Gilead at Bank of America 2025: Strategic Focus on HIV Innovation

On Tuesday, 13 May 2025, Gilead Sciences Inc. (NASDAQ:GILD) presented its strategic outlook at the Bank of America 2025 Healthcare Conference. The discussion underscored Gilead’s commitment to growth amid policy challenges, highlighting both opportunities and potential hurdles. The company emphasized its focus on top-line growth, operational discipline, and pipeline advancements, while navigating drug pricing regulations and government program adjustments.

Key Takeaways

• Gilead is prepared for policy changes with scenario planning and a dedicated team.
• The company is focusing on innovative HIV treatments, including Lenacapavir and Biktarvy.
• Gilead is addressing potential CDC funding cuts by educating lawmakers on HIV screening and diagnosis needs.
• The company aims to redefine HIV prevention with long-acting treatments and value-based pricing.
• Gilead is observing competitor strategies, particularly GlaxoSmithKline’s product launches.

Operational Updates

Joanna Mercer, Gilead’s Chief Commercialization Officer, outlined the company’s strategic direction, emphasizing its commitment to top-line growth, operational expense discipline, and pipeline advancement. Mercer noted that Gilead’s US-based intellectual property contributes to a favorable tax rate of 20%, aiding in its strategic execution.

Gilead is actively scenario planning for policy changes, including the impact of the Most-Favored Nation (MFN) rule, tariffs, and the Inflation Reduction Act (IRA). Despite potential government program cuts, Gilead sees these as temporary pauses and is focused on advocating for continued HIV surveillance and screening.

HIV Business and Products

Gilead is advancing its HIV portfolio with significant emphasis on Lenacapavir, which is expected to secure 75% US access within six months of its launch. The company’s launch strategy involves transitioning existing PrEP users to Lenacapavir and expanding to new populations.

Biktarvy remains a cornerstone of Gilead’s HIV business, projected to generate $14 billion in revenue this year, representing nearly 50% of the company’s total revenues. The integrase inhibitor market share for Biktarvy is just over 50% and growing.

Future Outlook

Gilead is optimistic about the HIV prevention market, which is growing at 16% year-on-year. The company believes that increasing prevention efforts by 25% could halve new HIV cases. Gilead is also focused on educating at-risk populations about prevention and treatment options.

Mercer highlighted Gilead’s strategy of multiple HIV launches before 2033, aiming to improve the current 40% of HIV patients who are not virologically suppressed. The company is considering partnerships with Walmart, CVS, and telehealth providers to enhance treatment access.

Competitor Analysis

Gilead is closely monitoring GlaxoSmithKline’s launch experiences with Cabenuva and Aptitude, noting the importance of dosing frequency. Gilead sees its every-six-month dosing as a key differentiator and is addressing concerns about "buy and bill" practices.

The company is aligning its pricing strategy with market benchmarks, with annual treatment costs for prevention between $24,000 and $26,000.

Conclusion

For a detailed understanding of Gilead’s strategic plans and insights from the Bank of America 2025 Healthcare Conference, please refer to the full transcript below.

Full transcript - Bank of America 2025 Healthcare Conference:

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: For joining us, I’m Tim Anderson, the US large cap pharma and biotech analyst of Bank of America, and excited to have Gilead with us today, specifically Joanna Mercer, who serves as the company’s Chief Commercialization Officer overseeing the global commercialization of the company’s medicines across really all areas. She’s been with the company since 2019. Prior to Gilead, I think twenty five years at Bristol Myers, so quite a long time, senior leadership roles there in both US and international markets. So we will start of course with some macro questions, which you’ll love to answer. So high level question just to begin with, which is, you know, new headlines every day, seems like MFN most recently, tariffs prior to that IRA possibly changing.

Is that impacting the day to day operations at Gilead? Are you guys doing anything differently? Hiring freezes, M and A on hold, anything like that? Or are you just plowing ahead as if it were six months ago or twelve months ago?

