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Major ClientsNarrow moat

Gilead Sciences (GILD) — moat facet

Gilead's buyers are three wholesalers with 74% of gross sales, but its real customers are the payers who took back $17.5 billion and never place an order.

Gilead's customers come in three layers, and the concentration in each is different. The buyers are three wholesalers, Cardinal Health, McKesson and Cencora, which took 29%, 24% and 21% of gross product sales in 20251. The deciders are insurers, pharmacy benefit managers, Medicaid and Medicare, which buy nothing directly and took back $17.5 billion in rebates and chargebacks2. The users are patients, most of them on HIV medicines they take every day.

Who Gilead sells to and who takes back, 2025 ($bn)28.9Net product sales20.0Gross-to-net deductions17.5of which rebates and chargebacksGilead Form 10-K FY2025
The deciders take back almost as much as Gilead keeps.

Revenue concentration is therefore high in form and low in substance. The wholesalers distribute; they do not choose which HIV regimen a doctor prescribes, and losing one would reroute rather than lose sales.

Backlog concentration is not a question here, because there is no backlog. Gilead's filings disclose no order book or remaining performance obligation for product sales; the nearest thing is the inventory management agreements under which wholesalers estimate "end-user demand"3. That makes quarterly sales sensitive to stocking, but annual sales follow prescriptions.

The concentration that matters is in the deciders. Medicare selected Biktarvy for price negotiation from 20284, and Gilead agreed to MFN prices in Medicaid for select products5. Government is both a major payer and, increasingly, the price-setter. The pricing facet under The Moat covers the arithmetic; this page covers who holds the power.

The concentration disclosure itself has moved. In the 2023 10-K the three wholesalers were reported as shares of total revenues6; the 2025 10-K reports them as shares of gross product sales7. The change is a matter of presentation, but it means the percentages in older and newer filings cannot be compared directly, and a reader adding them up across years should use one basis.

The four pages below take each relationship in turn: the wholesalers, the payers, PEPFAR, and the absence of a backlog. If rebates and chargebacks rise above 65% of net product sales, from about 60% in 20258, the deciders will be taking more than the moat can justify.

Moat trajectory: Narrowing

Payer rebates rising; Medicare negotiates Biktarvy from 2028.

The number that tests this moat
Reported
Largest single wholesaler's share of gross product sales, full year
29% (Cardinal Health, 2025 and 2024)

Single-distributor dependence; above 35% would concentrate credit and stocking risk.

