Gilead's HIV Portfolio Shines as Cell Therapy Sales Decline

Gilead Sciences reported mixed results in its third-quarter earnings, with its HIV franchise driving growth while cell therapy sales continue to face challenges. The company's long-acting HIV pre-exposure prophylaxis (PrEP) medication, Yeztugo, has shown promising early adoption since its June launch in the U.S., contributing to an overall positive outlook for Gilead's HIV business.

Yeztugo's Strong Market Entry

Yeztugo, Gilead's latest addition to its HIV prevention lineup, has garnered $54 million in sales since its U.S. launch in June, with $39 million generated in the third quarter alone. The company has secured 75% U.S. payer access for Yeztugo, three months ahead of its original six-month target. Gilead expects to reach 90% coverage by the end of the first half of 2026.

Johanna Mercier, Gilead's chief commercial officer, noted that Yeztugo is attracting users from across the PrEP spectrum, including those switching from GSK's competing long-acting injectable, Apretude. While Gilead aims to expand the PrEP market to new users, Mercier acknowledged that this population will "grow with time."

The rapid uptake of Yeztugo has been supported by updated PrEP recommendations from key health bodies, including the U.S. Centers for Disease Control (CDC) and the World Health Organization. Despite some analysts describing the quarterly sales as a "slight miss," Citi analysts view the broad uptake and rapid payer coverage as "hallmarks of a strong launch."

HIV Franchise Drives Growth

Gilead's HIV portfolio remains the cornerstone of the company's success, with total HIV sales reaching $5.3 billion in the third quarter. The standout performer, Biktarvy, generated $3.7 billion in sales and now holds 52% of the U.S. HIV treatment market share. Recent settlements have secured Biktarvy's market exclusivity until 2036, ensuring its continued dominance.

Descovy, Gilead's older once-daily PrEP pill, also showed impressive growth, capturing a record 45% of the U.S. PrEP market share and delivering a 20% year-over-year sales increase. This performance has led Gilead to raise its overall HIV sales growth forecast for the year from 3% to 5%.

Cell Therapy and COVID-19 Challenges

While Gilead's HIV business flourishes, its cell therapy products Yescarta and Tecartus continue to face headwinds. Yescarta sales declined 10% to $349 million, while Tecartus sales dropped 15% to $83 million. Mercier attributed these declines to "competitive headwinds from in- and out-of-class therapies."

The company's COVID-19 treatment, Veklury, also contributed to a 2% slide in overall product sales compared to the same period last year. However, total revenue, including royalties and other income, increased by 3%.

Despite these challenges, Gilead remains committed to its cell therapy business, establishing 40 new approved treatment centers this year and focusing on increasing adoption and utilization of these therapies.