Gilead Sciences in Charts: HIV Product Sales Drive Q1 Growth Amid Sector Challenges

Gilead Sciences (GILD) reported mixed results for the first quarter of 2025, with its HIV portfolio delivering the strongest performance across business segments. While total revenue held steady at $6.67 billion, the HIV division surged 6% year-over-year to $4.6 billion—accounting for 70% of total sales—and underscored the critical role of its flagship therapies in maintaining the company’s financial stability.

The HIV Engine: Biktarvy and Descovy Lead the Charge

Gilead’s HIV franchise remains its bedrock. Biktarvy, the company’s once-daily treatment for HIV, reported $3.15 billion in sales—up 7% year-over-year—while maintaining a commanding 51% share of new U.S. prescriptions and treatment switches. Descovy for PrEP, used to prevent HIV infection, grew even more sharply, rising 38% to $586 million. Despite generic competition, Descovy retained over 40% of the U.S. PrEP market, driven by price hikes and strong patient adherence.

Challenges Ahead: Medicare Policy and Sector Declines

While HIV sales shine, broader headwinds threaten Gilead’s trajectory. Medicare policy changes, aimed at reducing out-of-pocket costs for beneficiaries, have introduced uncertainty. Management now expects flat HIV revenue for the full year 2025, citing this policy shift as a key drag. Meanwhile, other segments faltered:
- Oncology sales dropped 5% to $293 million due to declining Trodelvy prescriptions.
- Veklury, a pandemic-era drug for severe COVID-19, saw sales plummet 45% as hospitalizations waned.

These declines highlight Gilead’s reliance on its HIV portfolio, which now must carry the company through broader market volatility.

Pipeline Momentum: Once-Yearly Lenacapavir Could Be a Game-Changer

Gilead’s HIV pipeline offers hope. The FDA is set to decide on approval for a twice-yearly formulation of lenacapavir by June 19, 2025. If cleared, this long-acting injectable could expand prevention and treatment options, potentially delaying generic erosion and boosting margins. Early data for a once-yearly formulation also shows promise, positioning Gilead to dominate the PrEP market for years.

Conclusion: A Balanced Outlook

Gilead’s Q1 results reflect a company thriving in its core HIV business but struggling to offset declines elsewhere. The HIV segment’s 6% growth and 70% revenue contribution demonstrate resilience, fueled by strategic pricing and unshaken demand. However, the Medicare policy shift and fading pandemic-era revenue underscore risks.

Investors should weigh two key factors:
1. Near-term stability: The HIV franchise’s dominance and pipeline advancements (e.g., lenacapavir) could sustain growth even amid policy headwinds.
2. Long-term risks: Generic competition for Descovy and Biktarvy, plus sluggish oncology sales, may limit upside unless new therapies materialize.

With HIV sales at $4.6 billion and a potential lenacapavir approval looming, Gilead’s future hinges on balancing its HIV legacy with innovation. For now, the company’s ability to navigate Medicare changes while capitalizing on its pipeline positions it as a cautiously optimistic play in a crowded biotech landscape.