Gilead Sciences (GILD) Earnings Call Transcript & Summary

Good morning. Welcome to the Citi Global Healthcare Conference. Continuing this morning. Next up, we have Gilead Sciences. And with us today, we're pleased to have Andy Dickinson, CFO. Welcome.

Thanks for having us again. Appreciate it.

Of course. But we start this way. Maybe give a couple of minutes to give some opening remarks, and then we'll go to some questions.

Sure. Yes. Maybe four things to highlight as we start. One, we've had a terrific 2025 so far. You see that in our third quarter results. We increased our guidance for the year. So we can talk about that specifically, but a great first 3 quarters of the year, carrying a lot of momentum in our business overall. You see the second thing I would highlight is a really strong durable portfolio -- so our base business led by our 2 flagship HIV therapies today, Biktarvy and Descovy are driving significant growth. And then we have a number of launches that are underway and coming. Yeztugo, in particular, a new HIV, which should be a transformational HIV prevention medicine. It's an every 6-month injection and Livdelzi for primary biliary cholangitis, those launches are off to very strong starts. And then we have a number of launches coming. The third thing I'd highlight is we have the deepest, broadest, strongest portfolio in Gilead's history, pipeline, I should say, which means that you should see a steady cadence of additional clinical data that can drive additional product approvals and product growth. We are in a unique position relative to many of our competitors that we don't have any major or significant patent cliffs until 2036 at the earliest. And then finally, really strong financial management and disciplined M&A. kind of focus. So it's a good setup. We're really pleased with our progress.

Maybe just starting on the topic of policy from a bigger picture perspective, obviously, a new administration, new Congress changes are happening. We're seeing deals with some of your peers with the White House and the Administration. Maybe thinking from the perspective of Gilead, your recent interactions with the administration on MFN, topics like that, Medicaid, we know is top of mind for you guys given the exposure there. So maybe just from a high level, how you view the policy landscape evolving today as it evolves to you guys?

Yes. I mean what I'd highlight, it's an important question. We -- what we've said and we'll continue to say, we're having ongoing and constructive discussions with the administration. That was true in the first Trump administration. It's true in this administration. I'd also highlight that we share -- we have a lot of shared objectives here. We want to make medicines. We have a lot of transformative medicines. It's important that we make those broadly accessible to patients not only in the United States, but outside of the United States. It's also important that countries outside of the United States recognize the value of the drugs that we're developing. We spend billions of dollars on research and development. So we have a shared view that other countries tend to undervalue the innovation that we're bringing to the market and like to see that change over time and work with the administration. In terms of Medicaid -- or maybe I should highlight, in terms of the deals that have been announced so far with the government, one, these are voluntary deals. The second thing I'd highlight is none of them appear to be the same. They're all slightly different, and they reflect the different circumstances of the companies that have entered into those agreements. So you saw a recent deal with 2 companies that open the Medicare market, for instance, for obesity drugs. So -- and the other thing is it appears from the outside that not the entire portfolio of companies is covered by some of these price reductions. So it's too early to say specifically where we're going to end up or if we're going to end up with an agreement. These are, as I said earlier, voluntary. But we're making progress. We're in ongoing discussions are constructive. And maybe the other thing I'd add is I think the administration really understands at probably a deeper level than people appreciated the companies that are interacting with. So they understand, for instance, that Gilead is one of the companies that has the vast majority of our IP in the United States, over 80% of our IP -- we pay over 90% of our taxes in the United States. Almost all of our research and development infrastructure is in the United States. We've made a $32 billion commitment to additional investments through 2030 in the U.S. in terms of both research and development and manufacturing. And those are all things that the administration appreciates. So I think they recognize that not only is the pharmaceutical industry important in the United States, Gilead is an important piece of that. They don't want to damage the industry, and we have the shared objective of bringing prices down for patients in the U.S. So more to come over time, but ongoing and constructive discussions.