Joanna Mercer, Chief Commercialization Officer, Gilead: Maybe in the middle of that. I would say that we’re incredibly focused on delivering on our strategy. That’s both the top line and delivering the growth in the top line, making sure we’re incredibly well disciplined on our OpEx, and and then, of course, driving the pipeline. So that’s been the focus. We have a small team that actually, of course, manages scenario plannings and, like I’m sure you all do, different scenarios of what’s playing out.

But there’s very little we know today, right, from a specific standpoint as to what, how, when, etcetera. And so it’s hard to manage a little bit in this fluid environment. But that’s why we need the teams, the majority of our teams to stay incredibly focused on what they need to deliver. I also think that, you mentioned field force or freezes or BD, it hasn’t changed our strategy at all, from that perspective. We believe that we need to continue to drive the science.

We need to continue to, you know, we have a lot of launches in play. We have Libdelzi that just launched last August. So that’s, you know, obviously still in launch mode. We have Lenacapavir for prevention that we’re very excited about with the June 19 PDUFA date around the corner and tracking towards that. We also have a needle cell data coming through at the end of the year.

We just got a center for positive data expecting a center three shortly to move us in first line triple negative breast cancer. So a lot of pieces in play and well positioned to move forward. Having said that, of course there’s uncertainties and we just need to make sure we’re best prepared. And we believe we’re probably a little better prepared than others in light of the fact that, you know, our average effective tax rate is about 20% for the last four years. It’s related to the fact that majority of our IP sits in The US, So we’re already kind of at a at a good place there versus some of our peers.

And, you know, as it relates to transfer pricing, obviously, less of an impact in light of that. And so so we’re tracking everything closely like you all are, and we’ll navigate it as it comes, right? As we get more details, as it plays out.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Outside of a venue like this, people like me are pestering you with these questions, are you spending any of your time when you’re back at Gilead on these matters? For myself? Yeah, yourself personally, you’re part of the executive committee.

Joanna Mercer, Chief Commercialization Officer, Gilead: Oh yeah.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: So is it all hands on deck where you are spending some portion of your time thinking through scenarios? MFN is, I mean, who better able to answer those questions than you had a commercial? It’s a drug pricing

Joanna Mercer, Chief Commercialization Officer, Gilead: issue. So of course we’re talking it through, but it’s hard to talk about how this plays out, because there’s so many permutations of it. And so I think it’s more about just making sure that as we move forward, we’re conscious of potential eventualities, right? As we think about value of our medicines, as we think about represent, how we move forward on launches. And thinking through a little bit also, you know, what potential consequences, unintended maybe consequences, play out from some of these decisions, whether it’s funding cuts or anything else.

And so we are thinking that through. And yes, of course, I do spend a little bit of my time, but again, with a very small team. And I think it’s really important because if you get everybody on board with you on this journey, then people that need to do their day to day job aren’t thinking that through. So I think the focus piece is critical for us to be successful. And that’s why it’s a very small team of experts that are coming together and just planning out, like we did with the IRA.

Prior to IRA, Part D redesign, etcetera, just making sure that there was a small team thinking through what does that mean, What are the questions we need to ask maybe differently than we did maybe five years ago, as we think about BD deals, as we think about development programs, etcetera. So that is something that I’m part of.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: So when Trump held his press conference, was that yesterday? He talked about equalization, right? So kind of making prices ex US closer to what they are in The US. And part of that is raising prices ex US. And I can’t figure out how that would possibly work, whether it’s drug companies trying to pull that lever or the US government trying to pull that lever.

Would you agree? Who can make prices in ex U. S. Countries go up?

Joanna Mercer, Chief Commercialization Officer, Gilead: I think, listen, some of the ideas that have been floated, I think will be challenging, there’s no doubt, especially for products on the market today. I also believe that maybe, you know, as they are thinking about a percentage of their GDP and having those discussions with other countries, that’s where the US administration might have a little bit more traction. So we’ll see how it plays out. But at this point in time, it’s hard to see a clear path.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Yeah. Okay, so we published a piece this morning where we ran scenario for all of our companies that if you cut government programs in The US by 20% and float it through the P and L, what would be the earnings impact? And the earnings impact of Gilead was kind of in the middle of the group, frankly. As I try to convey in the notes, it’s kind of an impossible exercise because it’s hard to even know what net pricing is in The US, though we can usually guess. Exide The US, we have no visibility because those usually are figures that are kept confidential, agreements between manufacturer and the different countries.

