Is Gilead Sciences (GILD) a Compelling Long-Term Buy in the Evolving Healthcare Sector?

In the ever-shifting landscape of healthcare investing, Gilead Sciences (GILD) stands at a crossroads defined by its valuation, pipeline innovation, and competitive resilience. As of late 2025, the biopharmaceutical giant offers a nuanced case for long-term investors, balancing undervalued earnings metrics with a high-book-value premium and a pipeline poised for reinvention.

Valuation: A Tale of Two Metrics

Gilead's valuation appears bifurcated. Its price-to-earnings (P/E) ratio of 19.4 trails the biotechnology industry median of 26.2, suggesting relative affordability for earnings-driven investors according to analysis. Similarly, its enterprise value/EBITDA (EV/EBITDA) ratio of 10.1 lags behind the sector median of 12.1, reinforcing the notion of earnings-based value according to analysis. However, the price-to-book (P/B) ratio of 7.19-far above the industry's 2.81-signals a premium on intangible assets, intellectual property, or growth expectations according to analysis. This divergence reflects a stock that is cheap on cash flow but expensive on balance sheet metrics, a duality that demands closer scrutiny of its fundamentals.

Pipeline Momentum: Reinventing Beyond HIV

Gilead's historical dominance in HIV therapeutics remains intact, with Biktarvy generating $3.7 billion in Q3 2025 sales, up 6% year-over-year, and the PrEP drug Yeztugo driving preventive care adoption according to company reports. Yet the company's long-term appeal hinges on its ability to diversify. The Liver Disease portfolio, led by Livdelzi, grew 12% in 2025, while Trodelvy, an oncology drug, saw a 7% sales increase to $357 million according to company reports. These gains offset declines in the cell therapy segment, where competitive pressures reduced sales by 11% to $432 million. Crucially, Gilead's pipeline is primed for a turnaround:

anito-cel, a next-generation cell therapy, is positioned to revitalize this segment starting in 2026 according to UBS conference insights. With no major patent expirations until 2036, the company's intellectual property moat remains robust according to company reports.

Competitive Positioning: Navigating a Crowded Arena

Gilead's competitive edge lies in its dual strategy of defending legacy markets while innovating in high-growth areas. In HIV, Biktarvy's market leadership and favorable inventory dynamics ensure sustained cash flow according to company reports. In oncology and liver disease, its ability to incrementally improve therapies-rather than disrupt-aligns with the healthcare sector's preference for reliable, incremental innovation. However, the cell therapy slump underscores vulnerabilities in its newer ventures. Here, Gilead must prove it can adapt: the CFO's emphasis on "innovation" and a "robust pipeline" signals a pivot toward high-margin, differentiated therapies according to UBS conference insights.

The Long-Term Verdict

For long-term investors, Gilead presents a compelling but conditional case. Its valuation metrics suggest undervaluation relative to earnings and EBITDA, while its pipeline offers a clear path to reinvent beyond HIV. Yet the high P/B ratio and near-term challenges in cell therapy necessitate confidence in management's execution. As the healthcare sector shifts toward personalized and curative therapies, Gilead's success will depend on whether anito-cel and other pipeline candidates can transform its growth narrative.

In a market where patience is rewarded, GILD's blend of defensive cash flows and offensive innovation may yet justify its premium book value-provided the company can navigate the next phase of its evolution.