But wait, there’s more. Smart or strategic beta health care ETFs have also rewarded investors, particularly those ETFs with a focus on pharmaceuticals stocks. Despite being underweight biotech relative to XLV, the Guggenheim S&P Equal Weight Healthcare ETF (NYSEArca: RYH), the equal-weight rival to XLV, is this year’s sixth-best health care ETF. That is good enough to make RYH the seventh-best sector ETF overall, according to Dorsey Wright data.

Each with year-to-date gains north of 26%, the SPDR Pharmaceuticals ETF (NYSEArca: XPH), another equal-weight ETF, and the PowerShares Dynamic Pharmaceuticals Portfolio (NYSEArca: PJP) are the next best health care ETFs.

PJP and XPH have performed well for different. XPH has delivered for investors due in part to its exposure to an array of health care names favored by hedge funds and some that have been front and center in the sector’s mergers and acquisitions cycle.

PJP, which evaluates companies for inclusion based on “price momentum, earnings momentum, quality, management action, and value,” according to PowerShares, has gotten a lift from significant biotech exposure. [Why This Pharma ETF is Soaring]

Health care’s out-performance is not new. Over the past three years, the average number of health care funds among those years’ 10-best sector ETFs is over three.

Chart Courtesy: Dorsey Wright & Associates