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Earnings Call: Q2 2019

Jul 30, 2019

Speaker 1

Ladies and gentlemen, thank you for standing by, and welcome to the Gilead Sciences Second Quarter 2019 Earnings Conference Call. My name is Liz, and I will be your conference operator today. At this time, all participants are in a listen only mode. And as a reminder, this conference call is being recorded. I would now like to turn the call over to Sung Lee, Senior Vice President, Investor Relations.

Please go ahead.

Speaker 2

Thank you, Liz, and good afternoon, everyone. Just after market closed today, we issued a press release with earnings results for the Q2 2019. The press release and detailed slides are available on the Investor Relations section of the Gilead website. The speakers on today's call will be Daniel O'Day, Chairman and Chief Executive Officer Joanna Mercier, Chief Commercial Officer and Robin Washington, Executive Vice President and Chief Financial Officer. Also in the room are Diana Braynard, Senior Vice President and Head of our HIV and Emerging Viruses Therapeutic Area and John Sundy, Senior Vice President and Head of our Inflammation Therapeutic Area.

Before we begin with our prepared comments, let me remind you that we will be making forward looking statements, including plans and expectations with respect to products, product candidates, financial projections and the use of capital, all of which involve certain assumptions, risks and uncertainties that are beyond our control and could cause actual results to differ materially from these statements. A description of these risks can be found in our latest SEC disclosure documents and recent press releases. In addition, Gilead does not undertake any obligation to update any forward looking statements made during this call. Non GAAP financial measures will be used to help you understand the company's underlying business performance. The GAAP to non GAAP reconciliations are provided in the earnings press release as well as on the Gilead website.

I will now turn the call over to Dan.

Speaker 3

Well, thank you, Sung, and good afternoon, everyone. It's now month 5, and I'm really pleased that I've had the chance now to talk with you the second time in the Q2 after the Q1 call with some very good results. I'd like to share a few opening comments and then I'm going to turn the call over to Joanna Mercier, who joined us at the beginning of the month as our new Chief Commercial Officer. Very happy to have Joanna with us as well. Robin will then take over and walk you through some of the highlights of the strong quarter.

So let me just start by saying, I'm really pleased with the progress we're making across all the fronts. As one example, as the leader in HIV, we're very focused on continuous innovation as you may have seen from some of the recent data we presented. Biktarvy is the number one regimen in the United States now, momentum continues to build and we expect that momentum to continue in the future. I mentioned on the last quarter that I would focus on 3 key priorities as I came into this organization. The first one was the pipeline.

The second one was optimal commercial delivery. That's both for our current products, but also as we prepare for some new and important and exciting launches. And then thirdly, really people, the organization, bringing the right team together at the right time for Gilead. And as you can see, we've had a very busy quarter. We've announced key changes this quarter that helped to address really all three of these priorities.

And importantly, we made these changes against a backdrop of strong financials and really promising pipeline progress. So let me say a few words about the major steps we've taken to, 1st of all, strengthen the pipeline with the Galapagos collaboration. Secondly, I want to dive a little bit into the highlights from our current pipeline. And 3, talk a little bit about the organizational changes as well. So first on Galapagos, it's fresh news.

Earlier this month, we announced an exciting new collaboration with Galapagos. As you know, Galapagos is a highly productive R and D engine. They have 7 medicines now in clinical development, including filgotinib, which has a very comprehensive lifecycle program. And they have more than 20 medicines now in preclinical and their model has been very productive at producing new candidates for the clinic every year. And of course, with our increased investment, we would expect that to even increase in the future.

This is a really unique collaboration because it combines complementary strengths between Gilead and Galapagos. And very importantly, and as you know, we structured this to allow Galapagos to remain independent. Many of you know my past. I'm a big believer that innovation requires independence, I think, to be preserved. And the structure of this deal allows us to preserve the great science and talent at Galapagos.

They can invest and innovate to accelerate the progress based upon our investments. And in return, we have an exclusive access right to their proven drug discovery platform. All of this, I believe, will help patient science in our business in a very significant way. So I was really pleased this was the first collaboration that I could announce under my tenure and yet this is still a beginning. We'll continue to explore other ways to strengthen our pipeline and our innovation network in the future.

Secondly, on the pipeline side, this has been an important time for our existing pipeline. Let me touch on a couple of things that speak to our growth potential before handing it over to Joanna. And there's 2 things I want to just highlight here, some recent promising HIV data that we presented recently. And secondly, since the last quarter, our plans to file filgotinib for approval. So first of all, we had a terrific week last week at the International AIDS Society Conference on HIV Science.

We were able to present clinical data for our 1st in class HIV capsid inhibitor, the GS-six thousand two hundred and seven. And as you saw, the early results support further development as a long acting therapy that we think will really meet the needs of the community that we serve. And then we also presented further data on Descovy for PrEP, additional data that reinforces the profile of Descovy in the PrEP setting. And as you know, this is currently under regulatory review in the United States and we also have plans to file Descovy for PrEP in the EU in the first half of twenty twenty. We are looking forward to the FDA advisory committee that will be held next week.

