Gilead Sciences has become a major biopharmaceutical company in oncology, but its competitive position is different from companies that dominate immune checkpoint inhibitors.
Gilead’s oncology strategy is built around antibody-drug conjugates (ADCs), CAR-T cell therapy and combination approaches, rather than relying primarily on PD-1 or PD-L1 checkpoint inhibitors. This gives Gilead a differentiated position, but it also puts the company against powerful oncology franchises from Merck and Bristol Myers Squibb.
Gilead’s Financial Strength Comes From HIV
Gilead enters the oncology competition with a strong financial base. In 2025, total product sales reached $28.9 billion, up 1% from 2024.
Its HIV portfolio generated $20.8 billion, accounting for the majority of product sales. Biktarvy alone generated $14.3 billion, up 7%, while Descovy reached $2.8 billion, up 31%.
This cash-generating HIV business gives Gilead significant capacity to fund oncology research, acquisitions, partnerships and clinical trials.
The company spent $5.8 billion on R&D in 2025, compared with $5.9 billion in 2024. R&D therefore remains a major part of Gilead’s strategy even as the company continues to generate substantial cash from established products.
Gilead vs. Checkpoint Inhibitors
The biggest difference is the treatment approach.
Merck’s Keytruda and Bristol Myers Squibb’s Opdivo are immune checkpoint inhibitors that work by helping the immune system recognize and attack cancer cells. Gilead’s Trodelvy is an ADC, while Yescarta and Tecartus are CAR-T therapies.
This means Gilead is not simply trying to replace Keytruda or Opdivo. Instead, its opportunity is to compete through different mechanisms and potentially combine its therapies with checkpoint inhibitors.
The scale of the competition is significant. Merck’s Keytruda/Keytruda QLEX generated $31.7 billion in 2025 sales, up 7%.
Bristol Myers Squibb also continues to expand its immuno-oncology portfolio. Its Q3 2025 Opdivo sales reached $2.532 billion, up 7%, while Opdualag generated $739 million.
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Simple Competitive Comparison
| Company | Key oncology product | 2025/Latest sales | Core approach |
|---|---|---|---|
| Gilead | Trodelvy | $1.4B | ADC |
| Gilead | Yescarta | $1.5B | CAR-T |
| Merck | Keytruda/Keytruda QLEX | $31.7B | Checkpoint inhibitor |
| BMS | Opdivo | $2.53B in Q3 2025 | Checkpoint inhibitor |
| BMS | Opdualag | $739M in Q3 2025 | Checkpoint + LAG-3 |
Gilead’s oncology products are therefore commercially much smaller than Keytruda, but the company does not need to replicate Keytruda’s sales to create value. A diversified oncology portfolio with differentiated mechanisms could provide another growth engine alongside HIV.
Trodelvy Shows Both Opportunity and Risk
Trodelvy is one of the clearest examples of Gilead’s strategy.
The ADC generated $1.4 billion in 2025 sales, increasing 6% from 2024. Growth was primarily driven by higher demand in breast cancer treatment. However, the company also faced the withdrawal of the bladder-cancer indication.
This is important competitively because ADCs can potentially complement checkpoint inhibitors rather than compete with them directly.
The opportunity is to develop combinations where a checkpoint inhibitor activates the immune response while an ADC delivers a cytotoxic payload to cancer cells.
Gilead therefore needs to demonstrate not just that Trodelvy works, but that it can deliver clinically meaningful advantages against established treatment combinations.
CAR-T Gives Gilead Another Differentiator
Gilead’s Kite business gives it another major oncology platform through CAR-T cell therapy.
However, the latest sales numbers show increasing competitive pressure. Gilead’s total cell-therapy sales fell 7% to $1.8 billion in 2025.
Yescarta sales declined 5% to $1.5 billion, while Tecartus declined 15% to $344 million. Gilead specifically attributed the Yescarta decline to in-class and out-of-class competition.
This suggests that simply having an advanced cell therapy platform is not enough. Gilead needs better durability, broader indications, faster manufacturing and easier treatment delivery to maintain differentiation.
Where Is Gilead Investing?
Gilead continues to allocate billions of dollars toward R&D while also using partnerships and business development to strengthen its pipeline.
In Q3 2025, Gilead reported $1.3 billion in R&D expenses and announced a $120 million upfront payment connected with its collaboration with Shenzhen Pregene Biopharma.
The company is also investing heavily outside oncology. Its HIV prevention portfolio is becoming an important future growth area, particularly with twice-yearly lenacapavir.
This diversification is important because Gilead does not have to depend entirely on oncology to grow. Its strategy combines a large HIV franchise with oncology, liver disease and emerging prevention products.
What Should Leaders Look at Before Investing?
For healthcare and biopharma leaders evaluating Gilead or similar oncology companies, revenue alone should not determine the investment decision.
The first area to examine is clinical differentiation. Leaders should ask whether a new ADC, CAR-T or combination therapy produces a meaningful improvement in overall survival, progression-free survival, response rate or quality of life.
The second is competitive positioning. A therapy that works only as well as Keytruda-based combinations may struggle commercially unless it offers advantages in safety, administration, patient selection or cost.
The third is pipeline concentration. Gilead’s 2025 results show how valuable diversification can be: HIV generated $20.8 billion while oncology products were considerably smaller.
Leaders should also examine R&D productivity, manufacturing capacity, regulatory risk, acquisition spending, patent life and reimbursement before committing capital.
Most importantly, investors should watch whether Gilead can turn its oncology platforms into sustained commercial growth while protecting the cash flow generated by HIV.
Overall Competitive Assessment
Gilead is not currently positioned as a direct equivalent of Merck’s checkpoint-inhibitor franchise. Keytruda remains vastly larger commercially, with $31.7 billion in 2025 sales.
Gilead’s stronger competitive argument is diversification through ADCs, CAR-T, targeted oncology and combination therapies.
Its $28.9 billion product-sales base, $5.8 billion R&D investment and strong HIV franchise give it substantial financial capacity. The key question for the next phase is whether that financial strength can be converted into differentiated oncology products that can compete alongside, or in combination with, the leading checkpoint inhibitors.
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