So I’ll ask you a question and I can predict how you’ll probably answer it. What can you say about net pricing in The US relative to net pricing in countries like, you know, EU5, for example?

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, what I can say is this. We believe in value of our medicines and the science and the unmet need that it serves. And so we make sure that as we move forward, and what we’ve always done in the past, this is no different than what we’ve done in the past, is making sure that value comes through. And we do that in The US, and we do that ex US as well. I mean, the only, piece that I would add is the difference would be in low middle income countries, and the work we’ve done with HIV and Hep C and Hep B, that’s very different, because that’s really countries that can’t afford to have access.

But we believe in innovation. We believe in making sure we get value for our innovation, and we believe access is really important, because there’s no point innovating if you can’t make sure that the people who should have access to these medicines do.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: One last question on MFN. So just play this scenario forward. So let’s say we’re right and you have to lower prices across Medicare Part D, Medicare Part B and Medicaid. Would that have any sort of spillover into the commercial side? Let’s say commercial is left alone by Trump, left alone by MFN, but functionally worth of being spilled over to the commercial side.

Joanna Mercer, Chief Commercialization Officer, Gilead: I mean, it’s too early at this point to even speculate about that. But I will say this, leverage a little bit the work that’s been done with the IRA and Part D redesign and whatnot. And we’re not seeing any of that spill over at this point. So that’s the way I would think that through. But yeah, I mean, this is something we’d have to play out a little bit, but the details are going to be important here.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Isn’t Medicaid a good example of how it doesn’t spillover? Because Medicaid is a price mechanism, they get drugs

Joanna Mercer, Chief Commercialization Officer, Gilead: much

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: And as much as commercial guys would love those prices, they don’t have access to it. They can’t force you to price it at that level. So even if Medicare went the way of Medicaid, is it really going to spill over to commercial?

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, so I think the example that you just gave, the example of the IRA and some of the drugs that have already been impacted by the IRA are other examples, that it’s two separate pieces of business.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Okay, so let’s talk about HIV. So this is your biggest book of business. It’s really a solid two thirds of Gilead’s total revenues. And I guess starting again with a policy question, there is certainly change of foot cuts at the CDC, HHS, reorganization of FDA, and there’s a big, Medicaid is a big channel, right? A big payer channel for HIV.

And the CDC does things like surveil for patients and hotspots of HIV infection. So what does this mean to Gilead? Are you seeing any consequence or do you expect that if these cuts actually go through and loss of personnel, which is already happening, that that could actually impact the business in 2025?

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, so what we’re seeing thus far is still more a pause than cuts, and they need to go through Congress, obviously, to get enacted. I think the role that we have to play is making sure we’re educating a lot of these lawmakers to make sure they understand the need, and what the CDC was doing, because I think you’re referring to a lot of the funding cuts there. The funding cuts, just remember though, they have nothing to do with the prescription. Screening, diagnosis, surveillance, specific to HIV. So I do think it’s important to educate and make clear of the need of that, how important it is, specifically if you think about surveillance, making sure you get, if there’s an epidemic that happens, that you get control of it as quickly as possible before it expands across the country.

All of those things are learnings from the past that we need to, which is why these pieces in CDC existed to begin with. I think from a screening diagnosis work that the CDC did was very important. There’s also a lot of work that Gilead does in this space, and we’re very targeted in our approach on this front, where HIV incidence is the highest, highest risk, etcetera. We do a lot of screening. We do a lot of diagnosis and linkage to care, which I think is really important because as you know, in HIV treatment, you still have about forty percent of the population that are not virologically suppressed.