And overall, we're encouraged by the government's engagement around HIV prevention in many forms. The advisory committee will be an important opportunity and provide a forum for Gilead to talk about the benefits of Descovy in the prevention setting for a broad population of individuals at risk for HIV. So secondly, on filgotinib, as you know now, based upon a meeting with the agency, we intend to file for U. S. Approval for filgotinib later this year in rheumatoid arthritis based upon our discussions with the FDA.

We will also be filing in the EU really imminently at this stage. So overall, very good news on the path forward filgotinib. I had the chance actually recently to attend the EULAR meeting, the Annual European Congress of Rheumatology in Madrid, so I could get a firsthand view of the enthusiasm among physicians and thought leaders about the profile of filgotinib and the potential it has to be a best in class among the JAK1 inhibitors. Finally, then a few comments about the work we've been doing to build the right team for the future. I'm very pleased to welcome Joanna, who you'll hear from next and Christy Shaw, who joins us from Eli Lilly.

She will start as CEO of Kite on August 1. And as you know with Christy's arrival at Kite, Kite will become its own business unit and we remain committed to accelerating the pipeline and maintaining our leadership position in cell therapy. I'd also like to very much extend the thanks to 3 leaders who will be leaving Gilead, John McCutcheon, Greg Alton and Katie Watson. John, Greg and Katie have all made tremendous contributions that help to shape today's results that you're seeing and really Gilead's progress over the past many years, decades in fact. So I'd like to thank them as we transition the team forward for Gilead.

So in closing from my side, I just wanted to emphasize how increasingly optimistic I am about the future of Gilead and the potential that it has. This is a unique company. It's a company that cured hepatitis C and transformed HIV. I'm getting an up close view of the unique strengths that made that possible. I'm looking forward to working with all the talented people at Gilead as we apply those strengths to the next wave of transformational advances in various diseases.

We're making great progress and there's much more to come and I look forward to continuing to share more about my vision for the future later this year as I communicated, but as you can tell, I'm not waiting for that. We're implementing along the course of that strategy with many of the things that you've seen in this past quarter. So I'd like to thank all of our employees and partners around the world for their dedication and hard work that led to a successful quarter and whose commitment will continue to make us successful in the future. With that, I'd like to turn the call over to Joanna.

Speaker 4

Thanks, Dan, and good afternoon, everyone. So although I'm only 1 month in, I've begun to get to know the company, the people, and I just want to say how impressed I've been by the talent and the strength of the team as well as what they've accomplished so far. And today, I wanted to take the opportunity to maybe highlight 2 areas that really caught my attention, both of which I believe are real growth opportunities moving forward for Gilead. Those are the strengths of our HIV business, both in treatment as well as in prevention, as well as the potential for filgotinib. So if we start with HIV.

You'll hear from Robin describe in more detail our results for the quarter, but our HIV portfolio has never been stronger. Biktarvy continues to be a very impressive launch. It's on an incredible trajectory. It's just hit its first $1,000,000,000 quarter in the U. S.

For Q2, is now the number one prescribed regimen in the U. S. For both naive and switch patients, as well as number 1 for naive and switch in Germany, in France and in Spain. We just got reimbursement in Italy and the U. K.

In the last 2 months or so, so more to come on performance there. As Dan mentioned, we had a really strong showing last week at the International AIDS Society Conference, presenting research that really demonstrated the breadth of the scientific work across our pipeline from prevention to treatment to cure. This included a couple of new analysis of our DISCOVER trial for Descovy for PrEP. We really believe that DISCOVER could offer important safety advantages over Truvada as it showed superior safety for bone and renal as well as rapid onset and longer duration of preventative therapy than Truvada. These are really clinically meaningful to individuals, physicians and payers for two main reasons.

Individuals at risk of HIV are not patients, they're generally healthy people. So therefore, the bar for safety among this population is just so much higher. The second reason is the persistency on PrEP has increased actually similar to that that what we're seeing in HIV treatment patients. In addition, younger people are initiating this therapy at the time when they're actually building peak bone mass. So overall, people on preventative therapies are on for longer periods of time, which is what makes these results even more compelling.

And that's exactly what we heard from physicians at an ad board last week during the conference. So I'm very excited about what's to come with DSUVY in PrEP. Dan mentioned that we're under review with the FDA for the prevention of HIV. And for the reasons I've just shared, we really believe it has significant potential to make a difference in the lives of a broad population of individuals at risk of HIV. So that's the first real growth opportunity, both in HIV treatment as well as in PrEP.

The second one is around filgotinib. I really see tremendous potential in filgotinib and the teams you can imagine they're really hard at work in preparing the launch of this medicine. It's a high priority for me and the team and the whole organization. Although it's a very competitive space and we know that, we truly have an opportunity to make a difference in the lives of people living with RA and potentially even other inflammatory indications, as these are just such debilitating diseases. And yes, there are numerous treatments on the market for RA.

However, many patients are actually helped by the therapies that are currently available. The FINCH studies highlight the strong efficacy and tolerability results of filgotinib in different patient types. Filgotinib, a JAK1 specific inhibitor, could actually answer a clear unmet need in the marketplace for an efficacious and safe oral agent. So still to come on that and obviously, more to come on the filing in the second half of this year. So with that, I really look forward to working with this great team to deliver on the promise of these medicines and to getting to speak with you in more detail in the near future.