And in terms of the Medicaid exposure, certainly, your HIV portfolio is an important part of of that payer population. So maybe just frame to us, maybe quantify your exposure to that population. We know that Medicaid is now set to be starting funding cut next year. What other off-ramps do you have to sort of make up for that funding in certain areas?

Yes. And HIV is a little bit unique in that there are a lot of different opportunities and safety net, so to speak, across HIV that we've highlighted over time. Look, I think when you step back and look at our HIV treatment business and the payer mix in HIV treatment and HIV prevention are very different, which sometimes people don't fully appreciate. But in HIV treatment, to your point, about 60% of the payers are government payers and 40% roughly are commercial payers. Within the government segment, a little more than 20%, so low 20 percentage points are Medicaid and treatment and a little bit more than that are Medicare. So it's a sizable portion. But that's always been the case in our sector. What we've seen in the last couple of years is interesting is actually lower Medicaid growth than expected and greater commercial growth. Part of that is driven by the health care exchange plans and the tightening of the Medicaid eligibility requirements. So as you've seen -- and it's also -- there's some macro market factors, I think, including unemployment that have probably helped as well as you've seen more people move into commercial insurance than we might have forecast. And that's been a bit of a tailwind for our HIV treatment business. I do think it's important to highlight that when you look at the growth in our HIV treatment business, the vast majority of the growth is demand-led volume growth. But there has been for the last couple of years, a pricing tailwind led by that more commercial growth over time. So this is -- the sector has always been this way. It's manageable. You see when you kind of step back and look at our HIV business again this year, -- we updated our guidance for the business to grow 5% year-over-year despite a $900 million roughly headwind from the Part D reform as part of the IRA, which just highlights the durability and strength of the business overall. If you adjust for the Part D impact, the HIV business would be growing 10% this year despite the fact that you have the significant government pay component of it that you highlighted.

Maybe just zooming in on Yeztugo, an important new launch for you guys this year. Still early days, but you still managed to put up a very good quarter in 3Q and updated your guidance for the full year. So -- maybe just talking about positioning the product like in terms of competing with existing oral options in PrEP and sort of the expansion of the category?

Yes. So for those of you that don't follow the story closely, Yeztugo is our HIV prevention medicine. It's the generic name is lenacapavir. It's an incredibly potent first-in-class HIV capsid inhibitor that is an every 6-month subcutaneous injection. Last year, we reported the PURPOSE-1 and PURPOSE-2 studies that showed a 99.99% prevention of HIV transmission across two very large studies in men and women. So really incredible data. And to put it in context to your question relative to the oral options that are available. So today, there's 2 oral pills available, both developed by Gilead. One is now generic called Truvada. Descovy is another medicine from Gilead that is used in about 45% of HIV prevention patients today. It's a once-daily pill with two medicines. The daily orals work really well. The challenge is that people that don't have HIV do not take the pills on a daily basis. So you don't get the benefit that you would get if people stay on the pills every day. It's really challenging. The adherence is very low for the daily pills. And that's where you see an incredible difference in the clinical data, which was actually a head-to-head study of the 6-month injection versus the daily orals across all these different patient populations. So the clinical data, as I said, is very strong. The pharmaco-economic story is also very strong, to promote the shift, payers know that they're getting the benefit that they're paying for because you're ensuring compliance over the 6-month period. The last thing I'll say here is this is all about building the market and kind of changing prescriber habits, physician habits, getting them used to the new distribution of an injectable versus the orals, and it takes time. So the launch is off to a great start to your point. We're really pleased with our progress. A couple of things that I'd highlight our J-code for reimbursement in the U.S. came -- it was effective October 1. It came a couple of months earlier than expected. We hit 75% payer covered lives, and that's both across commercial as well as government payers. A couple of months earlier than expected as well, which is great. And we guided to roughly $150 million of sales for the first half of this year, including a little less than $100 million of expected sales for the fourth quarter. So it's off to a great start. This is just the beginning of what we expect to be kind of a steady, consistent, durable growth in this business in Yeztugo, in particular, over time. Not that different. For me, I joined Gilead 9 years ago. We were launching Biktarvy at the time. And you look at Biktarvy today as we had $3.5 billion of sales in the third quarter. And you've just seen steady, consistent durable growth from the best-in-class HIV treatment. Yeztugo, it's a similar dynamic in HIV prevention, where we think you have a best-in-class profile and expect very meaningful, consistent, durable growth over time.

