With quarterly earnings underway, BioPharma Dive is providing a snapshot of some companies’ results and how they’re being received by investors. Today, we’re offering insight into the latest numbers from Gilead, Pfizer and Merck & Co.

Gilead’s ‘uncertain’ growth prospects

Gilead Sciences has spent tens of billions of dollars on deals hoping to show it can rely on more than its bread-and-butter HIV medicines to grow sales. But that business still accounts for the bulk of Gilead’s revenue, and is the focus of a debate among analysts tracking the company.

Gilead reported $7.6 billion in overall product sales in the second quarter, an 8% increase from the same period a year ago. Its two top HIV products, Biktarvy and Descovy, handily beat Wall Street projections to generate $5.7 billion combined. A third closely watched by investors, Yeztugo, hit $232 million, in-line with expectations and putting the drug on track to hit Gilead’s $1 billion projection this year. The company now believes overall HIV sales should grow anywhere from 9% to 10% in 2026, versus 8% previously.

To some analysts, those numbers calmed lingering fears about Gilead’s HIV franchise as well as the sales prospects of Yeztugo, a twice-yearly preventive shot that’s been hailed as a medical breakthrough. The market for HIV drugs has become increasingly fragmented and could be even more so in the future, with the arrival of newer options to “switch” from one treatment to another. But Gilead’s “strong operational performance” gives it a “higher base” with which to weather any coming erosion, wrote RBC Capital Markets’ Brian Abrahams.

The quarter was emblematic of “the good old days” for Gilead, Abrahams wrote. There was “plenty to like.”

Mizuho Securities’ Salim Syed added that, importantly, more than 70% of those who received a first Yeztugo injection returned for a second one six months later. Gilead claimed that figure was “well above” what’s seen with other options in the pre-exposure prophylaxis, or “PrEP,” market currently dominated by pills. And that’s “arguably the most important metric” in Gilead’s results, indicating Yeztugo’s total market opportunity could be “much larger” than the $6.7 billion-in-yearly-sales consensus, Syed wrote.

Others aren’t convinced. To Leerink Partners analyst Daina Graybosch, there were “several uncertain Yeztugo signals” in Gilead’s presentation. Gilead reiterated, rather than boosted, the drug’s 2026 sales predictions. Prescription trends from the analytics firm Iqvia suggest growth is slowing. Executives estimated Tuesday that 80% to 85% of the PrEP market prefers to stay on oral medications. Additionally, the “path to double-digit growth” likely runs through communities with historically low PrEP use, are “hard to acquire” and are less likely to stay on treatment, Graybosch wrote.

“We suspect these early adopters in this dataset are likely to be highly persistent patients who actively sought out Yeztugo,” she added, noting her team sees “meaningful risk of return rate degradation.” — Ben Fidler

Pfizer’s narrative shift

Pfizer has been trying to reinvent itself in the wake of a sharp revenue decline that’s left its share price well below the heights reached during the coronavirus pandemic.

Plunging sales of the COVID vaccine Comirnaty and antiviral treatment Paxlovid have been followed by multiple big acquisition bets. A $43 billion buyout of Seagen was designed to solidify Pfizer’s oncology prospects, while a $10 billion purchase of Metsera gave the company a crack at the lucrative obesity drug market. Pfizer has trimmed spending along the way, too, hiking more than once — most recently on Tuesday — an initiative expected to shed a total of $6.7 billion in expenses.

The returns on that strategy are unclear. Pfizer boosted its revenue guidance by $500 million on Tuesday thanks to stronger-than-expected sales that topped Wall Street analysts’ expectations. But while a Seagen-acquired drug, Padcev, was a key contributor, some of the products leading the charge — among them Eliquis and Vyndamax — are facing near-term patent expirations. Pfizer also recorded a $3.8 billion impairment charge after another Seagen therapy failed a lung cancer trial. It wrote down another $525 million from a sickle cell drug it no longer sells. Analysts are unsure whether Metsera’s drugs will stand out in a tough field, too.

"The quarter was solid, and the additional cost savings were welcomed," wrote RBC analyst Trung Huynh. But "We see Pfizer as a 'show me' dynamic."

One coming study could help shift investor sentiment. An experimental prostate cancer drug dubbed mevrometostat is now in a trio of Phase 3 trials, and the first is expected to report results in the fourth quarter. Pfizer posted encouraging data from an early study comparing a combination of the drug and the widely used therapy Xtandi to Xtandi alone. It’s hoping those findings will carry forward to the ongoing study, which is testing mevrometostat and Xtandi against Xtandi or chemotherapy in metastatic, castration-resistant prostate cancer.

On an earnings call, Chief Scientific Officer Chris Boshoff claimed the treatment could be a potential “breakthrough therapy in prostate cancer.” Pfizer’s hoping mevrometostat will prove clearly superior Xtandi, which is associated with delaying tumor progression for five to eight months. Billions of dollars could be riding on the results, as Pfizer has full rights to mevrometostat, whereas it co-markets Xtandi with Astellas Pharma.

That study is the biggest among a few readouts that could “determine whether [Pfizer] returns to a growth narrative or remains anchored as a restructuring story,” RBC’s Huynh wrote. — Delilah Alvarado

Merck’s PCSK9 pill predictions

Merck & Co. is adamant it ran reach $70 billion in annual sales despite the upcoming patent loss for its top seller Keytruda.

Like many of its biopharmaceutical peers, Merck is leaning on a mix of dealmaking and internal research to absorb the hit. The company showcased its progress in an earnings report on Tuesday.

Sales of a subcutaneous version of Keytruda, called Keytruda Qlex, grew from $128 million in the first quarter to $463 million between April and June, surpassing investor expectations. Three medicines it acquired in deals — Welireg, Winrevair and Ohtuvayre — either met or exceeded Wall Street projections, too.

Elsewhere, a China-licensed antibody-drug candidate has shown enough promise to become one of its cornerstone pipeline prospects. And Lipfendra, a cholesterol-lowering pill aimed at the protein PCSK9, won a speedy approval from U.S. regulators.

But some stumbles elsewhere spurred questions from industry watchers. A key drug the company gained from its nearly $11 billion buyout of Prometheus Biosciences succeeded in one Phase 2 study but failed in another, seeding doubt about an ongoing Phase 3 trial in Crohn’s disease. Merck is continuing a closely watched study of a preventative influenza medication through a second flu season, too, suggesting the treatment benefit might be “weaker than expected,” Leerink’s Graybosch wrote.

Additionally, RBC’s Huynh pointed out that Merck appears to already be “walking down” sales of Lipfendra, which it priced strategically in a bid to gain broader market share from injectables. Huynh predicted Lipfendra’s 2026 sales would be “negligible.” Graybosch, meanwhile, anticipates faster uptake than what’s been historically seen with PCSK9 drugs. She’s estimating that the drug hits $476 million in 2027.

On a conference call, CEO Rob Davis told investors that it will “take time to get access established” and that the pace won’t be “fast out of the gate.”

Still, “we continue to expect to see this to be definitely a blockbuster opportunity,” he added. — Delilah Alvarado