I just want to take a moment to thank everyone for such a warm welcome as I've arrived a month ago. And now I'll turn the call over to Robin. Robin? Thank you, Joanna, and welcome. Good afternoon, everyone.

As Dan said in his opening comments, we had a strong quarter led by our HIV franchise, predictable performance in HCV and continued growth of Yescarta. Total revenues for the Q2 were $5,700,000,000 with non GAAP diluted earnings per share of $1.82 This compares to revenues of $5,600,000,000 and non GAAP diluted earnings per share of $1.91 for the same period last year. Total revenues and non GAAP earnings per share for the Q2 benefited from an approximately $160,000,000 adjustment for statutory revenue clawback reserves, primarily related to HIV and HCV sales in Europe from prior years, which contributed $0.10 per share. Non GAAP earnings per share for the same quarter last year benefited from a settlement of a tax examination, which contributed $0.15 per share. So starting with HIV.

Total HIV sales for the 2nd quarter were $4,000,000,000 In the U. S, HIV product sales for the 2nd quarter were $3,200,000,000 up 13% year over year and up 14% sequentially. The year over year increase was driven by robust underlying prescription demand growth, up 13%. This marks the 5th consecutive quarter in which HIV sales have posted double digit year over year growth. And the Q1 in which Biktarvy surpassed the $1,000,000,000 mark, becoming the number one prescribed regimen for all patients.

More than 40% of new patients started on Biktarvy. Aided by the growing momentum of Biktarvy, Descovy based regimens accounted for 83% of our prescription volume for HIV treatment. Sequentially, the increase was primarily driven by the continued uptake of Biktarvy and PrEP and the full quarter impact of price increases taken in March of this year. In Europe, HIV product sales for the Q2 were $623,000,000 and benefited approximately $70,000,000 from the adjustment for statutory revenue clawback reserves related to sales made in prior years. Excluding the adjustment, our HIV product sales in Europe would have slightly declined sequentially.

The year over year decline was predictable, driven by the broad availability of generic versions of Truvada. We continue to see, however, the impact from generics moderating as the uptake of Descovy based products progresses. Biktarvy is now available across the EU5 with launches occurring in Italy in June and in the UK in July. Already in France, Germany and Spain, Biktarvy is the number one regimen for naive and switch patients. With access increasing for Biktarvy, we're optimistic that the declines in our European HIV business will continue to moderate and that our Descovy based franchise will continue to grow.

Turning to HCD. Total HCD sales for the Q2 were 842,000,000 dollars U. S. Product sales for the Q2 were $355,000,000 down 35% year over year and down 10% sequentially. The year over year U.

S. Decline was in line with our expectations and primarily due to competitive dynamics and lower patient starts. Sequentially, the decrease was primarily due to the Q1 purchasing activity by a State Department of Corrections. As a reminder, we mentioned on our prior call that Q1 U. S.

HCD sales were positively impacted by the timing of the State Department of Corrections order. We're very encouraged by the performance of the Asegua authorized generics, which accounted for more than 25% of our U. S. HCV revenues and continue to improve our HCV competitive positioning. In Europe, HCV product sales for the 2nd quarter were $277,000,000 and benefited approximately $80,000,000 from the adjustment for statutory revenue clawback reserves related to sales made in prior years.

Without the adjustment, HCV product sales would have declined 15% year over year and 1% sequentially. Turning to cell therapy. Worldwide Yescarta sales for the Q2 were 120,000,000 up 76% year over year and 25% sequentially. We were pleased with the steady adoption of Yescarta. Our efforts in the U.

S. Remain focused on educating providers on the profile of Yescarta and identification of appropriate patients. Additionally, as the Centers For Medicare and Medicaid Services looks to finalize the annual Medicare ITPS rule for fiscal year 2020, we continue to engage with agency officials and other stakeholders with the goal of improving Medicare reimbursement and access for patients over 65 years of age. This remains an area of focus to ensure continued uptake of Yescarta. In Europe, Yescarta has launched in Germany, the U.

K, France and Spain among the larger countries. Overall, we have been very impressed with the speed at which countries have provided reimbursement and the pace at which centers are being certified. Finally, I would like to comment on our cardiovascular products. As expected, we saw generic versions of Lateris introduced during the quarter. Lateris and RynXa sales totaled $223,000,000 for the Q2, down 51% year over year and down 37% sequentially, as a result of competition from generics.

Sequentially higher in the Q2, primarily due to a favorable inventory dynamics compared to a drawdown in Q1. But underlying prescription demand is eroding and we anticipate going forward sales will decline as we absorb the full quarter impact of generics. Now turning to expenses. Non GAAP R and D expenses were $916,000,000 for the 2nd quarter, down slightly compared to the same period last year, primarily due to the 2018 impact of our purchase of a priority review voucher, largely offset by higher investments to support our cell therapy program. Non GAAP SG and A expenses were $1,000,000,000 for the 2nd quarter, up 21% compared to the same period last year, primarily due to higher promotional expenses in the U.

S. And expenses associated with the expansion of Gilead's business in Japan and China. Our non GAAP effective tax rate in the 2nd quarter was 21.5% compared to 13.4% in the same period last year, which was impacted by a one time favorable settlement of a tax examination. Moving to the balance sheet. During the Q2, we generated $2,200,000,000 in cash from operations and ended the quarter with $30,200,000,000 in cash and investments.

