Catch up on the essentials
- Gilead Sciences reported third-quarter base-business sales of $8.2 billion, up 16% year over year, led by HIV medicines, Trodelvy and Livdelzi.
- Cell-therapy revenue was expected to decline by a mid-teens percentage rate for the full year, and third-quarter cell-therapy sales fell 18% year over year amid competitive headwinds.
- The reviewed coverage does not quantify how much of the expected HIV growth would occur after the Medicare effect begins.
Selected from this article · 2026-10-30
Read on for the full pictureGrowth broadens beyond a single HIV product
Gilead Sciences reported third-quarter base-business sales of $8.2 billion, up 16% year over year, led by HIV medicines, Trodelvy and Livdelzi. The rate was the company’s strongest in more than a decade, according to the earnings-call coverage. Total product sales including Veklury reached $8.3 billion, rising 13%.
The transcript identifies the October 29 call as Gilead’s third-quarter 2026 earnings call. It also records non-GAAP EPS of $2.55 against $2.47 in the prior-year quarter. The broader commercial picture was supported by several franchises: HIV sales rose 18% to $6.2 billion, while Trodelvy sales increased 42% to $506 million and Livdelzi sales rose 93% to $203 million.
Pricing and demand powered HIV growth
HIV portfolio sales of $6.2 billion reflected higher realized prices, demand and favorable inventory dynamics, Chief Commercial and Corporate Affairs Officer Johanna Mercier said. She also cautioned that the inventory contribution should normalize by year-end, limiting the extent to which third-quarter momentum can be treated as a recurring run rate.
Biktarvy remained the central franchise, generating $4.1 billion in quarterly sales and reaching a record 53% US treatment market share. Its growth was attributed to new patients, retention and improved access following changes to Florida’s ADAP program. HIV prevention sales nearly doubled year over year. Yeztugo, described in the coverage as a long-acting injectable prevention regimen, produced $305 million in sales, while Descovy sales reached $1 billion, up 49%.
Raised guidance signals operating momentum
Gilead raised its 2026 base-business sales outlook to $30.7 billion–$31 billion, a $900 million increase at the midpoint from its August forecast. The company now expects total product sales of $31 billion–$31.3 billion, including approximately $300 million from Veklury, and full-year HIV revenue growth of about 12%.
Non-GAAP diluted EPS guidance rose by $0.25 at each end to $8.75–$9.10, excluding acquired IPR&D and financing costs. Third-quarter product gross margin increased to 88% from 86%, which Gilead attributed primarily to the expiration of a TAF-related royalty obligation in November 2025. Approximately $1.4 billion was returned to shareholders in the quarter, including $370 million through share repurchases.
The outlook is not uniform across the portfolio. Cell-therapy revenue was expected to decline by a mid-teens percentage rate for the full year, and third-quarter cell-therapy sales fell 18% year over year amid competitive headwinds. This makes HIV prevention, oncology and liver disease the principal disclosed growth contributors rather than evidence of uniform expansion across all therapeutic areas.
Biktarvy pricing tempers the outlook
The principal counterweight is Medicare pricing for Biktarvy. Gilead said the Centers for Medicare & Medicaid Services set a maximum fair price of $2,600 per 30-day supply, approximately 38% below list price in the Medicare channel. The company expects a net revenue reduction of about $1.5 billion in 2028.
That pressure does not change Gilead’s stated expectation for overall HIV revenue growth in 2026, but it introduces a material tension between current franchise strength and the later pricing environment. The reviewed coverage does not quantify how much of the expected HIV growth would occur after the Medicare effect begins.
Pipeline execution remains the next test
Gilead is advancing anito-cel as a potential once-weekly HIV regimen and pursuing additional Trodelvy and Livdelzi indications. It also began launching Bixlenvo, a daily oral combination of bictegravir and lenacapavir for virally suppressed adults with HIV that received US approval in August; early uptake among patients with complex regimens was in line with company expectations.
The next verifiable checkpoints are whether HIV sales sustain growth as the third-quarter inventory effect normalizes, whether pipeline advances support the raised outlook, and how patients and payers respond to Biktarvy’s Medicare pricing before the projected 2028 revenue effect.
Industry and product implications
Industry / product | Disclosed fact | Demand interpretation | Verification signal | Main risk |
|---|---|---|---|---|
HIV medicines (downstream) | Gilead reported third-quarter 2026 HIV sales of $6.2 billion, up 18% year over year. [2] | Qualified inference; operating. Higher realized prices, demand and favorable inventory dynamics drove quarterly HIV sales. | Subsequent HIV-sales disclosure shows whether growth persists after inventory effects normalize by year-end. | Favorable inventory dynamics were expected to normalize by year-end. |
Biktarvy (downstream) | Biktarvy generated $4.1 billion in third-quarter sales and reached a record 53% US treatment market share. [3] | Qualified inference; operating. Gains among new patients, retention and improved access following changes to Florida’s ADAP program supported the franchise. | Subsequent US treatment-share and Biktarvy sales disclosures. | Gilead expects Medicare pricing to reduce Biktarvy revenue by approximately $1.5 billion in 2028. |
Yeztugo (downstream) | Yeztugo generated $305 million in third-quarter sales, up 31% sequentially, and Gilead continued to expect about $1 billion in full-year sales. [3] | Qualified inference; operating. Gilead described Yeztugo as the leading long-acting injectable prevention regimen, with more than 70% of users returning for their second injection. | Full-year Yeztugo sales and subsequent user-return disclosures. | The approximately $1 billion full-year figure is company guidance rather than realized revenue. |
Descovy (downstream) | Descovy sales reached $1 billion in the third quarter, rising 49% year over year, with PrEP representing about 80% of revenue. [3] | Qualified inference; operating. PrEP accounted for about four-fifths of Descovy revenue, while Descovy and Yeztugo held a combined 50% prevention-market share. | Subsequent Descovy sales and HIV-prevention market-share disclosures. | The reviewed coverage does not disclose a separate purchase pipeline for Descovy. |
Trodelvy (downstream) | Trodelvy recorded third-quarter sales of $506 million, up 42% year over year, reaching an approximately $2 billion annual run rate. | Reported sales; operating. The reported growth was associated with strong uptake in first-line metastatic triple-negative breast cancer. | Subsequent Trodelvy sales and indication-specific uptake disclosures. | The annual run rate does not establish a new order or guaranteed future sales. |
Livdelzi (downstream) | Livdelzi posted third-quarter sales of $203 million, up 93% year over year and 21% sequentially. | Reported sales; operating. The coverage attributed the performance to market leadership in primary biliary cholangitis and expansion in the second-line market. | Subsequent Livdelzi sales and market-position disclosures. | The reviewed coverage does not disclose new procurement activity for Livdelzi. |
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