GILD Q1 Earnings Call: HIV Growth and Pipeline Momentum Offset Revenue Miss

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GILD Cover Image — GILD Q1 Earnings Call: HIV Growth and Pipeline Momentum Offset Revenue Miss

Max Juang

Mon, May 12, 2025, 5:02 AM 6 min read

Biopharmaceutical company Gilead Sciences (NASDAQ:GILD) missed Wall Street’s revenue expectations in Q1 CY2025, with sales flat year on year at $6.67 billion. The company’s full-year revenue guidance of $28.4 billion at the midpoint came in 1.1% below analysts’ estimates. Its non-GAAP profit of $1.81 per share was 2.1% above analysts’ consensus estimates.

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Gilead Sciences (GILD) Q1 CY2025 Highlights:

Revenue: $6.67 billion vs analyst estimates of $6.81 billion (flat year on year, 2.1% miss)
Adjusted EPS: $1.81 vs analyst estimates of $1.77 (2.1% beat)
Adjusted EBITDA: $3.16 billion vs analyst estimates of $3.42 billion (47.4% margin, 7.7% miss)
The company reconfirmed its revenue guidance for the full year of $28.4 billion at the midpoint
Management reiterated its full-year Adjusted EPS guidance of $7.90 at the midpoint
Operating Margin: 33.6%, up from -64.6% in the same quarter last year
Free Cash Flow Margin: 24.8%, down from 31.6% in the same quarter last year
Market Capitalization: $120.5 billion

StockStory’s Take

Gilead Sciences’ first quarter results reflected growth in its core HIV and liver disease businesses, driven by rising demand for flagship therapies like Biktarvy and the ongoing launch of Libdelzi. Management attributed the company’s performance to commercial execution and highlighted solid operating margin expansion due to disciplined expense management. However, weaker oncology sales and declining COVID-19 treatment demand weighed on overall revenue.

Looking ahead, the company’s guidance centers on an anticipated FDA decision for lenacapavir in HIV prevention, as well as multiple clinical trial readouts for its oncology pipeline. Management reiterated its full-year targets, noting that demand-led volume growth in HIV could be offset by Medicare Part D redesign headwinds. CEO Daniel O’Day emphasized, “We have multiple potential launches ahead…including lenacapavir, anetocel, and now Trodelvy,” pointing to a focus on portfolio diversification and pipeline advancement.

Key Insights from Management’s Remarks

Gilead Sciences’ management pointed to a combination of product launches, market dynamics, and operational discipline as shaping the first quarter and the outlook for the remainder of the year. The company’s base business, excluding COVID-19 treatments, grew due to strong HIV sales and a successful new drug launch in liver disease, even as other therapeutic areas faced challenges.

HIV Franchise Expansion: Growth in HIV was buoyed by Biktarvy’s higher demand and market share, along with increased use of Descovy for HIV prevention, reflecting broader awareness and access. Management noted that the upcoming potential launch of lenacapavir for pre-exposure prophylaxis (PrEP) could further expand the company’s presence in HIV prevention.
Libdelzi Launch Momentum: The liver disease therapy Libdelzi achieved rapid uptake, securing significant market share in primary biliary cholangitis (PBC) and expanding into Europe. Management cited positive feedback from healthcare providers and robust coverage by commercial insurance plans.
Oncology Mixed Results: Trodelvy sales were impacted by inventory fluctuations and lower average prices, but management highlighted strong demand in key breast cancer indications and promising results from the ASCENT-04 study. The trial showed improved progression-free survival, which could support regulatory filings and future growth.
Cell Therapy Competitive Pressures: Sales of cell therapies such as Yescarta and Tecartus were affected by increasing competition from both similar cell therapies and emerging bispecific antibody treatments, particularly outside the U.S. The company continues to invest in next-generation products and manufacturing scale.
Operating Efficiency and Margin Discipline: Management reported flat product gross margin and reduced selling, general, and administrative (SG&A) expenses, citing ongoing cost controls and a focus on maintaining top-quartile operating margins despite competitive and macroeconomic pressures.

Drivers of Future Performance

Management’s outlook for the rest of the year is shaped by new product launches, policy headwinds in the U.S., and evolving competitive dynamics in oncology and cell therapy.

Lenacapavir Approval and Uptake: The anticipated FDA decision for lenacapavir in HIV prevention could drive new patient growth, with management preparing for phased market access and provider adoption over the next 6–12 months.
Medicare Part D Redesign Impact: Flat reported HIV sales are expected in 2025 as volume growth is offset by higher manufacturer contributions under the Medicare Part D redesign. Management indicated that any positive impact from improved patient access would likely appear later in the year.
Oncology and Cell Therapy Pipeline Readouts: Upcoming clinical data for Trodelvy and anetocel, as well as new CAR-T therapies, remain major swing factors for future revenue, especially as competition intensifies in both established and emerging treatment areas.

Catalysts in Upcoming Quarters

In the coming quarters, the StockStory team will closely monitor (1) the U.S. launch and adoption curve for lenacapavir in HIV prevention, (2) clinical trial updates for Trodelvy in breast cancer and anetocel in multiple myeloma, and (3) the company’s ability to navigate the Medicare Part D redesign’s impact on HIV revenues. Progress in expanding Libdelzi’s presence in Europe and evolving competitive dynamics in cell therapy will also be important markers of execution.

Gilead Sciences currently trades at a forward P/E ratio of 11.8×. In the wake of earnings, is it a buy or sell? Find out in our free research report.

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