We repaid $500,000,000 of senior unsecured notes, paid cash dividends of $800,000,000 and repurchased 9,000,000 shares of stock for $588,000,000 Moving to our guidance. We are raising our full year net product sales guidance based on favorable demand trends in the first half across our portfolio and the one time adjustment for Europe's statutory revenue clawback reserves. Net product sales are expected to be in the range of $21,600,000,000 to $22,100,000,000 We are also updating our full year diluted EPS impact of GAAP to non GAAP adjustments, which are expected to be in the range of $3.90 to $4 a share as a result of a collaboration agreement with Galapagos. All other components of our guidance remain unchanged. With regard to full year SG and A guidance, we are leaving that unchanged as we prepare for future launches of filgotinib for rheumatoid arthritis.

Our guidance is subject to a number of uncertainties, which are outlined in Slides 23 to 24 in our earnings call presentation. So I want to thank everyone very much for joining today's call. Let's now open up the call for questions. Operator?

Speaker 1

Today's question and answer session will be conducted electronically. Our first question comes from Matthew Harrison with Morgan Stanley. Your line is now open.

Speaker 5

Great. Good afternoon. Thanks for taking the question. I wanted to ask one related to the HIV pipeline. I noticed that you got breakthrough designation on the capsid inhibitor.

And I'm just wondering if you could talk a little bit more about the path to registration, how breakthrough enables you to potentially move that product ahead. And if you could just also comment on what you see as the patient opportunity for that product as well? Thanks.

Speaker 3

Great, Matthew. So we have Diana here and she will be more than happy to address that.

Speaker 4

Yes, thanks. Hi, this is Diana Braynard. We're very excited that the FDA recognized the importance of the capsid inhibitor GS-six thousand two hundred and seven by providing it with breakthrough designation for heavily treatment experienced patients with multidrug resistance. This is a small segment of the HIV population, but represents a really high unmet medical need. These individuals have limited treatment options due to the resistance they have.

And this highlights one of the important components of our capsid inhibitor, which is to say because it is 1st in class, there's no pre existing resistance to this class. And it makes it really a unique compound in that regard. And that's part of the value it brings. Of course, the other piece is that it's long acting. And so we see it as having value across a broad range of patient populations.

In terms of the path to registration, what breakthrough designation does is allows us to communicate more frequently and have more dialogue with FDA. And in fact, we have plans to do that in the coming weeks, where we'll get more clarity on exactly how we can best move our capsid inhibitor forward in this population as quickly as possible.

Speaker 1

Our next question comes from Brian Abrahams with RBC Capital Markets.

Speaker 5

Another question on the capsid inhibitor. How important will it be to pair that with additional antiretroviral agents? Can you talk about where you are with respect to development of long acting forms of internal assets that could potentially pair with 6,207? And then along those lines, what's your sense at this point kind of mapping the Phase 1 PK data with the Phase 2 viral decline data as to how often, how frequently you think patients will need to be dosed in order to maintain adequate exposures and still have a small injection volume for that drug? Thanks so much.

Speaker 4

Sure. Well, so I think when we talk about developing long acting regimens, we're envisioning that will need to be partnered with a second agent. And to that end, we've got a number of different internal candidates to become partners with Capsid. And we hope to be rolling that data out and those plans out over the next coming months. In terms of the frequency of injection, one of the things about capsid that's so exciting is that it's got picomolar potency, which really makes it an order of magnitude more potent than any other approved antiretroviral and allows us to give the amount of drug needed for very long term injections.

And so really the frequency of drug injection is going to be dictated in large part by the partner and also by the formulation. And we're still gaining clarity on what the initial regimens will look like, but there's a huge potential here for very infrequent dosing.

Speaker 1

Our next question comes from Michael Yoo with Jefferies. Your line is now open.

Speaker 6

Hey, thanks for the question. Congrats on a good quarter. I wanted to talk a bit more high level about R and D. Obviously, John McCutcheon, not sure if you're in the room, but it's been good to spend the years together, particularly in the HCV days. But maybe just a comment either from John, but obviously Dan going forward, where the shape of R and D goes from here, what you would like to try to do in the next, say, 12, 24 months, how oncology plays with that?

And then the second part of the question is, since you've done the SCALOPAGOS deal, it would seem that that's a big part of early stage discovery. How much of your R and D is early stage discovery? And does that help offset some of that? Again, sort of related to the first question. Thanks.

Speaker 3

Yes. Thanks, Michael. Can I just get some clarity on your second question, sorry, around Galapagos? I want to make sure I understand what your question was there.

Speaker 6

Yes. I guess, if you can quantify or describe how much of your R and D budget, I think it's $3,500,000,000 $4,000,000,000 is early stage discovery. It would seem that Galapagos is going to be either additive to that as resources or that that could actually allocate some of your R and D early stage to have them do some of that and supplement that?

Speaker 3

Okay. Thanks. So Michael, first of all, thanks a lot. We will certainly pass your good wishes on to John McCutchenson. He's got his team here, but he's not in the room today.

But John has really made tremendous contributions to Gilead and we wish him nothing but the best as he seeks his next challenge. But let me just comment first on your first question about the shape of R and D next 12 to 24 months. Well, again, I think a lot has happened in the past quarter just to emphasize where we stood when we spoke just a few months ago. Certainly, we've had progress on the HIV front, which we just spoke about in the first two questions with Diana. But we've also gotten much greater clarity around the path forward for filgotinib.

