Gilead Sciences Q4 2024: Contradictions in PrEP Growth, Lenacapavir Launch, and HIV Business Outlook

These are the key contradictions discussed in Gilead Sciences' latest 2024Q4 earnings call, specifically including: PrEP market growth expectations, lenacapavir for PrEP launch plans, lenacapavir PrEP market dynamics, TIGIT cancer treatment approach, HIV franchise growth expectations, and the impact of the Medicare redesign on Gilead's HIV business:



Strong HIV Business Performance:
- Gilead reported HIV sales of $5.5 billion for Q4, up 16% year-over-year, and $19.6 billion for the full year, growing 8% from 2024.
- This growth was driven by strong demand, higher average realized prices, and favorable inventory dynamics, particularly for Biktarvy and Descovy, which increased by 21% year-over-year in sales.

Orphan Drug Launch and Market Impact:
- Livdelzi, launched in August, achieved $30 million in sales during its first full quarter, with strong early brand share.
- The positive launch momentum is attributed to Livdelzi's statistically significant improvements in primary biliary cholangitis (PBC) and its unique safety profile.

Oncology Portfolio Growth:
- Full-year oncology sales reached $3.3 billion, increasing 12% year-over-year.
- Growth was driven by higher demand for Trodelvy, which increased 24% year-over-year to $1.3 billion, and the continued progress of cell therapies.

Investment in R&D and Pipeline Expansion:
- Gilead's research and development expenses remained flat at $5.7 billion in 2024, highlighting a strategic focus on a diverse pipeline with 54 ongoing clinical programs.
- Investments in innovation like lenacapavir, a breakthrough therapy for HIV prevention, are expected to drive future growth and enhance Gilead's global health impact.