Source: Gilead Sciences Form 10-K, FY2025 ↗
Dig deeper
DIG DEEPER 01
Three Wholesalers, Seventy-Four Percent
Three wholesalers bought 74% of Gilead's gross product sales in 2025, but they distribute rather than decide: the patients belong to the prescribers.
DIG DEEPER 02
The Payers Who Never Place an Order
Payers who never order a Gilead drug took back $17.5 billion in rebates and chargebacks in 2025, about 60% of net product sales.
DIG DEEPER 03
PEPFAR: Two Million People at an Undisclosed Price
Gilead will supply lenacapavir PrEP for up to two million people through PEPFAR, a customer that buys for access at a price Gilead does not disclose.
DIG DEEPER 04
No Backlog, Only Prescriptions
Gilead has no order backlog; its forward book is millions of HIV patients refilling every month.
References
  1. ReportedThe buyers are three wholesalers, Cardinal Health, McKesson and Cencora, which took 29%, 24% and 21% of gross product sales in 2025.
    Gilead Sciences Form 10-K for 2025 - customers, wholesalers, distribution and gross-to-net deductions. — FY2025 · publ. 24 February 2026 · source ↗
  2. ReportedThe deciders are insurers, pharmacy benefit managers, Medicaid and Medicare, which buy nothing directly and took back $17.5 billion in rebates and chargebacks.
    Gilead Sciences Form 10-K for 2025 - Item 1A risk factors and pricing regulation: the IRA, Medicare negotiation, Medicaid, the ACA and tariffs. — FY2025 · publ. 24 February 2026 · source ↗
  3. ReportedGilead's filings disclose no order book or remaining performance obligation for product sales; the nearest thing is the inventory management agreements under which wholesalers estimate "end-user demand".
    Gilead Sciences Form 10-K for 2025 - customers, wholesalers, distribution and gross-to-net deductions. — FY2025 · publ. 24 February 2026 · source ↗
  4. ReportedMedicare selected Biktarvy for price negotiation from 2028, and Gilead agreed to MFN prices in Medicaid for select products.
    Gilead Sciences Form 10-K for 2025 - Item 1A risk factors and pricing regulation: the IRA, Medicare negotiation, Medicaid, the ACA and tariffs. — FY2025 · publ. 24 February 2026 · source ↗
  5. ReportedMedicare selected Biktarvy for price negotiation from 2028, and Gilead agreed to MFN prices in Medicaid for select products.
    Gilead Sciences Form 10-Q for the quarter ended 30 June 2026 - acquired IPR&D for Arcellx, Tubulis and Ouro, the $1.75 billion Trodelvy impairment, debt, receivables and the December 2025 agreement with the US administration. — Q2 2026 · publ. 6 August 2026 · source ↗
  6. ReportedIn the 2023 10-K the three wholesalers were reported as shares of total revenues; the 2025 10-K reports them as shares of gross product sales.
    Gilead Sciences Form 10-K for 2023 - revenue by product group for 2021-2023, wholesaler shares of total revenues and the 2023 balance sheet. — FY2023 · publ. February 2024 · source ↗
  7. ReportedIn the 2023 10-K the three wholesalers were reported as shares of total revenues; the 2025 10-K reports them as shares of gross product sales.
    Gilead Sciences Form 10-K for 2025 - customers, wholesalers, distribution and gross-to-net deductions. — FY2025 · publ. 24 February 2026 · source ↗
  8. Moat Explorer calcIf rebates and chargebacks rise above 65% of net product sales, from about 60% in 2025, the deciders will be taking more than the moat can justify.