And with that path forward with filgotinib in rheumatoid arthritis, I remind you, we have a very broad and expansive program around filgotinib in other disease states, including IBD. And so we really have had a good quarter for our internal portfolio. Now moving forward, I mean, obviously, our emphasis is on growth. It's on long term growth. It's on our ability to shape that R and D portfolio into an area where we have a good number of innovative medicines balanced across our stages of development.

As we spoke about last time, one of the areas that we really need to continue to strengthen is our late stage portfolio as well. And I do think that the collaboration with Galapagos and some of the acceleration of molecules that we have within Gilead will help us to strengthen that late stage portfolio. I remind you with Galapagos, we have 2 products that are in later stage, one for IPF and one for osteoarthritis in addition to the broad program around filgotinib. But moving forward and more on this Michael later in the year, obviously inflammation with the lead with filgotinib, the work we have on HIV, long acting treatments for highly experienced patients and cure programs. Oncology is a clear focus and it certainly is within the cell therapy realm where we've had really some transformational effects on a subset of B cell lymphomas.

And you know our strategy there is bring it to earlier lines of therapy with B cell lymphoma to other hematologic malignancies to potentially solid tumors into allogeneic. And then we're bridging that across to a broader oncology portfolio that we'll continue to advise you on within Gilead and partners that include small molecules and bispecific antibodies that will be focused on really providing significant benefits for patients with high unmet medical needs in oncology. And then finally, of course, liver diseases. We continue to work in the liver area on hepatitis B. We have important data readouts on NASH later this year.

So I think when we sit here in the next couple of quarters, a lot of these things are also going to come to more fruition and we'll get a chance to look at what we have in our hands today in terms of late stage in terms of our portfolio. And we'll continue to supplement that with innovation from the outside, an innovation network like Galapagos. Secondarily, on Galapagos in particular, I think it's probably the best way to put it into context is and as I said this on the call previously with Galapagos is with the collaboration with Galapagos, we essentially double our research capacity. And what does that mean? I mean, we've got roughly the same number of scientific colleagues across the 2 organizations.

In fact, Galapagos will be increasing their number to get a little closer to what we have with Gilead, but it provides with 2 sources of early stage discovery input into our late stage portfolio. And I think that's very exciting, because if we can get 2 highly productive research engines feeding the late stage portfolio that speaks well for kind of the future of our portfolio as we move forward. We haven't really completely disclosed We haven't really completely disclosed exactly the spending patterns in each of those areas. I'll suffice it to say that we'll those investments will be driven by the science, the decisions on the portfolio will be driven on making sure we keep the bar high for patients. And we'll continue to look at other ways to expand that innovation network with early stage collaborations and deals and when possible late stage collaborations and deals.

Hopefully, Michael, that gives you a little color to so far what I can articulate in the past 5 months.

Speaker 6

I appreciate and look forward to the rest of the year on that. Thanks. Thanks, Mike.

Speaker 1

Our next question comes from the line of Jeff Porges with Leerink. Your line is now open.

Speaker 7

Al, thank you very much and appreciate the question. Dan, there's been a lot of pretty interesting moves in the industry, sort of a macro level companies changing portfolios, shifting assets around. And I realize your focus has primarily been on R and D, but is there anything that you believe you could potentially consider moving out of the company's portfolio? Or do you have any appetite for bringing in any marketed products that might be available for any other company's portfolios? And just related to that, could you comment on how much of an issue FTC considerations are as you look at outside products given what we've seen so far this year?

Thanks.

Speaker 3

Thanks, Jeff. Yes. I mean, I guess, just taking a step back about how we look at our approach to M and A overall and our partnerships. Again, I would say that you're right, there's a lot of moves in the field. I think what's characterized Gilead is the ability to really focus on the science in a way that's been pretty transformational with HCV and HIV.

And I've commented before on my observation on the quality of the science and the scientists that are here at Gilead and I would only emphasize again after 5 months. And that's important not only for the science we do within the company, it's also important for how we can evaluate external scientific opportunities. I can say that as we partnered with Galapagos, the respect and admiration from a scientific perspective between Gilead and Galapagos was very high. And that's what led me with confidence to move forward with the team in striking that deal. So we will be driven by science for sure.

We'll focus on the areas of expertise that we have today. I mean that's HIV, oncology, liver disease, inflammation and the intersections between those 2. To your point, I mean, I don't think we'll have a one size fits all strategy for bringing innovation into the company. I think that the Galapagos structure was the right structure for that collaboration. It allowed independence.

It allowed us to secure our investment. It allowed us rights to everything that comes out of that investment. And therefore that collaboration was fit for purpose for that particular transaction. But it doesn't mean that we won't look at different ways of transacting when we look at other aspect. On the FTC standpoint, I don't really have a lot of comments there.

I'd aspect. On the FTC standpoint, I don't really have a lot of comments there. I think we haven't had any issues right now with FTC and the type of transactions we're going after. So I don't have a whole lot of personal insight into that question as well. So hopefully that gives you some indication of how we'll continue.

Speaker 7

Thanks very much.

