFEPfizer Inc | 3.42% | 0.22% | 3.20% |
| BIIBBiogen Inc. Com | 3.24% | 0.05% | 3.19% |
| REGNRegeneron Pharmaceuticals, Inc. | 2.69% | 0.12% | 2.57% |
| GEHCGe Healthcare Technologies Inc | 0.29% | 0.05% | 0.24% |
You are not choosing between two funds in isolation.
Whichever of MEDX and VOO you pick has to sit alongside everything else you own. Add the rest and see what the combination actually holds.
Free for up to 10 holdings. No account needed.
Frequently Asked Questions
Which is cheaper, MEDX or VOO?
MEDX has an expense ratio of 0.85% while VOO charges 0.03%. VOO is the cheaper option, by $82 a year on a $10,000 investment.
Which performed better, MEDX or VOO?
Over the past year MEDX returned +11.27% vs +16.33% for VOO, so VOO leads on 1-year performance. Over the longest common window we track (4 years), MEDX annualized +5.89% vs +20.66% for VOO. Past performance does not guarantee future results. This is information, not a recommendation.
Which is riskier, MEDX or VOO?
MEDX has been the more volatile fund at 14.3% annualized versus 12.3% for VOO. Worst drawdown: MEDX -21.6% vs VOO -18.7%.
Should I hold both MEDX and VOO?
MEDX and VOO have a monthly-return correlation of 0.40, so their returns are far enough apart for the mix to behave differently from either one alone. This is information, not a recommendation.
What is the holdings overlap between MEDX and VOO?
At least 4.6% of VOO's money is in holdings MEDX also owns. Our book for MEDX is partial, so the real figure is this or higher. They hold 11 positions in common, counted across the 31 positions we hold weights for in MEDX and 494 in VOO.
Which pays a higher dividend, MEDX or VOO?
MEDX yields 1.12% while VOO yields 1.04%, so MEDX currently pays the higher dividend yield.
Is VOO better than MEDX?
VOO has a lower expense ratio. VOO led over 1Y, 3Y and the full window. Which one suits a particular account depends on what it is for. This is information, not a recommendation.