Can Gilead's HIV Portfolio Sustain Its Growth Trend in 2026?

Gilead Sciences, Inc. GILD has a market-leading HIV franchise, led by flagship HIV therapies — Biktarvy for treatment and Descovy for prevention.

Earlier this week, the company reported strong fourth-quarter and full-year 2025 results.

HIV product sales were up 6% in 2025, driven by 7% growth in Biktarvy and a 47% surge in its prevention portfolio.

This performance was delivered despite an estimated $900 million headwind from the Medicare Part D redesign. Excluding this impact, HIV sales grew 10%.

HIV product sales also exceeded management’s annual target of 5% growth.

Biktarvy continues to be a dominant player in the HIV treatment market, holding more than 52% market share and retaining its position as the most prescribed therapy for both treatment-naïve and switch patients across major markets.

Descovy’s performance was robust with sales increasing 31% year over year to $2.8 billion, primarily driven by higher demand and average realized price.

Descovy accounts for more than 45% of the U.S. market share in pre-exposure prophylaxis (PrEP), reinforcing Gilead’s leadership in prevention.

The FDA approval of injectable lenacapavir, a first-in-class capsid inhibitor (under the brand name Yeztugo), solidifies GILD’s HIV portfolio. With a twice-yearly dosing schedule, the therapy offers meaningful adherence advantages over daily oral regimens and targets a broad patient population.

Early uptake has been encouraging, generating $96 million in fourth-quarter sales and $150 million in 2025. Management projects Yeztugo revenues of approximately $800 million in 2026, positioning it as a key incremental growth driver.

Looking forward, Gilead expects total HIV sales, including both treatment and prevention, to grow approximately 6% year over year. The guidance incorporates pricing pressure from government drug-pricing agreements affecting select legacy products, as well as potential channel mix shifts tied to proposed Affordable Care Act changes. These factors are expected to reduce growth by roughly two percentage points.

Excluding these headwinds, the HIV business is expected to grow 8% in 2026.

Meanwhile, positive phase III results from the ARTISTRY-1 and ARTISTRY-2 studies for the investigational once-daily oral single-tablet regimen of bictegravir 75 mg and lenacapavir 50 mg (BIC/LEN) in virologically suppressed adults with HIV increase the probability of regulatory approval. If approved (potential launch by year-end), the therapy would reinforce Gilead’s leadership in the high-value switch segment.

GILD has also collaborated with Merck MRK to advance its HIV pipeline further. Data from two studies, evaluating Merck’s islatrovir plus lenacapavir, a potential first once-weekly oral treatment for people with virologically suppressed HIV, is expected in 2026.

The company is advancing multiple long-acting integrase inhibitor programs and prioritizing GS-3242 (in combination with lenacapavir) as a potential twice-yearly treatment.

GILD also plans to initiate a phase III study evaluating lenacapavir plus broadly neutralizing antibodies in the second half of the year.

Approval of additional treatments should strengthen its dominant HIV franchise.  

Competition for GILD’s HIV Business

The HIV treatment landscape is dominated by many bigwigs, such as GSK plc GSK and Merck, apart from GILD.

HIV sales account for a major chunk of GSK’s Specialty Medicines portfolio. GSK continues to grow its HIV business, driven by strong patient demand for long-acting injectable medicines (Cabenuva and Apretude) and Dovato. The solid growth from these drugs has helped GSK combat the decline in Triumeq sales.

MRK markets doravirine for treating adults with HIV-1 in the United States, either as a monotherapy under the brand name Pifeltro or as part of the single-tablet combination regimen under the brand name Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate).

Merck is also evaluating a once-daily, oral, two-drug, single-tablet regimen of doravirine/islatravir [DOR/ISL (100 mg/0.25 mg)] in treatment-naïve adults with HIV-1 infection.

GILD’s Price Performance, Valuation and Estimates

Shares of GILD have surged 45.9% in the past year compared with the industry’s growth of 19.6%.

Going by the price/earnings ratio, GILD’s shares currently trade at 17.46x forward earnings, higher than its mean of 11.20x but lower than 18.51x for the large-cap pharma industry.

The bottom-line estimate for 2026 has moved down to $8.57 from $8.61 in the past seven days, while that for 2027 has moved north to $9.37 from $9.33 in the same time frame.

GILD currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.


 

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This article originally published on Zacks Investment Research (zacks.com).

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