What Management Said

Read the full Q1 2026 transcript ↗

Just after market close today, we issued a press release with earnings results for the first quarter of 2026. I'm pleased to share highlights from Gilead's first quarter, which has extended our consistent track record of commercial, clinical, and financial execution. Our strong financial performance and increase in sales guidance reflects the depth and quality of our portfolio, the numerous launches underway, and our continued focus on financial discipline. As we execute on the strongest pipeline in our history, Gilead is also taking steps to further strengthen the company's position for the future.

Our HIV business grew 10% year-over-year, reflecting 7% growth for BIKTARVY and an impressive 87% growth for our U.S. The ongoing success of the YEZTUGO launch is a key driver of this growth in HIV prevention, with first quarter sales growing 72% sequentially. Looking forward, with no major LOEs until 2036, Gilead's HIV business is poised for strong, durable growth, supported by up to seven potential new HIV product launches by 2033. In oncology, first quarter TRODELVY sales were up 37% year-over-year, reflecting growing demand for TRODELVY.

The pending acquisition of Tubulis is another significant milestone in building Gilead's oncology franchise. The company brings a clinical-stage candidate, TUB-040, which we believe has the potential to be a leading ADC in ovarian cancer and a next-generation ADC platform with a promising early pipeline. Our acquisition of Arcellx, which closed on April 28th, reflects our conviction in the potential of Anito-cel as a differentiated option for patients with multiple myeloma. In liver disease, LIVDELZI revenue for second-line primary biliary cholangitis more than tripled year-over-year.

What went well
  • Base business grew 8% year-over-year to $6.8 billion, driven by HIV, Trodelvy and Livdelzi, and non-GAAP diluted EPS rose 12% to $2.03.
  • HIV sales grew 10% year-over-year, with Biktarvy up 7% and the U.S. PrEP business up 87%, as Yeztugo sales grew 72% sequentially.
  • Product gross margin reached 87%, up two percentage points year-over-year on the expiration of a long-standing TAF-related royalty and favorable mix, at a 47% operating margin.
  • Trodelvy sales were up 37% year-over-year (NCCN Category 1 in first-line TNBC), and Livdelzi revenue for second-line PBC more than tripled year-over-year.
  • Gilead raised 2026 guidance by $400 million, lifting HIV growth to about 8% (from 6%), Yeztugo to roughly $1 billion (from $800 million) and base-business growth to 5%-6%.
  • The company closed the Arcellx acquisition on April 28 and announced the Ouro Medicines and Tubulis acquisitions, expanding its oncology, cell-therapy and inflammation pipeline, with a bictegravir + lenacapavir FDA decision expected in August.
What went wrong
  • Cell therapy sales fell to $407 million, down 12% year-over-year and down 11% sequentially, on in-class and out-of-class competition.
  • HCV-driven virology sales of $767 million rose only 1% year-over-year, reflecting inventory drawdown and lower HCV patient starts.
  • Sequential product sales fell 12% on typical seasonal inventory dynamics, and SG&A rose 12% year-over-year on Yeztugo launch spending.
  • Updated full-year 2026 guidance now implies a non-GAAP loss per share of $(1.05)-$(0.65), reflecting about $9.50 per share of upfront payments and financing costs (roughly $11.5 billion) tied to the Arcellx, Ouro and Tubulis deals, with the effective tax rate guided to 140%-190%.
  • Guidance continues to embed a roughly 2% growth headwind from the December 2025 drug-pricing agreement and the Affordable Care Act.

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Q1 2026 call
Reported 2026-05-07 · figures from the Gilead Sciences, Inc. Q1 2026 earnings call.

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