What Would A Biktarvy Slowdown Do To Gilead Stock?

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Gilead Sciences (GILD) stock has returned 31.6% over the past year, compared with a 15.1% return for the S&P 500, with HIV drugs led by Biktarvy still generating most of the company’s sales. During the August 4, 2026, call, management said growth in the HIV treatment market slowed in the second quarter. On August 27, the FDA approved a new once-daily Gilead combination pill for adults whose HIV is already at very low levels, a group of patients Biktarvy also treats. How far has Biktarvy’s own growth already slowed?

How Much Has Biktarvy’s Growth Slowed Already?

Biktarvy’s growth rate roughly halved over a single year. Sales of the drug rose 13.3% in fiscal 2024, followed by a 6.8% increase in fiscal 2025. In the second quarter of 2026, Biktarvy sales reached $3.8 billion, up 7% from a year earlier. Management credited this gain to a higher average price from channel mix and an inventory build, as well as higher demand, so only part of the increase came from additional patients.

The market surrounding the drug is also growing slowly. Management expects HIV treatment to return to its typical 2% to 3% annual growth, although Biktarvy again gained market share in the second quarter. During the same call, a question arose about whether patients moving from one Gilead regimen to another could dilute sales. Management answered that the company’s newer drugs offer a chance to expand its lead among patients who switch treatments.

What Would A Flat Biktarvy Cost Gilead?

A flat performance from Biktarvy would have wiped out Gilead’s overall sales growth in 2025. The drug brought in 48.7% of Gilead’s fiscal 2025 revenue. It added about $0.9 billion in sales that year, more than the roughly $0.7 billion by which Gilead’s total revenue grew. Had Biktarvy sales remained flat in 2025, Gilead’s revenue would have shrunk.

This dynamic matters for the price you pay. Investors currently pay 6.4 times sales for Gilead, against 3.2 for the S&P 500, and a Gilead without sales growth would be harder to justify at that multiple.

What Gilead Has Beyond Biktarvy

Gilead’s HIV prevention business is growing far faster than Biktarvy. Management said prevention sales doubled from a year earlier in the second quarter, crossing $1 billion in a single quarter for the first time. Descovy, which derives most of its sales from prevention, grew 30.5% in fiscal 2025. Management now expects full-year HIV sales to grow 9% to 10%, up from 8% previously.

Gilead also has the cash to wait. The company produced $12.9 billion of free cash flow over the twelve months to June 2026, and its operating income covered its interest expense 11.7 times. A Biktarvy slowdown would test Gilead’s growth rather than its finances.

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