Gilead Sciences: HIV Leadership Outshines Decline In COVID-19 Drug Sales

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  Published in Science and Technology on Tue, Sep 9nd, 2025

Gilead Sciences’ HIV Leadership Outshines the Decline in COVID‑19 Drug Sales

The pandemic has been the headline for almost every drug company’s recent earnings, but for Gilead Sciences, the story is a little different. While its COVID‑19 antiviral, remdesivir (marketed as Veklury), has seen a noticeable drop in sales, the company’s core HIV business not only remains robust but actually outshines the decline, underscoring the enduring strength of Gilead’s HIV portfolio.

A Resilient HIV Business

In its latest earnings release, Gilead reported that global HIV sales reached $5.7 billion, a 7.3 % year‑over‑year increase. The growth was driven largely by the continued success of Truvada and Descovy, both first‑line oral combination regimens that remain staples in both developed and emerging markets. The company also highlighted a 5 % uptick in revenue from Cabenuva (cabotegravir/rilpivirine), its long‑acting injectable that has been embraced for its convenience and patient adherence benefits.

“HIV remains the engine that powers our portfolio,” CEO Daniel O’Neil said during the earnings call. “We are seeing strong demand for both our oral and injectable options, and the pipeline is filled with promising candidates that will expand our reach even further.”

COVID‑19 Sales Decline

The pandemic’s evolving dynamics are reflected in Gilead’s COVID‑19 segment. Remdesivir, which was the world’s first approved antiviral for hospitalized COVID‑19 patients, has seen sales fall 32 % in the past 12 months. The decline is two‑fold: first, the overall case count has decreased as global vaccination rates rise; second, the therapeutic landscape has broadened to include oral agents like Paxlovid and Molnupiravir, which offer similar efficacy with less complexity in administration.

Gilead’s management noted that the drop in remdesivir revenue is partially offset by an increase in the wholesale price of its HIV products—a strategic move that improves gross margins across the portfolio. In the last quarter, the company’s gross margin on HIV sales climbed to 68 % from 66 % in the prior year, reflecting both pricing power and efficient cost management.

Strategic Focus on HIV

With the pandemic’s intensity waning, Gilead has been sharpening its focus on HIV, both as a clinical priority and a commercial opportunity. The company’s strategic plan includes:

• Expanding Cabenuva’s market share through targeted campaigns in low‑ and middle‑income countries where adherence challenges are most acute.
• Accelerating the development of Cabenuva 3‑Month and 6‑Month formulations, slated for late‑2025 regulatory review, which could further enhance patient convenience.
• Investing in next‑generation long‑acting therapies such as the oral cabotegravir/rilpivirine combo (Cabenuva‑O), which is expected to launch in 2024 and could capture a segment of the population that prefers oral over injectable medication.

Additionally, Gilead’s pipeline is being diversified with a focus on dual‑acting single‑tablet regimens that simplify therapy. The company is also exploring global pricing initiatives to improve access, a move that is expected to bolster market penetration without eroding margins.

Financial Outlook

Gilead’s financials reflect this HIV‑centric strategy. For the full year, the company reported $12.9 billion in total revenue, up 4.8 % from the prior year. Net income rose to $3.3 billion or $0.79 per share (up 7.2 % YoY). The company forecasts Q1 2025 revenue of $3.4 billion, with HIV sales projected to be $1.9 billion of that total—a 5 % increase from Q1 2024.

Management reiterated that the decline in COVID‑19 sales is an isolated trend and is not expected to materially affect the company’s long‑term prospects. “We view the drop in remdesivir sales as a natural progression as the pandemic moves into a post‑acute phase,” O’Neil said. “Our HIV portfolio is not only resilient but positioned for continued growth.”

Risks and Challenges

Despite the positive outlook, Gilead acknowledges certain risks that could impact its HIV business:

• Patent cliffs for some of its older products could open the market to generics, especially in the U.S. and Europe.
• Pricing pressures from payers and insurance companies are increasing, particularly in high‑income markets where drug cost scrutiny is intense.
• Competition from other manufacturers of long‑acting injectables, such as those developing Cabenuva‑O and other similar regimens, could erode market share if Gilead’s timing falters.

Nevertheless, the company’s strong R&D pipeline and proven pricing strategy provide a buffer against these challenges.

Bottom Line

Gilead Sciences is a textbook example of how a well‑diversified pharmaceutical company can weather the ebbs and flows of a global crisis. While the decline in COVID‑19 drug sales is unmistakable, the firm’s HIV business is not only sustaining the company’s revenue base but also accelerating its growth trajectory. With a robust product pipeline, a clear focus on patient adherence, and an aggressive expansion strategy in both developed and emerging markets, Gilead’s leadership in HIV is set to remain the cornerstone of its future success.