What Gilead Sciences (GILD) Said on Its Q3 Earnings Call

Key Points

• Strong third-quarter performance: Gilead’s base business sales rose 16% year over year to $8.2 billion, led by HIV products, TRODELVY and Livdelzi. Non-GAAP EPS increased to $2.55 from $2.47.
• Guidance raised: The company lifted its 2026 base business sales outlook to $30.7 billion-$31 billion and expects HIV revenue to grow about 12% for the full year.
• Future pricing pressure and pipeline growth: Gilead expects Medicare pricing and related payer effects to reduce BIKTARVY revenue by approximately $1.5 billion in 2028, but still forecasts overall HIV revenue growth. The company is advancing potential growth drivers including anito-cel, a once-weekly HIV regimen, and additional TRODELVY and Livdelzi indications.

Gilead Sciences NASDAQ: GILD reported third-quarter 2026 base business sales growth of 16% year over year, its strongest growth rate in more than a decade, as HIV products, TRODELVY and Livdelzi drove performance. The company also raised its full-year base business revenue outlook while outlining the expected impact of Medicare drug pricing on BIKTARVY beginning in 2028.

Total product sales excluding Veklury were $8.2 billion, up 16% from a year earlier and 8% sequentially, according to Chief Commercial and Corporate Affairs Officer Johanna Mercier. Including Veklury, product sales were $8.3 billion, up 13% year over year. Veklury sales declined as COVID-19-related hospitalizations fell.

Non-GAAP diluted earnings per share were $2.55, compared with $2.47 in the prior-year quarter. Chief Financial Officer Andrew Dickinson said that, excluding a prior-year contribution tied to royalty contract and other revenue, non-GAAP EPS rose 15% year over year. Third-quarter product gross margin was 88%, up from 86% a year earlier, primarily due to the expiration of a TAF-related royalty obligation in November 2025.

HIV Portfolio Leads Commercial Growth

HIV sales reached $6.2 billion in the quarter, rising 18% year over year. Mercier attributed the performance to higher average realized prices, demand and favorable inventory dynamics, though she said the inventory effect is expected to normalize by year-end.

BIKTARVY sales increased 10% to $4.1 billion. The drug reached a record 53% U.S. treatment market share, supported by gains among new patients, retention and improving access following changes to Florida’s ADAP program, Mercier said.

HIV prevention sales nearly doubled from a year earlier. Yeztugo generated $305 million in sales, up 31% sequentially, and Gilead continues to expect about $1 billion in full-year Yeztugo sales. The company said Yeztugo has become the leading long-acting injectable prevention regimen, with more than 70% of users returning for their second injection.

DESCOVY sales rose 49% year over year to $1 billion, with PrEP representing about 80% of total DESCOVY revenue. Combined, Yeztugo and DESCOVY for PrEP held 50% market share and represented a $4 billion annual run rate, according to Chief Executive Officer Daniel O’Day.

Gilead also began the launch of Bixlenvo, a daily oral combination of bictegravir and lenacapavir for virally suppressed adults with HIV that received U.S. approval in August. Mercier said early uptake among patients on complex regimens was in line with company expectations.

Guidance Raised, BIKTARVY Pricing Impact Detailed

Gilead raised its 2026 base business sales forecast to a range of $30.7 billion to $31 billion, representing a $900 million increase at the midpoint from its August outlook. Total product sales are now projected at $31 billion to $31.3 billion, including approximately $300 million in expected Veklury sales.

The company expects HIV sales to grow approximately 12% for the full year, while cell therapy revenue is expected to decline by a mid-teens percentage rate. Gilead said fourth-quarter inventory building should be smaller than typical because of a larger-than-usual increase during the third quarter.

Gilead also updated investors on the Medicare maximum fair price process for BIKTARVY. Dickinson said the Centers for Medicare & Medicaid Services set a price of $2,600 per 30-day supply, representing an approximately 38% discount to list price in the Medicare channel.

The company expects a total net impact of about $1.5 billion on BIKTARVY revenue in 2028, including the Medicare effect and spillover effects across Medicaid, 340B and other U.S. payer segments. Mercier said the impact is primarily related to Medicare and is net of the Medicare Part D redesign effect that Gilead experienced in 2025.

Despite the anticipated BIKTARVY pressure, Gilead expects total HIV revenue to grow in 2028 versus 2027, supported by other products and pipeline programs. The company also expects total product sales and EPS to rise in 2028 compared with 2027, based on current assumptions.

Oncology, Liver Disease and Pipeline Updates

TRODELVY sales climbed 42% year over year and 11% sequentially to $506 million, reaching an approximately $2 billion annual run rate. Growth reflected demand in metastatic triple-negative breast cancer and HR-positive, HER2-negative metastatic breast cancer in the U.S. and Europe. Gilead received European approval during the quarter for TRODELVY combined with pembrolizumab in first-line PD-L1-positive metastatic triple-negative breast cancer.

Livdelzi sales increased 93% year over year to $203 million, driven by demand in the U.S. and Europe. Gilead said Livdelzi is the U.S. market leader in second-line primary biliary cholangitis, or PBC. The company plans global filings to add data from the Phase III IDEAL study to the drug’s label and expects a potential U.S. label update in 2027.

Cell therapy sales were $355 million, down 18% year over year amid competitive pressure. However, Gilead is preparing for a Dec. 23 FDA decision on anito-cel for fourth-line or later relapsed or refractory multiple myeloma. Kite Executive Vice President Cindy Perettie said the company is targeting activation of 80% of its authorized treatment centers within six months of launch and 90% payer coverage within 12 months, if approved.

In research and development, Gilead expects to file islatravir plus lenacapavir with the FDA this year. If approved, the once-weekly oral regimen would be the first such HIV treatment option for virally suppressed patients. The company expects an FDA decision in 2027.

Gilead is also advancing emvistegrast, an investigational oral alpha-4 beta-7 inhibitor for inflammatory bowel disease, toward Phase III ulcerative colitis studies in 2027. The company’s inflammation pipeline now includes 13 clinical programs. In oncology, Gilead expects a Phase III update around year-end from ASCENT-GYN, which is evaluating TRODELVY in advanced or recurrent endometrial cancer.

About Gilead Sciences (NASDAQ:GILD)

Gilead Sciences, Inc is a biopharmaceutical company that discovers, develops and commercializes medicines for serious and life-threatening diseases. The company is best known for its HIV treatments, including Biktarvy, Descovy, Genvoya and Truvada, as well as therapies for chronic hepatitis B and hepatitis C. Its portfolio also includes Veklury (remdesivir), an antiviral treatment for COVID-19.

Gilead has expanded into oncology and cell therapy through products such as Trodelvy and the CAR T-cell therapies Yescarta and Tecartus, which are developed and marketed through its Kite subsidiary.

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