Speaker 3

Thanks, Jeff.

Speaker 1

Our next question comes from the line of Alethia Young with Cantor Fitzgerald. Your line is

Speaker 8

now open. Hey guys, thanks for taking my question. Congrats on the very solid quarter. I just want to talk about a trend in Europe. I'm slightly intrigued by the fact that you guys tend to like are able to mitigate kind of the generic pressure you're seeing from the Biktarvy offsets.

I just wanted to get a little bit more color on why you think that's the case. I mean, we all know Europe is fairly cost conscious and understand that there's differentiated profile, but what has really been the driver there that allows you to have growth in your TAC franchise there? Thanks.

Speaker 4

So, Alethia, I'll take that one. I mean, I think it really has been the underlying opportunity that we have with Descovy. We have seen with the Descovy and now launch of Biktarvy, sorry, I was about to say, but of Biktarvy, we're just seeing really a moderating of that deceleration. So it really speaks to the innovation of the product and the drug and we've seen really solid, adoption.

Speaker 1

Our next question comes from the line of Carter Gould with UBS. Your line is now open.

Speaker 9

Great. Good afternoon. Thanks for taking the question. Maybe one for, I guess, Dan and Joanna. Can you maybe just elaborate a bit further on how we should think about PrEP providing another leg of growth for the HIV franchise, particularly given some of your moves in the quarter to improve access in the U.

S? And I guess when you think about Europe, some of the historical challenges there? And then, I guess, a follow-up there, just any insight you can provide on what you expect the focus of the AdCom to be for the for DESCOVID there? Thank you.

Speaker 3

That's great. So we'll have Joanna pick up on the first aspect of your question, Carter, and then Diana can talk about the AdCom.

Speaker 4

Yes. So thanks for the question, Carter. So basically, in prep, what you see today, if you think about our Truvada business, the growth is very solid. It's about a 27% growth year on year. But having said that, there's only about 200,000 individuals that are actually on Truvada and that represents about 20% to 25% of the total potential of individuals that could benefit from prevention treatment.

And that's where Descovy comes in. And I do think Descovy, as we talked about earlier on this call, real opportunity in light of the fact that it just has such benefit in the prevention setting for a broad patient population a broad population of individuals, namely because of its superior safety both on bone and renal, as well as the fact that there's a rapid onset and longer sustained duration of HIV protection than Truvada. So those things will definitely play an important role as we think about our launch for Descovy moving forward in the second half of this year. On the flip side, you talked about a little bit about Europe. Obviously, Truvada prep in Europe is not available in light of the fact that it was genericized, but we will be looking at filing for PrEP in the first half of next year.

And maybe Diana for the Sure. Yes. So with respect to the AdCom, the FDA has the liberty to convene an advisory committee for a number of different reasons. And And in this case for Descovy for PrEP, I think it's probably part of a larger effort to increase awareness and signal the commitment of the government to HIV prep efforts. And this is a forum where experts can come together and provide a discourse on the benefits of PrEP and also the trial results of DISCOVER.

And as you know, we are seeking a broad indication for Descovy for PrEP and our study was conducted in men and transgender women who have sex with men. And so this will certainly be a topic for discussion as well as the study results themselves. And so that's what we're prepared for.

Speaker 3

Thank you.

Speaker 1

Our next question comes from the line of Umer Raffat with Evercore ISI. Your line is now open.

Speaker 10

Hi. Thanks so much for taking my questions. I wanted to focus on 2 pipeline programs, if I may. 1st, on silgotinib. So based on everything disclosed so far in the pool data, there is no DVT imbalance and that's very important.

But my question was, what about all thrombotic events? So for example, the retinal vein occlusion in FINCH 2 was technically not a DVT. So what about all thrombotic? Is that still no imbalance at all? That's point number 1.

And the second one was on the Galapagos IPF program. We know the Phase 2 trial they ran had a meaningful baseline and bounce on FVC medians. And my question is, have you analyzed the FVC data on similar sets of FVCs on the placebo arm versus the active arm? Thank you very much.

Speaker 3

Thanks, Umer. So we're going to get John involved here, John Sundy. Thanks, John.

Speaker 9

Sure. So first of all, to start off with filgotinib, getting to the issue of issues across all thrombotic events, we are still very pleased with the results across all of those events and don't really see anything that would change our perspective on that compared to the specific data that we presented already. Moving on to the Galapagos compound. As you might imagine, we look very carefully at all of the available data in the IPF program. We have quite a bit of experience in IPF ourselves with prior programs at Gilead as well.

And we saw the data that really provided the confidence to Galapagos to be able to move ahead, and we share that confidence with them.

Speaker 1

Our next question comes from the line of Mohit Bansal with Citi. Your line is now open.

Speaker 11

Great. Thanks for taking my question. So, good question on capsid inhibitors. Do you think a longer acting agent such as capsid inhibitors could expand the PrEP market just to penetrate 20%? And then when can we learn more about your plans for capsidin fat?

Thank you.

Speaker 3

Yes. Before I turn it over to Diana, Mohit, I think it's a good question. By the way, we fully intend prior to the capsid to get beyond 20 percent of the prep market with both Truvada and Descovy. I mean, and you're seeing the increase of course quarter on quarter there, but also our wraparound programs with the community and really taking this more global. So there's lots of opportunity with the current programs.

