GILD Q2 2026 Earnings Analysis
Gilead delivered 10% base business growth in Q2 2026 driven by HIV, Trodelvy, and Livdelzi, raising full-year HIV guidance to 9-10% and planning two additional launches before year-end.
Key Metrics
Points clés
- Base business up 10% YoY to $7.6B driven by HIV (+12%), Trodelvy (+26%), and Livdelzi (doubled).
- PrEP business exceeded $1B quarterly for first time with 70%+ persistency; $4B annual run rate.
- Raised full-year HIV growth guidance to 9-10% from 8%; expect launches of BIC/LEN and anito-cel by year-end.
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// Full episode scriptWelcome to Beta Finch, your AI-powered earnings breakdown! Today we're diving into Gilead Sciences' second quarter 2026 results — and Jordan, this is a big one.
It really is. Big numbers, big acquisitions, big pipeline news.
Before we get into it, quick disclaimer: this podcast is AI-generated content for educational and entertainment purposes only. Nothing we discuss should be considered investment advice. Always do your own research and consult a qualified financial advisor before making any investment decisions.
Good to have that out there. Okay, let's talk numbers. Gilead's base business — that's total product sales excluding the COVID drug Veklury — came in at $7.6 billion, up 10% year-over-year. That's their strongest second-quarter growth in three years.
And it's broad-based too. HIV sales were up 12% to $5.7 billion, Trodelvy in oncology up 26%, and Livdelzi in liver disease more than doubled. On the back of that, management raised full-year HIV growth guidance to 9-10%, up from 8%.
The headline stat for me was PrEP — that's HIV prevention. Quarterly PrEP sales topped $1 billion for the first time, doubling year-over-year, putting that business on a $4 billion annual run rate. Yeztugo, their twice-yearly injectable, is now the leading option for new PrEP starts and even leads the switch market after just four quarters on the market.
And they shared something pretty striking — more than 70% of Yeztugo patients are coming back for their second injection at six months, meaning they get a full year of protection. That persistency rate is apparently well above anything else in the category.
Now, EPS is where things get messy — but for a good reason. Non-GAAP diluted EPS was actually negative $6.75 for the quarter.
Wait, negative? That sounds alarming.
It sounds alarming, but it's really an accounting story. Gilead closed three acquisitions this quarter — Arcellx, Tubulis, and Ouro Medicines — totaling about $11.2 billion in acquired R&D expense, which under accounting rules gets taken as a hit all at once. Strip that out, along with a one-time non-cash revenue item, and EPS was actually $2.27 for the quarter — up about 13% year-over-year on an apples-to-apples basis. That's outpacing revenue growth, which tells you there's real operating leverage in this business.
Right, and full-year guidance reflects that same split — they're now guiding to $30.1 to $30.4 billion in total product sales, raised from prior guidance, but full-year EPS on a GAAP-ish basis is guided negative because of those acquisition costs. Excluding the deal noise, full-year EPS guidance is $8.50 to $8.85, actually raised slightly on the low end.
So the deals are the real story of the quarter, strategically speaking. Let's unpack them. Arcellx gives Gilead full ownership of anito-cel, their multiple myeloma cell therapy — that's five months from its PDUFA date, so a launch is coming. Tubulis brings an antibody-drug-conjugate platform, and there's already exciting early data on GS-8824 in ovarian cancer — 61% response rate in a tough, pretreated population.
And on the existing portfolio side, it wasn't just an acquisitions quarter. Trodelvy got approved for first-line metastatic triple-negative breast cancer, roughly doubling its addressable patient population. Livdelzi, the liver disease drug, posted positive phase III data that could expand its use. And they launched Hepcludex, the first-ever approved treatment for chronic hepatitis D.
One thing that jumped out in the Q&A — an analyst pushed CEO Dan O'Day on whether Gilead still cares about diversifying away from HIV, since HIV remains such a dominant chunk of revenue. His answer was basically "yes, but we're doing it two ways" — diversifying within HIV itself with new dosing options, daily, weekly, monthly, twice-yearly, and diversifying outside HIV into oncology and, increasingly, inflammation, where they teased more data later this year.
There was also a nice exchange about a seeming contradiction — why launch a once-weekly oral PrEP pill when you just spent years convincing people injectables are better? Johanna Mercier, the commercial chief, pushed back on that framing. She said 80-85% of the PrEP market is still on daily pills, so a better oral option doesn't cannibalize the injectable story — it's about capturing people who just don't want a shot.
There was a bit of a speed bump too — Biktarvy, their flagship HIV treatment, saw softer demand in the quarter tied to ACA subsidy changes pushing some patients off insurance. Management framed it as transitory and expects the market to bounce back to its normal 2-3% growth rate.
Worth flagging for listeners — cell therapy was the one soft spot, with sales down 14% year-over-year due to competition, and Veklury guidance was cut because there are simply fewer COVID hospitalizations these days. Not every part of the portfolio is firing.
Sure, but taken together, this was a quarter where Gilead raised guidance twice in one call — both HIV growth and overall sales — while also closing three acquisitions and racking up three positive phase III readouts. That's a lot of simultaneous execution.
Looking ahead, the next catalysts are an FDA decision on BIC/LEN, a new once-daily HIV switch pill, expected by August 27th, and an anito-cel decision in multiple myeloma before year-end. Management called those two potential launches in the second half.
Before we wrap up — everything discussed is AI-generated analysis for educational purposes. Past performance doesn't guarantee future results. Please do your own due diligence.
Well said. So, plenty to watch from Gilead in the back half of 2026 — two more potential drug launches, integration of three new acquisitions, and a PrEP franchise that's just getting started.
We'll be following it closely. Thanks for tuning in to Beta Finch — until next time.