HIV strength funds a risky rebuild
- HIV is still the center of Gilead, with Q2 2026 sales of $5.7 billion, up 12% year over year.
- The HIV prevention business reached a $4 billion annual run rate, pushing management to raise 2026 HIV growth guidance to between 9% and 10%.
- Trodelvy is the bright spot in oncology, with Q2 2026 sales up 26% year over year to $457 million.
- Cell Therapy is still shrinking, with Q2 2026 sales down 14% year over year to $417 million.
- Biktarvy has a longer U.S. patent runway to April 2036, but Medicare price negotiation starts in 2028.
The HIV engine got stronger
Gilead is still mainly an HIV company. That is a good thing right now. In Q2 2026, HIV product sales were $5.7 billion, up 12% year over year. Management also raised its 2026 HIV growth outlook from 8% to between 9% and 10%.
The main reason is the HIV prevention business, which reached a $4 billion annual run rate. If that growth continues, Gilead gets more cash and more time to build the next leg of the company.
The rebuild is the hard part. Gilead is buying growth through deals like Arcellx, Tubulis, and Ouro to deepen oncology and inflammation. Trodelvy is helping, with Q2 2026 sales up 26% year over year. But Cell Therapy is moving the wrong way, falling 14% year over year in Q2 2026.
The stock story is balanced. Gilead has a strong cash engine and a longer Biktarvy patent runway to April 2036. But the company is still highly tied to HIV, Biktarvy faces Medicare price negotiation in 2028, and investors are being asked to trust a large acquisition plan.
Patented drugs, concentrated cash flow
Gilead discovers, develops, and sells prescription medicines for serious diseases. Most revenue comes from patented drugs sold through wholesalers. That means pricing, patent life, insurance access, and doctor use matter a lot.
HIV is the main profit driver. Biktarvy is the key treatment drug, and Descovy and Yeztugo help in prevention. This franchise funds research, dividends, share repurchases, and acquisitions.
The risk is concentration. If HIV pricing falls or if Biktarvy loses more net price after 2028, the whole company feels it. Oncology and inflammation are supposed to reduce that dependence, but the results are mixed so far.
Gilead is now leaning harder on acquisitions. That can add new science faster than internal research alone, but it also adds integration risk. The company has to bring in new teams and programs while keeping the HIV business running well.
The drugs that matter most
Biktarvy
Biktarvy is Gilead's flagship HIV treatment. A patent settlement moved the earliest U.S. generic entry date for full dose Biktarvy to April 1, 2036, but Medicare price negotiation begins in 2028.
Yeztugo
Yeztugo is a twice-yearly HIV prevention shot that is fueling higher full-year growth guidance.
Descovy and other HIV medicines
Descovy for prevention continues to grow, while Genvoya, Odefsey, and Symtuza support the broader HIV base. Together, HIV product sales were $5.7 billion in Q2 2026.
Trodelvy
Trodelvy is the stronger part of Gilead's oncology portfolio right now. Q2 2026 sales were $457 million, up 26% year over year.
Yescarta and Tecartus
These Cell Therapy products were meant to diversify Gilead beyond HIV. Q2 2026 sales were $417 million, down 14% year over year because of competition.
Livdelzi and liver disease drugs
Gilead sells medicines for HCV, HBV, HDV, and primary biliary cholangitis. Liver Disease sales were $877 million in Q2 2026, up 10% year over year.
Veklury
Veklury is Gilead's COVID-19 antiviral. Full year 2026 guidance was reduced to approximately $300 million due to lower hospitalizations.
Q2 sales still lean on HIV
This mix uses Gilead's product group sales for the three months ended June 30, 2026. The listed product groups total just under reported product sales because of rounding and smaller items.
What could go wrong
Biktarvy price cut in 2028
High impact · High oddsBiktarvy was selected for Medicare price negotiation under the Inflation Reduction Act, with the new price effective in 2028. Gilead says the negotiated Medicare price will be substantially lower than the current Medicare price. The impact could also spread through Medicaid rebates and 340B pricing.
Cell Therapy keeps losing share
Medium impact · High oddsCell Therapy sales were $417 million in Q2 2026, down 14% year over year. Management tied the decline to in-class and out-of-class competition. If Yescarta and Tecartus do not stabilize, Gilead's oncology diversification looks weaker.
M&A becomes too much to digest
Medium impact · Medium oddsGilead is using larger deals, including Arcellx, Tubulis, and Ouro, to build oncology and inflammation. That can speed up growth, but it can also distract teams and add integration costs. The risk rises because the core HIV business must keep executing at the same time.
Oncology pipeline disappoints again
Medium impact · Medium oddsTrodelvy is growing, but it already had a Phase 3 miss in ASCENT-07 for HR-positive, HER2-negative metastatic breast cancer. More failures would hurt the case that oncology can become a second growth pillar. Upcoming readouts matter because they shape the long-term value of the franchise.
Drug channel and legal pressure
Medium impact · Medium oddsGilead disclosed risks tied to counterfeit versions of its medicines and legal fights around the 340B drug pricing program. Counterfeits can hurt patients and trust. 340B disputes can affect how much revenue Gilead keeps from certain drug sales.
In one breath
What does Gilead Sciences make?
Gilead makes prescription medicines for HIV, liver disease, cancer, inflammation, and viral infections. Its most important business is HIV, led by Biktarvy for treatment and Yeztugo and Descovy for prevention.
Why is Yeztugo important for Gilead?
Yeztugo is a twice-yearly HIV prevention shot, which makes it easier for some people than taking pills often. It is helping the prevention business reach a $4 billion annual run rate.
What is the biggest risk for Gilead stock?
The biggest risk is that Gilead still depends heavily on HIV while Biktarvy faces Medicare price negotiation in 2028. If the price cut is large and oncology does not grow enough, earnings growth could be limited.
Is Gilead growing outside HIV?
Yes, but the picture is mixed. Trodelvy grew 26% year over year in Q2 2026, while Cell Therapy sales fell 14% year over year because of competition.