If you’re not virologically suppressed, you are transmissible. And and those people include people that, haven’t been screened, right? Don’t know they have HIV, have been screened, diagnosed, but not on treatment, are on treatment, but are on older legacy drugs and are not virologically suppressed appropriately. So all of that is a real, from an HIV treatment standpoint, important for us to make sure that we continue to create the screening diagnosis and linkage to care to bring them into the marketplace. Think that’s really important for us as a nation.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: So if these cuts actually go through, it sounds like it’s the sort of thing Gilead could possibly spend more and pick up the slack and do its own strategies?

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, I don’t think we’re going to cover what the government was doing. I think we’re going to continue doing what we’ve been doing, making sure that we can help the populations that need it.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: And then if you could just talk about treatment versus PrEP, so treatment if you have an infection versus PrEP versus prevention, thinking through these same cuts, are they more likely to impact one or the other treatment versus PrEP?

Joanna Mercer, Chief Commercialization Officer, Gilead: Not really, I mean, cuts were really more in the treatment setting because it was screening diagnosis. Prevention is obviously incredibly important. It’s a market that’s been growing at about 16 points or so year on year. It is one that HHS has supported as well for preventative It’s one that the current administration talks a lot about how prevention is key. And if you think about it, as we think about prevention, if you increase prevention by even twenty five percent, you’re reducing new HIV cases by fifty percent.

So from a cost containment standpoint, it’s a really interesting proposal, for the government because you’ve reduced cost in the long term. So those are all pieces that we believe prevention is important. The work that we do there is more about awareness and education for people at risk. And a lot of people don’t even know prevention exists and making sure that we get to the people where the highest risk exists. And that’s usually, you know, generally speaking, it’s not the major cities, it’s more rural cities, it’s the Southern Belt of The US.

That’s where HIV incidence is the highest and where people really need to understand how to protect themselves.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Okay, let’s shift to some specific products. So lots of focus on Lenacapavir, we’ll get to that. You saw it on quarterly results, a lot of questions, and in other venues, it tends to be maybe the biggest

Joanna Mercer, Chief Commercialization Officer, Gilead: focal it’s upcoming, right? It’s super exciting It’s transformational for prevention. We think we’re gonna redefine HIV prevention completely with something that’s every six months. And the data that we’ve shown with purpose one and purpose two, over 9,000 people in that study, really looking at incredible data, one hundred percent efficacy in the PURPOSE one trial, and just over ninety six percent in PURPOSE two, never been seen before. And that’s really linked to the frequency of dosing.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Yeah, so there’s a lot of focus on the upcoming launch, Should be probably summer if everything stays on track.

Joanna Mercer, Chief Commercialization Officer, Gilead: June 19 PDUFA date.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: June 19, you guys will launch soon thereafter presumably. Access in The US in terms of getting payer coverage, do you guys expect any sort of hurdles? I know you’ve set out some parameters before, but maybe you can just recapitulate what those Sure.

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, from an access standpoint, it’s in line with other launches, right? As you start, you’re working through with the plans to make sure you bring them up to date. We’ve already started working, but obviously at launch is when you really activate that. What we’ve said is we believe that probably by the six month mark, we should be at about 75% access or so, and then about 90% or so by twelve months. And so you’ll see a ramp as you go forward.

At launch, obviously, you’re going to go through medical exceptions just like you do with other launches like we’ve done with LivDelsey, and you’ll build the access, through the different plans as we go forward. We do believe that, you know, the the there’s real value here. I think the plans are also pretty clear that they have been giving unrestricted access. For example, for Descovy, we’re at about over 85% unrestricted access, despite the fact that there are generics in the marketplace. We believe over time the same thing will play out for linacapavir.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: So out of the gates, 75 access

Joanna Mercer, Chief Commercialization Officer, Gilead: Six months.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Six months, yep.

Joanna Mercer, Chief Commercialization Officer, Gilead: Not out of the gates.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: I’m sorry. I was defining that as a six month window. So in six months, seventy five percent, you’re saying that would likely be unrestricted, right, no edits? So buy and bill, this is a semi unique product. Laxo is there right now with Apritude and with Cabanuva for treatment.

