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While Gilead Sciences' HIV portfolio, as well as liver disease drug Livdelzi, posted impressive growth in the third quarter, their gains were tempered by losses across the drugmaker's cell therapy portfolio and a continued sales slump for COVID-19 drug Veklury — a similar story to its first-quarter print (see – Spotlight On: Gilead continues to walk a fine line with lenacapavir.However, this time around, Gilead eked out something of a success story, beating analysts' revenue estimates and raising the low-end of its full-year sales guidance. The company's shares were mostly flat during after-hours trading on Thursday. HIV hits new heightsFor the third quarter, Gilead brought in $7.77 billion in revenues, up from $7.55 billion in the year-ago period and besting expectations of about $7.46 billion. Driving that growth, in part, was Livdelzi, approved last year for primary biliary cholangitis (PBC); it helped push the company's liver disease sales up 12% to 819 million. However, the greatest proportion of the drugmaker's revenues, by far, came from its HIV portfolio, which generated $5.3 billion in sales for the third quarter, up 4% from the same period in 2024. Specifically, Biktarvy sales ticked up 6% year-over-year to $3.7 billion, while Descovy's jumped 20% to $701 million (see – Vital Signs: Gilead's fastest growing drugs).Spurred by the pair's positive performance, Gilead raised its full-year growth expectations for its HIV portfolio to 5% from 3%, an encouraging sign as the drugmaker had previously projected flat HIV sales in 2025 due to a $900-million impact on its revenues from a US Medicare Part D redesign.Gilead also shared a few details on its twice-yearly HIV preventative, Yeztugo. Since its FDA approval in June, the pre-exposure prophylaxis (PrEP) agent has brought in $54 million in sales, and its full-year revenues are expected to be around $150 million, Chief Commercial Officer Johanna Mercier said during the company's call with analysts (see – Spotlight On: Yeztugo's launch is off to the races). Key to the drugmaker's anticipated success with Yeztugo is its campaign to secure payer coverage, and Gilead reported Thursday that it has met its 75% coverage goal nearly three months ahead of schedule. Some of the payers that have signed on include UnitedHealthCare and Express Scripts, as well as 20 of the top 25 state Medicaid plans, though it plans to continue expanding access and is aiming for 90% coverage by the end of the first half of 2026.For its overall 2025 revenues, the company brought up the bottom of its guidance by $100 million; it now expects full-year product sales between $28.4 billion and $28.7 billion, versus a previous range of $28.3 billion to $28.7 billion. Analysts, however, are hoping for full-year revenues closer to $28.8. Gilead also upped its earnings per share (EPS) expectations, and now is projecting an adjusted EPS between $8.05 to $8.25, up from its earlier estimate of $7.95 to $8.25. Can cell therapy make a comeback?However, Gilead's product sales were down year-over-year, slipping 2% to $7.35 billion as Veklury's revenues plummeted 60%. The COVID-19 drug was responsible for $277 million in sales for the third quarter, compared to $692 million for the same period last year. Another portfolio disappointment came from Gilead's cell therapy products, whose sales decreased 11% to $432 million due to lower demand. Specifically, Yescarta's revenues dipped 10% to $349 million, and Tecartus' fell 15% to $83 million."We anticipate these headwinds to continue in the near future. We remain committed to increasing the adoption and utilisation of cell therapies, given their curative potential for many patients," said Chief Commercial Officer Johanna Mercier on the company's quarterly call. "As shared in prior quarters, our efforts to lower the hurdles to community adoption are progressing, but it's clear that we have more to do before all eligible patients have the opportunity to benefit from these cell therapies." As the cell therapy pair continues to struggle, Gilead appears to be instead turning its attention to — and pinning its cell therapy growth aspirations on — a next-generation product: anti-BCMA CAR-T anitocabtagene autoleucel (anito-cel), which is due to report data from the Phase III iMMagine-3 multiple myeloma study at the American Society of Hematology (ASH) meeting in December. If the data are positive, Gilead is planning to commercially launch the cell therapy next year (see – Spotlight On: Four next-gen CAR-Ts to watch in MM and Spotlight On: Ten major clinical data readouts to watch in 2025). The drugmaker also touted its recent acquisition of Interius BioTherapeutics as giving it a foothold in the rapidly evolving in vivo cell therapy space (see – Vital Signs: Gilead aims to reverse its cell therapy slump).

iStock, Porechenskaya Gilead is actively looking for late-stage and de-risked assets for potential deals across various therapeutic spaces, including liver disease, cancer and immunology. Gilead will stay on the lookout for dealmaking opportunities across a wide range of therapeutic fields, CFO Andrew Dickinson told investors during the pharma’s Q3 earnings call on Thursday. “We are actively looking at opportunities across the [business development] spectrum in all our areas of strategic interests,” Dickinson said. “That includes liver diseases.” In February 2024, Gilead made a $4.3 billion play to acquire CymaBay, a deal anchored by the biotech’s liver disease drug seladelpar. A few months later, the bet paid off when the FDA cleared the drug for primary biliary cholangitis, for which it is marketed as Livdelzi. “We would like to add more therapies just like Livdelzi,” Dickinson said, noting that the pharma is consistently searching for “best-in-class therapies that serve patients.” In particular, Gilead is looking to add “late-stage derisked assets” at a pace of “every two to three years at a minimum,” he continued. Aside from liver diseases, Gilead is also actively scouting for potential deals in oncology, virology, immunology and cell therapy, Dickinson said. Gilead has yet to report exact sales figures for Livdelzi, but has previously said that the drug has proven to be a valuable asset. In a statement accompanying the pharma’s second quarter report, CEO Daniel O’Day named Livdelzi as one of the biggest contributors to the company’s “strong growth.” O’Day sang a similar tune on Thursday’s call, touting 35% “sequential growth” for Livdelzi, which he said led to the “commercial outperformance” of the pharma’s liver disease franchise. Gilead’s hepatology line made $819 million in Q3, up from $733 million during the same period last year. Across its business, Gilead recorded a 3% year-on-year increase for $7.8 billion in revenue. Product sales, on the other hand, dipped 2% to $7.3 billion, coming 1% under the consensus estimate. This dip was driven, according to analysts at BMO Capital Markets, by “more pronounced demand declines in cell-therapy.” Earnings of the CAR T therapies Yescarta and Tecartus fell 12% and 10%, respectively, below expectations, according to BMO. Also contributing to Gilead’s mixed Q3 was the COVID-19 drug Veklury, which crashed 60% year-over-year to $277 million. BMO noted the miss, which fell 24% below consensus estimates, and said that COVID product sales could shift to the fourth quarter, where the infection cycle is expected to be later this year. HIV remained Gilead’s strongest franchise, with sales ticking up 4% year-over-year to bring in $5.27 billion and beat forecasts by 1%. The pharma’s top-performing asset was the daily HIV pill Biktarvy, which grew 6% to make nearly $3.7 billion. The recently approved twice-yearly pre-exposure prophylaxis Yeztugo commanded a lot of attention during the call. The drug made $39 million in its first commercial quarter, racking up $54 million in total since landing on the market. Gilead expects uptake to pick up in the coming quarters, with full-year sales hitting “around $150 million or so,” Chief Commercial Officer Johanna Mercier said. Overall, Gilead narrowed its 2025 forecast. The pharma now expects to hit $28.4 billion to $28.7 billion in full-year product sales, up from previous guidance of $28.3 billion to $28.7 billion.