So Yeztugo obviously, dosed twice a year by injection versus the oral options. You mentioned adherence, which leads to better clinical outcomes. Can you just talk us through your strategy on how you educate both patients as well as physicians on the benefits of twice yearly injection versus the once daily, because I think it's like in terms of convenience -- anything you want to...

Yes, I mean the clinical data is so obvious. But to your point, it takes time to change habits, both with the physicians and with people at risk of getting HIV. So it's just starting. I mean we've built out our sales force in HIV prevention. We have health care educators. We are working practice by practice with the physicians that treat people at risk of getting HIV. You've seen broad prep advertising overtime. There's typically a 6-month window under the -- some of the guidelines in terms of direct-to-consumer marketing for new launches that -- so at some point next year, you will likely see Yeztugo-specific advertising campaigns that should further increase awareness over time. So it's all of those things. It's working practice by practice, raising awareness generally. When you step back, I'll use the third quarter as an example of the progress because I think it's one thing to focus on Yeztugo. It's also important to look at the total HIV prevention business with an understanding that most of that should switch the long-acting over time. So if you look at the third quarter, Descovy grew 20% year-over-year. But if you look at just HIV prevention, which is about 75% of Descovy sales, Descovy grew 32% year-over-year in HIV prevention, and then you add on Yeztugo, our HIV prevention business collectively grew 42% year-over-year. And again, that's in the first real quarter of Yeztugo launch. So it really underscores the incredible growth that you're seeing in the HIV prevention market, which even though there've been HIV prevention options for people at risk of getting HIV since 2012, the market is really just developing now that you have multiple options, including the long-acting therapies. So it's an early early days. We estimate today, there's maybe 0.5 million people that are on HIV prevention therapy. The CDC just updated earlier this year, their estimates to estimate that at least 2.2 million people in the United States would benefit from HIV prevention. And of course, we think the market opportunity could be much larger than that when you look at in the United States, there's about 10 million to 12 million people each year that are diagnosed with a sexually transmitted disease. If you think about in that context, again, it underscores, I think, that we're at the beginning of building out the HIV prevention market.

Can you just talk us -- so you updated your guidance for the full year for Yeztugo sales and it implies continued robust growth into the fourth quarter, building off of a strong third quarter. So maybe just like zeroing in on where you're seeing that demand from -- in the sort of early days of the launch? Is this patient switching over from the oral options or once-daily options or these patients that are sort of new to prep. Where are you seeing the sort of early wins?

Yes. So there have been a number of things in the launch that have surprised us to the upside. I mentioned kind of the earlier J-code and the 75% coverage of commercial lives are of all lives -- covered lives coming earlier than expected, at least 3 months earlier than expected. The other thing that's been encouraging is when you look at the mix of where patients are coming from, and we've seen, in particular, more naive patients, so patients that are naive to HIV prevention starting on Yeztugo and more patients coming from generic Truvada than we expected at launch. The largest bucket are people switching from the other long-acting injectable option for HIV prevention. The second largest bucket is our people switching from Descovy but we've seen much more -- many more people that are naive to HIV prevention and coming from generic Truvada than we would have expected at this stage of launch which bodes well for kind of the long-term transition of the market that you're highlighting. So again, it's early days in the launch. We're not even 6 months into it. And we're encouraged by what we're seeing in terms of where patients are coming from. And as I highlighted earlier, the market's really just beginning to kind of form and grow, not only in the United States, but then you have the opportunity to grow the market outside of the United States.

