The Health Care Select Sector SPDR (NYSEArca: XLV) was the second-best of the nine sector SPDR exchange traded funds last year, trailing only the Utilities Select Sector SPDR (NYSEArca: XLU) on its way to a 25.1% gain.

To this point in 2015, XLV is again the second-best of the nine SPDRs, up 6% entering Tuesday, trailing only the Materials Select Sector SPDR (NYSEArca: XLB). A 6% gain in less than two months is impressive, but it might also imply the health care sector is tired and in need of a breather. Price action across health care sector and industry ETFs indicates otherwise. Last week, XLV, the largest health care ETF, notched a technical breakout, reasserting its leadership.

“On the chart we can see a classic ascending triangle formation, so named because it has a flat top and rising, or ascending, bottom. While all triangles have the potential to be both reversal or continuation patterns, an ascending pattern usually leans bullish as bulls get more aggressive. They do not let prices dip to prior lows before buying and that suggests demand is still strong despite the overall sideways movement of the stock,” reports Michael Kahn for Barron’s.

There are multiple ways of confirming the health care sector’s strength in 2015. For example, entering Tuesday, 87 S&P 500 stocks were up at least 10% year-to-date, 14 of which were healthcare names.

The iShares U.S. Healthcare Providers ETF (NYSEArca: IHF), which has risen to acclaim as one of the premier ETF avenues for playing Obamacare, has been a notable source of strength. Of the 14 S&P 500 healthcare stocks that are up at least 10% this year, several are IHF constituents. That group includes Aetna (NYSE: AET), Cigna (NYSE: CI) and Dow component UnitedHealth (NYSE: UNH). Those three stocks combine for nearly 28% of IHF’s weight. [Healthcare Services ETF Gets a Boost]

UnitedHealth is one of just four Dow stocks up at least 10% this year. One of the other three is Pfizer (NYSE: PFE), XLV’s second-largest holding at a weight of 7.8%. With that, it is not surprising that IHF is one of 185 ETFs that have touched all-time highs, as of this writing, Tuesday. Twenty five of those 185 ETFs, including XLV, are health care ETFs. [More M&A News Lifts Pharma ETFs]

A bullish sign for XLV is that the ETF is hitting new highs even as Dow component Johnson & Johnson (NYSE: JNJ), the ETF’s largest holding with a weight of 10%, is faltering. The good news is J&J’s downside momentum is waning.

J&J “has lost its downside momentum. If it can move above its declining trendline, it could give the healthcare ETF a big boost and propel it solidly back into the lead relative to the broad market,” according to Barron’s.

XLV has added nearly $607 million in assets this year. Among the nine SPDRs only XLU and the Energy Select Sector SPDR Fund (NYSEArca: XLE) have hauled in more new assets. Entering Tuesday, six of the 10 best sector ETFs and four of the top 10 non-leveraged ETFs overall were healthcare funds.

Health Care Select Sector SPDR