It’s not really what HIV docs are used to, in terms of, we buy the drug and then we give to the patient, now we bill and we make a small spread. So that is different, right? And there’s a big question about, is that an impediment towards the uptake? Now, think as you and I’ve talked about before, you don’t have to do buy and bill.

Joanna Mercer, Chief Commercialization Officer, Gilead: Exactly.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: You can do other things besides buy and bill to use this product. Do you want to kind of describe what the

Joanna Mercer, Chief Commercialization Officer, Gilead: yeah. I think, you know, we’ve been really over the last, I would say, twenty four months or so, digging into understanding what are the impediments, what are the challenges in the past for long acting injectable in this area. And from that understanding, it’s been clear that a lot of these clinics and providers have never done buy and bill to your point. And so the opportunity is to make sure we’re flexible for them. And so we’re giving them optionality.

We believe that many folks, especially at the beginning, will probably prefer going through a specialty pharmacy. And so what that means is they’ll do white bagging. So they’ll write a script. The script will go to the specialty pharmacy. Specialty pharmacy will do all the reimbursement workup, get it through the system, and then send back the product to the office for the providers to inject their patient.

That’s the white bagging process. Others will say, I don’t want to do anything. All I want to do is write the script. Great. Write the script, you’ll have an alternate site of care where the the specialty pharmacy will still do all the reimbursement work.

We’ll send it to the alternate site of care, and that’s where the the patient will get their injection. And then you have some that have started doing buy and bill. They’re few and far between, but there are some. And I think those clinics and providers, their bigger clinics usually, will be very open to doing buy and bill, and they’ll be able to do it with a miscellaneous j code at first. And then, of course, we’ll get the j code down the road and carry on from that.

So we’re assuming that probably at launch, probably it’s more like a 75, 20 five, 70, 30 kind of split of white bagging to buy and bill. And over time, we do believe, to your point, that as volume increases for lenacapavir, that there might be clinics that decide they wanna invest in buy and bill. Because it is it’s an investment. Right? You need to bring in people, do all the reimbursement work, and and then, of course, store product, pay for it out front, and then get reimbursed for it.

So there’s an out of pocket cost for clinics, and so I do think that’s when volume will kind of play out over time, and that’s when you might see a little bit more buy and bill lift. But we’ll be ready for it all, and I think that flexibility and optionality will create a seamless customer experience, because that’s what we’re all about.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: And then how much of a play is there here on alternate sites of distribution, meaning where you can actually get your injection? You and I both live in California and Safeway near me, you can go there, you can get your COVID shot, can get your bloods drawn, you don’t have to go see a physician. So why can’t that be a channel for a product

Joanna Mercer, Chief Commercialization Officer, Gilead: So we’re looking into that. Not all pharmacies can do that because there’s very specifics to this. You need privacy, need, right, you think about HIV prevention. And and we want to make sure that people are trained for the injection as well. This is a subcutaneous injection, but we also need to make sure that we’re providing that training prior to that first injection, just to make sure there’s a great customer experience as well.

So we are looking at, you know, to your point, Walmart, CVS, etcetera. We’re also looking through telehealth because a lot of people do prep through telehealth. Making sure telehealth has, some telehealth providers have brick and mortar offices where they can do the injections. Others will use alternate sites of care, One Medical, right, for example, well, as we think about California. All of those pieces are kind of coming into play to make sure that at launch, there’s optionality.

So yes, absolutely, all those things have been thought through.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: And will those start to actually materialize those alternate sites in the current year in 2025?

Joanna Mercer, Chief Commercialization Officer, Gilead: As access works up, I think that’s when that’ll play out as well.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: And do you know if Cabo is a Aptitude, Glaxo product being given in any of those channels to your knowledge?

Joanna Mercer, Chief Commercialization Officer, Gilead: I think you’d have to ask JSK. I think at launch they were not.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Okay, so let’s talk about that Glaxo product, because I’m imagining you guys have looked at the launch experience there and it hasn’t done very well, it’s gone fairly slow. I think there’s some really obvious reasons for that. But how do you guys view that as a benchmark?