So just on that point, you mentioned about, I believe you said 500,000 patients today in that treat market, but could expand by multiples into the future. So just bridge us, how do we get to where we are today to that aspirational target of I think you had over 2 million patients?

It's really building awareness. But to your point, like when you think about launch strategy, what we've always highlighted, our Chief Commercial Officer, has said repeatedly, a focus on first, the launch of the patients that are on HIV prevention therapy today. So -- and again, the numbers vary, but today, most resources suggest 0.5 million or more people in HIV prevention. Those are the people that already have an identified need that are already taking HIV prep. Some of them about 5% are on long-acting alternatives today. That's the primary focus. And then kind of that switch market will be the primary focus for the early stages of launch. Over time, building awareness of the HIV prevention, every 6-month alternative, the clinical data for that broader patient population. So using like the CDC update, for instance, historically, in the United States, the CDC focused on men having sex with men and IV drug users, their most recent update where they added another 1 million people to their estimate that would benefit from HIV prevention now increase the number of people in those populations, but also added heterosexual women, for instance, identifying the fact that I think in the United States today, roughly 1 in every 5 HIV infections is in heterosexual women population. So there are a number of underserved populations, whether it's people of color in the southeast, heterosexual women where you see greater growth than people might expect. So again, we'll start with the people that are on PrEP today and work to expand awareness for people that would benefit in all of these different populations.

Just switching gears to the other side of market that you're certainly well entrenched in treatment, Biktarvy, the patent settlement offers long-term stability. So I guess how does this extended exclusivity sort of influence your long-term long-range planning? And I know you're working on a lot of other combination options within treatment.

Yes. I guess I would just step back. So I mean, the update that you're alluding to is a patent summon earlier this year that highlighted that the earliest we would expect to lose exclusivity to Biktarvy in the United States is now 2036. Previously, the expectation was 2033. And we have a very deep pipeline of next-generation HIV treatment alternatives most of which are long-acting alternatives for patients. So we have 8 programs in clinical development, including 1 yearly prevention alternative. But when you look at to your question, HIV treatment. There are 7 different programs in clinical development today. 6 of those 7 are long-acting programs. I think 6 of the 7 are also wholly-owned with a partnership with Merck. All of them will give patients with HIV new alternatives. Biktarvy is an incredible medicine. There's a reason that today, 52% of people in the United States that are treated for HIV are on Biktarvy. I think it's 67% or 68% of new patients start on Biktarvy. It is absolutely the gold standard for a daily pill. And our belief is that we can replicate that efficacy and safety in weekly orals, monthly orals, every 3-month injectable in every 6-month injectable and we're bringing forward the portfolio that will do that. So we were confident that we would bring up to those 7 new launches in HIV treatment by 2033. That remains the case. We will -- we have an incredible research group that's bringing more molecules into the clinic, so we can add to that over time. And of course, some of those may fall out over time. But a lot of confidence that we will have numerous launches coming that will support the further diversification and growth of the business prior to 2036. One of them that I'd highlight is not a long acting, but it's a really important therapy that's bictegravir, which is the same integrase inhibitor that's in Biktarvy and lenacapavir that we talked about for prevention, an HIV capsid inhibitor that is a daily doublet, so two medicines. We had the first set of Phase III data a couple of weeks ago in an important patient population. There's about 6% to 8% of HIV patients in the United States that are on what we call complex regimens. And for many of them, that means they're taking 5 to 11 pills a day because they've developed resistance to some of the older alternatives that are available, typically protease inhibitors or [indiscernible]. We see very little resistance with bictegravir as an integrase inhibitor -- which is why it's such an important cornerstone for HIV treatment and then you add lenacapavir, which also has a very high barrier to resistance. This is a great alternative. So it's a big opportunity just in that 6% to 8% of patients where you could imagine going from to 5 to 11 pill a day to a single pill once a day with very high barrier to resistance. And then we have another Phase III study reading out in the coming weeks before the end of the year in switch, which will allow -- so if the roughly 20% of patients will switch off their HIV therapy over time, this will give them another alternative of what we believe could be a very attractive switch candidate for patients to move to, whether it's switching off of Biktarvy or competitive regimens over time.