Having said that, Diana, do you want to address maybe the casid for PrEP concept?

Speaker 4

Sure thing. And I didn't catch the second part of the question, but I'll answer the first part. So John, I mentioned this large gap between the number of people in the U. S. Who are eligible for PrEP and the number of people who are on PrEP.

And of course, we're trying to close that gap. But the part of that strategy is going to be having additional options beyond daily PrEP. And the capsid inhibitor could be one approach to that. It's got a long acting potential. We're looking at preclinical models to assess its efficacy in the prep setting.

And we're very excited about its potential as our physicians and the community about having this as an option. So we're looking forward to generating the data that will allow us to get into the clinic with that.

Speaker 11

Got it. Very helpful. Thank you.

Speaker 3

Thank you.

Speaker 1

Our next question comes from the line of Cory Kasimov with JPMorgan. Your line is now open. Great. Good afternoon.

Speaker 12

Thanks for taking the question. So I guess, Dan, I'm curious, how should investors be thinking about building out your management team versus building out the company's capabilities via external BD? In other words, there are clearly some important positions to fill such as a permanent CFO, a permanent CSO, etcetera. So how much are the search for assets and technologies and the search for personnel correlated or mutually exclusive? And obviously, I recognize what you were recently able to do with Galapagos, but there was an established relationship that was already there.

Thanks.

Speaker 3

Thanks. I really appreciate the opportunity to answer that. I think they can both very much happen in parallel. I mean, I can just articulate that the Galapagos collaboration, for instance, I mean, it involved teams of people within our organization that are absolutely dedicated to both the discovery platform aspect of it as well as the clinical programs. And so I don't see any slowdown at all in our ability to proceed ahead with corporate development during this period when we're still recruiting key individuals.

First of all, Robin is here and very active. So we don't lack a CFO by any means and we'll certainly have a good transition of a CFO before Robin leaves. And Robin's appetite to continue to grow the portfolio is good, isn't it Robin?

Speaker 4

Very high.

Speaker 3

Okay. So that's we don't sell anything there. We have a very, very effective corporate development team in the organization that Andy has built up over the past couple of years. But the most important thing about the effectiveness of that corporate development team is that they're interconnected with all the different respective experts within the organization. So Diana's team and John's team and the other clinical TA heads and then Bill Lee's team and the entire research organization.

So that machine is still operating at full steam and full effectiveness. So I just want you to know that. In the interim, of course, we are then proceeding ahead with Robin's replacement and with John's replacement, and we look forward to bringing some additional new colleagues into the organization that will also be focused on science and growth and driving the future of Gilead's mission, like we did with Joanna and with Christy so far. Thank you.

Speaker 1

Our next question comes from the line of Phil Nadeau with Cowen and Company. Your line is now open.

Speaker 13

Good afternoon. Thanks for taking my question. My question is specifically on the recent proposed changes to Medicare and specifically Part D. I'm wondering if you'd be willing to disclose what proportion of your U. S.

Revenue in Q2 came from Part D and whether given it's done any preliminary analysis of those changes and their potential impact on your revenue. It seems like based on the pricing of your medicines, you're right around the break point between helping and hurting your revenues. I'm curious if you've done any final analysis to figure out

Speaker 3

what the impact would be? Yes. Let me start, Phil. Let me give you a little context and then I'll turn it over to Robin on some detail. So first of all, I mean, I think it's important to note that there's

Speaker 13

a lot

Speaker 3

of things that have been happening in Washington recently and a lot of things that still need to be provided clarity with. With. What I would say is a couple of things over this past quarter have been very encouraging. First of all, the work that we've done with the administration ending the HIV epidemic, our drug donation and ability to get to many, many more patients with HIV really shows the support we have around increasing that those number of individuals that are eligible for PrEP. The other thing is the Part D protected class rule was a really important patient choice legislation that was upheld and that's we think that's good for patients.

We also think that supports our portfolio as well. And then the other thing that I think is a really ongoing dialogue is the consensus that we have now and that's emerging around the need for new solutions and different approaches for CAR T therapies. So I just point to those three things as things that I think have been really encouraging for our portfolio that happened in the past quarter. Now at the same time, we completely accept and understand that there's going to continue to be pressure on drug pricing. I remind you that the vast majority of our business is driven by volume.

We're actively involved of course in the Part D discussions and where that may go. We believe in initiatives that support CAF to patient out of pocket expenses that help patients at the end of the day in Part D reform. And that's where we and others in the industry are rolling our sleeves up on to be active participants in Part D reform. Specifically relative to our exposure to Part D, I don't know. I'm going to turn it over to Robyn to see if she has any other things she wants to add there.

Speaker 4

No, Dan, I think you covered a lot of areas. I will only add, Phil, that we don't typically disclose the various specific payer mix. I will tell you that overall it's a low double digit percentage. If you think about Gilead, particularly our HIV, I mean, overall, we have a high proportion of public pay, right? And we've always come up with innovative programs, as Dan was describing, some that support full access to those patients.

So I think that is something that we'll continue to do as we work with Washington.

Speaker 1

Our next question comes from the line of Salim Syed with Mizuho. Your line is now open.