Joanna Mercer, Chief Commercialization Officer, Gilead: Yeah, so we’ve looked at a lot of the different, you know, we’ve looked at obviously current in market prevention competitors, and we’ve also looked at out of market, where you went from an oral to an injectable, and there’s different markets that apply to that, just to get the best learnings for us to prepare for this launch. A lot of learnings were, in this marketplace specifically. Frequency of dosing is really important. And the why behind that is to go into a clinic every couple of months versus every six months, where they’re already kind of going every six months anyway for STI testing, where it’s sometimes even every three months, you’re adding a lot of burden of number of hours of patients coming back in into that clinic. So a lot of the smaller clinics couldn’t support that.

So that’s one. Two is, I think at launch, there wasn’t much flexibility. I think I I think there was a real, know, misunderstanding that maybe people would just pick up buy and bill right away and kind of move forward with that because there was maybe a financial incentive for clinics to do that. So I think that was misunderstood a little bit, and I think that’s where the flexibility and the optionality that I described earlier is so important to our launch. And then just the value of the product itself.

If you think about the differentiation of Lenacapavir, I talked about every six months, but let’s talk efficacy. Right? We are talking about incredible efficacy. Of course, it’s linked to adherence that it offers, but any research we’ve done in prevention, it is clear. It’s different in treatment.

It’s a little bit more balanced, but in prevention, is super clear that less is more. And so less frequency, these aren’t people that are sick. These are people that just want to make sure they protect themselves from getting, HIV in the future. And so it’s about empowering them to own their sexual health. So that’s the piece that we need to focus on.

And I do think every six months is going to be a real differentiator to redefine HIV prevention, and that’s why we believe this is such an important launch for Gilead.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Pricing benchmarks, my guess is you have those clearly established, it’s namely Descovy, your own product that runs around 25,000 a year. Is that the right way to think about it?

Joanna Mercer, Chief Commercialization Officer, Gilead: So we haven’t discussed pricing yet as we don’t have approval. But what we are thinking is, as you think about an annual treatment cost of prevention being in the range of anywhere between 24,000, 20 6 thousand currently for branded products, we are thinking to be in line with that range, and making sure at the same time that the value of Lenacapavir, the differentiation that we’re bringing to market, gets recognized as well.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: There already is hyper focus on what’s the first quarter of launch sales going to look like second quarter. And one of the unique things about this product is every patient that gets dosed essentially has kind of six months worth of revenue recognition upfront by Gilead. So you’ll be largely cannibalizing Descovy, right? You’ll be taking share invariably from Glaxo product, you’ll be helping to grow the market. But that dynamic of every script being worth six months of revenues could be actually be meaningful, right?

Joanna Mercer, Chief Commercialization Officer, Gilead: Especially if you’re thinking about a script in December, right? Of course, later in the year, a greater value in that year timeframe, in the six months

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: of

Joanna Mercer, Chief Commercialization Officer, Gilead: launch. I would say a couple of things. One is the market today is about 95% daily orals and 5% long acting injectable. We believe the market at launch, the strategy is going to be a switch strategy. And so it’s existing people on PrEP moving over, whether it’s from Descovy, Truvada generics, or the long acting.

We think there’s real value proposition there for lanacapavir. So, yes. And when you think about, you know, we talked a little bit about annual, at a high level, annual cost of treatment. When you think about adherence of current daily orals, in real world data, the current daily oral is used maybe 55% adherence, because people don’t remember to take a pill every single day when they’re not sick. And so that also creates risk, right, from an efficacy standpoint.

As you think about something like elenacapavir, which is every six months, your adherence shoots right up. And so when you think about annual treatment revenues, that’s also very different, right? You’re thinking potentially half for a daily oral versus something like Lenacapavir every six months. So that’s also an advantage as we think that through. So definitely switch at launch, and obviously the newer people and there’s a you know, we believe anecdotally, we’ve heard a lot of people kind of, waiting for something every six months.