You mentioned some of these longer-acting options that you're developing in the treatment market. You've talked about sort of a potential monthly blister pack oral, longer acting injectable monthly, quarterly, biannually. Where is that sort of sweet spot in this patient population for what is maybe most convenient?

Yes. That's a great question. I don't know that there is a sweet spot, and this is like when people take of the HIV market with Biktarvy, we found the sweet spot for a once-daily oral pill. But what's interesting is when you interview HIV patients it will -- they will have different views on what works best for them. And that's why we are really focused on bringing all of these different treatment options for them to meet patients where they are in terms of for some its weekly oral, for some, it's the every 6-month injectable. I would say directionally, the monthly oral combination for treatment and in every 6-month injection for treatment, probably are the two biggest opportunities of all the things that are in development. But that -- it doesn't mean that the other alternatives are not important and wouldn't have significant opportunity because every patient has a slightly different perspective on what would work best for them.

Maybe switch gears to oncology, hem/onc, Anito-cel is a very important new product in the pipeline, we're going to get an update very soon at ASH. So could you maybe walk us through what we should expect to see you guys update us on?

Yes. I mean just again to step back Anito-cel is a cell therapy, BCMA-directed cell therapy for multiple myeloma. There are two approved BCMA cell therapies for multiple myeloma that have helped transform the second-line plus multiple myeloma market. Anito-cel so far, so we'll present an update on the Phase III data, the pivotal data at ASH here in the coming days. So I'm not going to -- you'll see the data update. What you've seen to-date suggests that Anito-cel has the potential to be best-in-class therapy in particular, on safety, potentially on efficacy, too, as we see the data over time. But in terms of safety, we don't see any of the neurological side effects from Anito-cel that you see with at least the leading competitive cell therapy where you can see Parkinsonism and similar CNS side effects. There's another side effect that I'm forgetting off the top of my head that you see with some of the competitors. So again, Anito-cel is a completely different construct that has a different binder called the D-domain. There's less tonic signaling, meaning that the cell therapy doesn't stay on the the cell and continue to signal for as long. So it may be part of why you see lesser side effects. But we're excited to present a data update together with our partners, Arcellx here at ASH and then we can talk more about it. We've highlighted the update by the end of the year. We expect to launch in fourth line plus by the end of next year, and it's a significant growth opportunity for our Cell Therapy business. So very exciting for patients and really exciting for Gilead and Arcellx.

You mentioned potentially launching in later line. Can you talk to your efforts in clinical development in terms of moving up in the third line of therapy?

Yes. We already have the second line plus Phase III study underway. We also have a first-line study its either underway or expected that's in planning. So absolutely, the plan is to move Anito-cel up into earlier lines of treatment, and you see a size [indiscernible]. We've highlighted together with Arcellx and I think this is consistent with what you've heard from the competitors. But if you look at fourth line plus, it's probably a $3.5 billion plus market opportunity. Second-line plus multiple myeloma for cell therapy is about a $12 billion roughly opportunity. So these are really important therapies for a large unmet hematological cancer. So it's -- there's a lot of room. And then of course, if you get into some of the more severe first-line patients as well, it won't be likely in all first-line patients, but there may be some first-line patients with really quickly moving disease or more advanced disease where cell therapy will be the best option. So we'll have to see how that develops as well.

Trodelvy, a big win in first-line metastatic triple-negative breast cancer. Can you just update us on the time line for regulatory submissions? And I guess, at what point can we see a real inflection in the franchise?

