What caused the significant change in Gilead's operating profit in Q1 2024?

Gilead's operating profit decreased by 4.1% in Q1 2024 compared to the previous year, primarily due to lower Veklury revenues and higher total costs and expenses.

1. **Impact of Veklury Sales**: Veklury, used for hospitalized COVID-19 patients, saw a 28% decline in sales, amounting to $720 million. This drop was a significant contributor to the revenue decrease, despite slightly exceeding Wall Street expectations.
2. **HIV Product Sales**: HIV product sales fell by 2% to $4.7 billion, influenced by increased sales to government programs receiving price discounts. Notably, sales of Biktarvy, a key HIV drug, rose by 7% to $3.1 billion but missed both the Zacks Consensus Estimate and model estimates.
3. **Cost and Expense Factors**: Gilead's adjusted profit rose by 3% year-over-year, reaching $1.72 per share, due to lower total costs and expenses. However, this was not enough to offset the revenue declines, particularly in Veklury and HIV sales.
4. **Market Dynamics**: The overall market dynamics, including increased competition and pricing pressures, likely played a role in the revenue declines, especially for HIV products.

These factors, combined with higher expenses, led to the decrease in operating profit for Gilead Sciences in Q1 2024.