And, so excitement about the launch is kind of ramping up as we speak. The the other piece of the puzzle is course then expansion. We we believe there’s a real opportunity for a lot of folks that are currently not educated, aware, on prep today to actually bring them in. And that means, you know, as I think about black Latino MSMs, I think about black women, I think about younger folks as well, because that’s usually where you see the highest risk of HIV incidence. Making sure we get to those folks where they are is gonna be really important.

So that’s kind of the phase of expansion that’s gonna come through in parallel with the switch strategy, but probably you won’t see that really come through until a little later out, you know, eighteen, twenty four months out, because it’s gonna be a little tougher. We’ve done a lot of ethnographic research, geo mapping to find out where these people are, where do they go, do they go, which doctor do they go to? Do they go to a doctor? Where do we get to them through churches, community groups, etcetera? And the cultural stigma aspect is strong here, so this is something we’re very well aware of and making sure we address that appropriately.

But we believe that there’s a real expansion strategy in The US, let alone ex US geographies, to make sure prevention is much more widely used to protect from HIV.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: All right, let’s talk about Biktarvy. There’s a lot of folks on linacap here, Biktarvy is really what drives the P and L. So 14,000,000,000 this year, that’s at least what we forecast, nearly 50% of revenues of the whole company. The share in the integrase inhibitor market now for you guys is I think just over 50% and just continues to motor up. So when I launched HEROBIVA with a buy in Gilead, one of the reasons was I think consensus is under modeling Biktarvy when I look forward over five and six and seven years.

So you’re hitting an air pocket this year because of Part D Last two years, you grew in the teens, three years ago, you’re 20 some percent. Why can’t that share penetration just continue almost linearly like it is and just continue to carry this product at a very strong trajectory? We get past 2025, the Part D redesign annualizes, then we’re kind of back off to the races, right?

Joanna Mercer, Chief Commercialization Officer, Gilead: So you can come talk to my team because I’m in agreement with you, right? I think that as we’ve talked about Biktarvy growth, and you’ve seen it even just recently with the Q1 earnings call, we talked about 7% year on year growth. And that’s with Part D redesign. So that’s a couple of points just of Part D applied to that. And so we’re at over 51% share and growing.

We are outpacing our competitors that have been out there more recently than us. We’ve been out since 2018, and we continue to deliver. There are many markets around the world that are over 50% share. Most markets, Biktarvy is number one. It has set the standard of care for all.

And we believe there’s still a lot of room for growth here. So absolutely. We also believe that our LOE is out till late twenty thirty three. So we have a large and long runway. And remember when I said that the market in treatment is a little different than in prevention when it comes to long acting.

As much as long acting are well underway and will come through, and many of those are actually at Gilead, we believe in patient centricity. We’ve looked at the market and we think that from a very different than prevention, the daily orals will have a really critical role continuing to play. You have a lot of people that have been diagnosed with HIV and wanna know they’re doing something about it every single day. And then you have the other extreme that don’t want to be reminded that they have HIV. And that’s where long acting’s will come out.

We have over nine HIV launches across treatment and prevention that are going to play out prior to 02/1933. So a lot more to come, but I do believe there’s still opportunity for growth with Biktarvy. And of course, then we’re going to launch, you know, the first oral weekly with lenislatrovir, followed by an integrase combination in the oral weekly as well, let alone three, six month, etcetera, coming through. So there’s a lot more to come. So I would think about Biktarvy as definitely still the standard of care in the daily oral market, with an expansion with the long act as well.

So more room for growth, let alone the fact, and I’m going to bring us back to what I said earlier around HIV, you still have a lot of people out there that are not currently virologically suppressed. And, you know, that’s the opportunity. So the market grows about two to three points year on year, and it’s been quite consistent. There’s a lot more work to be done to get a lot of linkage to care to those people that are not currently virologically suppressed. That’s the opportunity from a growth standpoint when you think about HIV treatment.

Tim Anderson, US large cap pharma and biotech analyst, Bank of America: Great, okay, the light’s flashing. I think we’re done. Johanna, thanks so much for joining us today.

Joanna Mercer, Chief Commercialization Officer, Gilead: Time. Thanks.

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