Yes. I think that -- well, first of all, we had two sets of pivotal data in first-line triple-negative breast cancer earlier this year, that continue to highlight the strength of Trodelvy in triple-negative breast cancer just validates the earlier data set in later lines and helps people understand why Trodelvy today is the absolute standard of care in triple-negative breast cancer. I think we've treated over 60,000 patients in triple negative breast cancer and then second line plus hormone receptor positive, HER2-negative. So we -- the updated label expansion filings are in, in the United States. We expect to receive an updated label next year. And that's part of the overall -- when I talked earlier about the the breadth of our portfolio and the launch. The launch is underway and the launch is coming. Anito-cel is one of the launches coming next year, the label expansion with Trodelvy is another launch coming that should drive significant growth from where we are today. So if you look at the third quarter, Trodelvy was roughly a $1.4 billion kind of run rate. [indiscernible] bladder coming out of the label last year. And so you should see Trodelvy continue to grow from here, especially as you get the label expansion. I'm not sure that you see a significant inflection point. I think the right way to think about Trodelvy is sustained durable growth over an extended period of time.

Shifting gears to capital allocation, you're a company that we all know has been very active on the external business development front and bringing in new assets to the pipeline. But you've also described yourself as being selective right on that front. So maybe can you just elaborate a little bit more on the sort of specific technology platforms or therapeutic modalities or areas that you're prioritizing for future deals?

Yes. We have -- so we do a lot of corporate development to your point. I would highlight that we don't have the same need as many of our peers today. So we're active in the M&A market. We're active in regular partnering, and I'll break each of those apart. But it is important to highlight that given where we are today with our portfolio, the launches that are either underway or coming, the strength of the existing portfolio. We don't -- and the lack of any LOEs until 2036 of substance between now and 2036. We have the ability to be selective. We will add to our portfolio over time with late-stage derisked assets similar to Livdelzi, which we acquired last year, a year before from CymaBay. We're looking -- that was a $4 billion deal roughly of a [indiscernible] derisk asset that was a great synergistic fit with our liver disease franchise. Those are the type of opportunities that we're looking at. So we'll continue to look for those things, but we don't have the same need that we had when I joined the company 9 years ago or when our CEO, Dan joined the company 6 years ago, where we had a much thinner pipeline than we have today. So we have the luxury of being able to be disciplined. We generate a lot of cash flow from our business that allows us and we can reinvest that in R&D. You've seen us increase the R&D investment in our internal research significantly over the last 6 years, that's really starting to pay dividends as the strategy is is delivering now. So we will do more M&A, but very different situation to many of our peers. And then in ordinary course business development, every year, we do about $800 million to $1.2 billion of ordinary course BD, which is licensing small acquisitions. We did -- for instance, a licensing deal on a STAT6 last year, with LEO Pharma that we're very excited about. That's just a great example of the ordinary core stuff that we'll continue to do. So we'll continue to be active, but we're disciplined. We have the luxury of making sure that something is both a strategic fit and that the value works for us and our shareholders.

Last May, we had you at our conference in Napa. And I think you made some really interesting comments on BD in China. I believe thinking just remembering the conversation, in terms of your BD people spending more time on the ground in China and being very active on sort of your pursuit of assets outside of that region. We've seen a number of deals, more so early this year than the first half of the year than the second half of the year in terms of some of your peers doing BD in the region. Can you just maybe give us a little update on that 6 months later on how you're feeling about China? And this sort of time that you're spending on the...