Speaker 14

Hey, guys. Thanks for taking the question. Dan, I just wanted to talk about hepatitis B as in boy for a second. So the beginning of the year before you joined, some of your colleagues mentioned that Gilead plans to be a leader in hepatitis B. I was wondering if you still maintain that view, how you prioritize it within the company versus perhaps oncology or inflammation areas?

And if there's any science that you feel like you don't have that's of interest to you?

Speaker 3

Thanks. I'm still digging into that a bit, Salim, but it's clear that we have tremendous expertise in our organization and colleagues that are focused on liver disease and in particular hepatitis B. It's also clear that our current product, Enlity, is a significant benefit for patients with hepatitis B and underutilized. So one of the things we're working with Joanna and others on in the organization is how do we make the current standard of care more available to patients at need and at risk around the world and that's something you may hear more from us on in the coming quarters. But relative to your question about the next level of advances in hepatitis B, And I also had the experience to talk to some key thought leaders around this as well.

There's no doubt that it's a challenging scientific area to think about coming up with a hep B cure. And yet I still think there are some very promising scientific avenues. As you can imagine, I won't comment necessarily on specific technologies that we either have in house or that we think we may need to partner to collaborate with. But I would give you confidence that we know the landscape extraordinarily well. We know the science extraordinarily well.

And like many viral diseases, we may need to think about combination approaches in this area to get to longer duration and sustained responses. But because of the sensitivity of some of those programs, I'm not going to get into more detail. But suffice it to say that I think as a company with our type of expertise that we do need to be on the cutting edge of hep B and we need to be thoughtful about how we approach it and what level of investment we put into it. But there's no doubt that as long as our scientists think there's an avenue forward, we should be we should have some concentration in that area.

Speaker 14

Great. Thanks so much.

Speaker 3

Thanks. Our

Speaker 1

next question comes from the line of Hartaj Singh with Oppenheimer. Your line is now open. Yes. Hi. Thank you.

Thanks for

Speaker 15

the question. I just had a question on the ESKARTA. You reported now a good quarter, I think 2 in a row. I think you had indicated earlier in the year, this year that you had over 1500 patients on the therapy, which had accelerated from the end of 2018. Could you just give some more color on the dynamics of the patient adds in how you're feeling for the rest of the year?

Plus also how over the next couple of years you will sort of roll out into earlier lines of therapy as that clinical data reads out? Thank you.

Speaker 3

Thanks a lot, Hitesh. So let me start and then maybe other colleagues want to add a little bit here. So let me just restate my belief that I said on previous quarters that as Gilead thinks strategically about how to approach an entry into oncology, I think the concept of approaching it with a pioneering technology is a very sensible path forward. In other words, instead of jumping into where everybody else is right now, really moving to where the treatment paradigm can go, I think makes sense. Now with the pioneering technology comes all of the rewards and risks associated with being on the cutting edge of science.

But I would say that I'm very impressed by the data that's been generated so far from the KITE team and the sustained level of responses we're getting and we'll continue to update you on those responses. I know again later this year as well on the duration of those responses, but we're seeing very consistent response in that subset of DLBCL patients. So but in addition to the scientific strength of this and the broader R and D program that I mentioned before about moving into earlier lines of therapy, other hematologic diseases, solid tumors and allogeneic. I would say that there are clearly some near term factors that can affect the trajectory of Yescarta. We're carefully monitoring those.

Something I've been personally involved in is some of the discussions around the reimbursement changes. Robin mentioned it in her prepared remarks around the Medicare reimbursements and then we're also investigating further patient flow dynamics. So I think there's no doubt that in the near term, with the pioneering technology where hospitals are getting used to how to get reimbursed, CMS is trying to come up with new programs as you've seen published about how to encourage adoption for Medicare patients. There could be some variability, if you like, on the quarter to quarter sales for Yescarta. But having said that, when I just take a step back and think about the mid- to long term trajectory of Yescarta and the duration of response in patients, I continue to be very encouraged.

And as the quarters go on, we'll be able to of course provide data for you on the continued profile of Yescarta just as we did at ASCO of course where we talked about some of the ways to ameliorate some of the initial responses and to encourage Yescarta in even more patients from an early standpoint. So that's what I would say so far about Yescarta. I don't know, Robin, would you like to add anything on that?

Speaker 4

No, I think you covered all the areas, Dan. And as I said on the call, we also have Europe now where we're very encouraged relative to the receptivity reimbursement. It's an innovative therapy, but we're doing very well with our launch there, in addition to all the factors that you mentioned in the U. S.

Speaker 3

And just maybe one last point on that. So we expect the new Medicare reimbursement rules to go into effect in October of this year. So that's obviously going to be a key pivot point for how we see uptake in use in Medicare patients. And we know that the use of Yescarta in Medicare patients also has an influence in centers on how they treat their non Medicare patients. So lots to continue to innovate here, not just on the science, but also on the reimbursement and access programs, and we're fully committed to that.

Speaker 11

Thank you.

Speaker 1

And that will conclude today's question and answer session. I'd like to turn the call back to Sung Ji for closing remarks.

Speaker 2

Thank you, Liz, and thank you everyone for joining us. The team here looks forward to providing you an update on our next call.

Speaker 1

Ladies and gentlemen, thank you for your participation in today's conference. This concludes the program and you may now disconnect. Everyone have a great day.

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