Gilead (GILD) Q4 2025 earnings review
HIV and Liver Disease Power a Strong Finish
Gilead closed 2025 with accelerating momentum, delivering 5% revenue growth in Q4. The core business (excluding Veklury) grew 7%, driven by the HIV franchise and a breakout performance in Liver Disease (+17%). While Biktarvy remains the volume leader, Descovy's 33% surge highlights the expanding PrEP market. However, Cell Therapy remains a drag (-6%), and a clinical setback for Trodelvy (ASCENT-07) dampens the oncology narrative. FY26 guidance projects continued steady growth with Sales of $29.6-30.0B.
🐂 Bull Case
The core engine is firing on all cylinders. HIV sales rose 6% to $5.8B. Descovy surged 33% to $819M, driven by higher demand and pricing, proving the PrEP market expansion is real and profitable.
Livdelzi is driving a renaissance in the Liver Disease segment, which grew 17% YoY to $844M. This segment has shifted from a stable cash cow to a growth contributor.
🐻 Bear Case
Despite years of investment, Cell Therapy (Yescarta/Tecartus) contracted 6% to $458M. In-class and out-of-class competition continues to erode market share, raising questions about the segment's long-term ceiling.
The Phase 3 ASCENT-07 study in metastatic breast cancer missed its primary endpoint (PFS). While overall survival showed a favorable trend, this limits near-term label expansion opportunities for a key growth asset.
⚖️ Verdict: 🟢
Bullish. Accelerating growth in the base business (HIV + Liver) outweighs the drag from Cell Therapy. The successful launch of Yeztugo and robust FY26 guidance ($8.45-$8.85 EPS) signal strong execution.
Key Themes
HIV: PrEP Market Expansion
Accelerating. The HIV portfolio is not just stable; it is growing. Descovy sales jumped 33% YoY to $819M, significantly outpacing the 6% growth of the broader HIV segment. This confirms strong adoption in the prevention (PrEP) market, further bolstered by the U.S. launch of Yeztugo (twice-yearly prevention).
Liver Disease Breakout
Accelerating. Driven by high demand for Livdelzi (seladelpar), the Liver Disease segment broke its historical flat trend, growing 17% YoY in Q4 to $844M. This diversification reduces reliance on the HIV franchise.
Cell Therapy Competitive Erosion
Decelerating. Cell Therapy remains the weak link, declining 6% YoY. Yescarta fell 6% and Tecartus dropped 9%. Management cites 'ongoing competitive headwinds,' implying share loss to bispecifics and other CAR-T therapies rather than market saturation.
Trodelvy Clinical Miss
Reversing. While Trodelvy sales grew 8% commercially, the pipeline took a hit. The Phase 3 ASCENT-07 study (HR+/HER2- metastatic breast cancer) missed its primary progression-free survival endpoint. This limits the expansion narrative for the drug in the near term.
Expense Discipline
Stable. SG&A expenses decreased to $1.8B (from $1.9B), and R&D remained flat at $1.6B despite pipeline activity. This operational discipline contributed to Non-GAAP EPS of $1.86, protecting margins as Veklury revenue fades.
Other KPIs
Stable. Grew 5% YoY. While growth is slowing mathematically due to the large base, it remains the absolute bedrock of Gilead's cash flow, contributing over 50% of total product sales.
Decelerating. Down 37% YoY as COVID-19 hospitalizations decline. This drag is now largely annualized and becoming less material to the overall growth story ($911M FY25 total vs $1.8B FY24).
Strong. Increased from $3.0B in the prior year period, supporting $1.0B in dividends and $230M in buybacks during the quarter.
Guidance
Stable. Implies ~1.0% to 2.5% growth over FY25's $29.4B. However, excluding the expected further decline in Veklury (guided to $600M vs $911M in '25), the base business growth is stronger (~3-4%).
Accelerating. Midpoint of $8.65 implies ~6% growth over FY25's $8.15. This outpaces revenue growth, indicating continued share buybacks or margin expansion.
Decelerating. Expected to decline another ~34% from FY25 levels ($911M), continuing to act as a slight headwind to top-line growth.
Key Questions
Cell Therapy Turnaround
With Cell Therapy sales declining 6% and facing 'ongoing competitive headwinds,' do you view this segment as structurally impaired, or is there a specific catalyst in 2026 that returns it to growth?
Trodelvy Strategy Post-Miss
Following the ASCENT-07 miss in HR+/HER2- breast cancer, how does this alter the peak sales estimates for Trodelvy, and are you shifting resources to other indications?
Yeztugo Access Ramp
Yeztugo (Twice-yearly PrEP) is a major launch. Can you quantify the initial payer coverage uptake and whether you are seeing cannibalization of Descovy or market expansion?