Yes. I mean, we're still spending a lot of time there, and we're seeing a lot of really high-quality assets. What I highlighted is there's been this fundamental shift in the last 5 or 6 years from the assets that we used to see in China that were more follow-on me-too assets, less innovation, more of kind of specialty pharma generic to really innovative assets. And anything that we are looking for, you can typically find a number of different permutations of that in China. So whether that's bispecific cell therapies, small molecules. I didn't answer your question earlier, by the way, we are looking across all of those areas. So I'm sorry, like we are absolutely focused on virology, oncology and inflammation, across small molecules, antibodies, bispecifics, degrader, cell therapies. We have all of those in our portfolio today. We are experts that are really skilled scientists focused on all those areas. And we're seeing all those, not only in the United States and Europe, but also in China. So what I highlighted earlier this year is that 5 years ago, maybe 5% of what we'd be prioritizing for corporate development would be out of China or Asia earlier this year at the beginning of the year when we were focused looking at kind of what we wanted to accomplish for the year in BD, 50% or more of what we were interested in was sourced in China. So that will change from year-to-year. It doesn't -- it doesn't -- it highlights more the strength of what we're seeing there versus a lack of strength in the United States and Europe because we're seeing really interesting assets here. And in Europe, you've seen the renewed strength in the biotech markets here over the last 6 to 7 months, which I think is great for us in the markets in the long run. But it is for the larger companies like Gilead and many of our peers, it's great that we have a number of alternatives coming out of Asia that we didn't see before as well.

Just want to touch on the financial profile. So you've sort of outlined your road map and your guidance in terms of what you're expecting for top line growth, but you're seeing significant leverage from an operational perspective that is taking your earnings growth significantly higher than that. So how can we expect that to progress beyond 2026? You mentioned even accelerating internal R&D spend, but how about sort of another area of OpEx?

Yes, you're really seeing the strategy that we laid out 6 years ago play out positively. And so that was always we needed to invest in our internal and external R&D to drive this new product cycle, which we've done. So that includes almost doubling our R&D expense year-over-year, which is a sizable investment, it meant taking down temporarily our operating margin. You saw it kind of trough at just below 40%, which is still very strong for most companies. But in the third quarter, our operating margin was back up to roughly 50%. And you see the strength in our model. I mean, we are a lean company relative to most of our peers. So not only have we focused on building out R&D, we've also focused on, as we grew the company now pulling through efficiencies. So you see very disciplined, sustained cost focus -- fiscal focus over the last 3 years where our expenses have been roughly flat. So the strategy was always to build out the pipeline and then to have a quartile revenue growth that would then translate into a much stronger EPS growth. And that's what you've started to see the last couple of years. So it is very encouraging. I also think we're just at the beginning of the cycle. I mean, as you know, in our industry, these are long cycles. And given that we don't have any major patent cliffs, as I said, until 2036, at the earliest, and all of these launches underway are coming. It gives us -- we're really encouraged by the development of the strategy and the ability to have not only one of the best top line growth profiles in the industry, but then to drop an increasing amount of that to the bottom line over time. So you've seen healthy margin expansion. There's a point -- as you're developing a healthy company for the long term, we want -- we're happy to have that operating margin continue to expand, but there's a limit to where you want that to go. You want to make sure that you're reinvesting enough in R&D and sales and marketing with the launches. And I think we're really kind of hitting that that sweet spot now. But a lot of progress, you're seeing the strategy play out. We're really pleased with where we are, and I think it's just the beginning.

Okay. We're coming up on time. I'm going to borrow a frequently asked question of what my colleagues at Citi. Hopefully, you'll be joining us next year at this conference 1 year from now. So the question is 1 year from now, what do you think we're going to be talking about today as it relates to Gilead that maybe we're not talking much about right now?

Well, it's a good question. I think that -- it's the pipeline. I mean, it's -- to me, we spend a lot of time talking about the Yeztugo launch, which is incredibly important, and they set off to a great start. The other launches that are underway, there's a growing appreciation for the diversification of the business, both within HIV, and outside of HIV. But there's not a lot of focus paid on our mid-stage pipeline, whether it's the I&I pipeline, some of the mid-stage oncology programs, additional cell therapy programs. And I think over time, the market will come to appreciate not only the launches that are underway and coming but the pipeline that's coming behind it, it is all essentially a call option for shareholders today. So that would be one of the things in particular I think people will focus on a year from now.

Great. Well, thanks for joining us.

Thanks for having us. We appreciate it.