    Moat Explorer calculation from Gilead Sciences reported figures ($ millions unless stated). HIV and Biktarvy: HIV share of total revenues 20,752 / 29,443 = 70.5% (2025); of product sales 20,752 / 28,915 = 71.8%; 16,438 / 22,449 = 73.2% (2019); 16,315 / 27,305 = 59.8% (2021); 18,175 / 27,116 = 67.0% (2023); 19,612 / 28,754 = 68.2% (2024). Biktarvy share of total revenues 14,334 / 29,443 = 48.7%; of HIV 14,334 / 20,752 = 69.1%; Biktarvy US 11,467 / 14,334 = 80.0%; Biktarvy growth 2025 14,334 / 13,423 - 1 = +6.8%; 2019-2025 14,334 / 4,738 = 3.0 times, (3.03)^(1/6) - 1 = about 20% a year. Other HIV 20,752 - 14,334 = 6,418; HIV other than Biktarvy, Descovy, Genvoya and Odefsey 20,752 - 14,334 - 2,758 - 1,498 - 1,167 = 995; Veklury plus Other plus royalties 911 + 799 + 527 = 2,237. Genvoya 1,498 / 3,931 - 1 = -61.9%. HIV growth 2019-2025 20,752 / 16,438 - 1 = +26.2%, about 4.0% a year; 2021 16,315 / 16,938 - 1 = -3.7%; 2023 18,175 / 17,194 - 1 = +5.7%; 2024 19,612 / 18,175 - 1 = +7.9%; 2025 20,752 / 19,612 - 1 = +5.8%, about 6%; H1 2026 10,723 / 9,675 - 1 = +10.8%; Q2 2026 5,693 / 5,088 - 1 = +11.9%. Descovy 2025 2,758 / 2,113 - 1 = +30.5%, about 31%; Q2 2026 967 / 653 - 1 = +48.1%; Descovy over Yeztugo Q2 2026 967 / 232 = 4.2, about four times. Yeztugo Q1 2026 = H1 397 - Q2 232 = 165; Yeztugo over Biktarvy H1 2026 397 / 7,133 = 5.6%, about 6%. US HIV 16,904 / 20,752 = 81.5%, about 81%; US product sales 20,816 / 28,915 = 72.0%; Europe 4,617 / 28,915 = 16.0%. Gilead HIV growth Q2 2026 +11.9% less ViiV +11% = about +1 point. Exclusivity: Descovy + Vemlidy + Odefsey 2,758 + 1,070 + 1,167 = 4,995, about $5.0bn, / 29,443 = 17.0% of revenue; Descovy + Vemlidy 2,758 + 1,070 = 3,828; Vemlidy share of Liver Disease 1,070 / 3,217 = 33.3%, a third; 2025 sales by primary US patent window: Tecartus 344 + Genvoya 1,498 = 1,842 (2027-2029); Trodelvy 1,397 + Descovy 2,758 + Vemlidy 1,070 + Odefsey 1,167 + sofosbuvir/velpatasvir 1,272 = 7,664 (2028-2033); Biktarvy 14,334 (2036). Hepatitis C 2015 Harvoni 13,864 + Sovaldi 5,276 = 19,140, / product sales 32,151 = 59.5%, about 60%; product sales 2018 21,677 / 32,151 - 1 = -32.6%; Liver Disease 2025 3,217 / 19,140 = 16.8%, about 17%, a sixth. Liver Disease 2019 HCV 2,936 + HBV/HDV 742 = 3,678; 2020 2,064 + 860 = 2,924. Price: gross product sales 2025 28,915 + 19,953 = 48,868, about $48.9bn; 2024 28,610 + 17,776 = 46,386; net product sales growth 28,915 / 28,610 - 1 = +1.1%, about 1%; gross-to-net deductions 19,953 / 17,776 - 1 = +12.2%; accrued rebates 4,337 / 3,892 - 1 = +11.4%, about 11%; rebates and chargebacks over net product sales 17.5bn / 28,915 = 60.5%, about 60% (2025); 15.5bn / 28,610 = 54.2% (2024). H1 2026 capital expenditure = operating cash flow 6,117 - free cash flow 5,859 = 258. Three wholesalers 29% + 24% + 21% = 74% of gross product sales (2025); 29% + 23% + 21% = 73% (2024). Hepatitis C share of revenue 1,272 / 29,443 = 4.3%, about 4%; sofosbuvir/velpatasvir 2025 1,272 / 1,596 - 1 = -20.3%, a fifth; Mavyret 1,317 / 1,311 - 1 = +0.5%. Cash and capital: free cash flow over revenue 9,456 / 29,443 = 32.1%, about 32%; dividends paid over free cash flow 4,003 / 9,456 = 42.3%, about 42%; free cash flow left after dividends and buybacks 9,456 - 4,003 - 1,922 = 3,531. Dividend per share (3.16 / 1.29)^(1/10) - 1 = 9.4% a year; increases 1.84 / 1.29 - 1 = +42.6% (2016); 2.72 / 2.52 - 1 = +7.9% (2020); 3.00 / 2.92 - 1 = +2.7% (2023); 3.08 / 3.00 - 1 = +2.7% (2024); 3.16 / 3.08 - 1 = +2.6% (2025); quarterly 0.82 / 0.79 - 1 = +3.8% (2026). Buybacks 2015-2016 10,002 + 11,001 = 21,003, about $21bn; year-end market value 2016 over 2015 94.34 / 145.83 - 1 = -35.3%, about a third. Net debt 31 December 2025 = total debt 24,937 - cash and marketable debt securities 10,605 = 14,332; 30 June 2026 = 26,246 - 3,179 = 23,067; net debt over 2025 free cash flow 23,067 / 9,456 = 2.4 years. Interest over operating income 1,024 / 10,022 = 10.2%, about a tenth (2025); 977 / 1,662 = 58.8%, more than half (2024). Gilead stockholders equity 11,829 / 22,703 - 1 = -47.9%, about 48%; return on equity 2025 8,510 / ((19,330 + 22,703) / 2 = 21,017) = 40.5%. Acquisitions: Trodelvy IPR&D impairments 2.7bn (2022) + 2.4bn + 1.8bn (2024) + 1.75bn (2026) = 8.65bn of 15.8bn recorded = 54.7%; Trodelvy Q1 2026 = H1 859 - Q2 457 = 402; Kite plus Immunomedics 11,155 + 20,600 = 31,755, over $31bn; cell therapy 2025 1,839 / 1,973 - 1 = -6.8%; Arcellx IPR&D 7.0bn / cell therapy 2025 1.839bn = 3.8 years. Acquired IPR&D 2019 5,051 + 2020 5,856 + 2021 939 + 2022 944 + 2023 1,155 + 2024 4,663 + 2025 1,024 + H1 2026 11,290 = 30,922, about $30.9bn; acquired IPR&D 2019-2025 alone = 30,922 - 11,290 = 19,632; Biktarvy 2025 US 11,467 + outside US 1,676 + 1,190 = 14,334, all other revenues 29,443 - 14,334 = 15,109 (shown 15.1); net income 2019-2025 5,386 + 123 + 6,225 + 4,592 + 5,665 + 480 + 8,510 = 30,981, about $31.0bn. Revenue lines: Liver Disease share 3,217 / 29,443 = 10.9%, about 11%; Oncology share 3,236 / 29,443 = 11.0%; Oncology 2020 cell therapy 607 + Trodelvy 49 = 656; Oncology 2025 3,236 / 3,289 - 1 = -1.6%, about 2%; 2019-2025 3,236 / 456 = 7.1 times, about sevenfold. Veklury 2021 5,565 / 27,305 = 20.4%, about a fifth; 2025 911 / 29,443 = 3.1%; product sales 2021-2025 28,915 / 27,008 - 1 = +7.1%; excluding Veklury (28,915 - 911 = 28,004) / (27,008 - 5,565 = 21,443) - 1 = +30.6%, about 31%. Other product sales plus royalty, contract and other revenues: 1,547 + 330 = 1,877 (2019); 1,026 + 334 = 1,360; 1,027 + 297 = 1,324; 946 + 299 = 1,245; 859 + 182 = 1,041; 889 + 144 = 1,033; 799 + 527 = 1,326 (2025). Bands sum to total revenues: 2025 20,752 + 3,217 + 3,236 + 911 + 1,326 = 29,442 against reported 29,443 (rounding); 2019 16,438 + 3,678 + 456 + 0 + 1,877 = 22,449. Non-HIV revenue 29,443 - 20,752 = 8,691, / 29,443 = 29.5%. Valuation and earnings: trailing twelve months to June 2026 revenue 29,443 - H1 2025 13,749 + H1 2026 14,763 = 30,457; net income 8,510 - 3,275 + (-8,475) = -3,240; diluted EPS 6.78 - 2.61 + (-6.82) = -2.65. Year-end market value over net income and revenue: 2015 145.83bn / 18,108 = 8.05, / 32,639 = 4.47; 2016 94.34 / 13,501 = 6.99, / 30,390 = 3.10; 2017 93.58 / 4,628 = 20.2, / 26,107 = 3.58; 2018 80.92 / 5,455 = 14.8, / 22,127 = 3.66; 2019 82.21 / 5,386 = 15.3, / 22,449 = 3.66; 2020 73.03 / 123 = 594, / 24,689 = 2.96; 2021 91.08 / 6,225 = 14.6, / 27,305 = 3.34; 2022 107.68 / 4,592 = 23.4, / 27,281 = 3.95; 2023 100.94 / 5,665 = 17.8, / 27,116 = 3.72; 2024 115.12 / 480 = 240, / 28,754 = 4.00; 2025 152.28 / 8,510 = 17.9, / 29,443 = 5.17; October 2026 179.47bn / 30,457 = 5.89. 2026 product sales guidance midpoints (29,600 + 30,000) / 2 = 29,800 (February); (30,000 + 30,400) / 2 = 30,200 (May); (30,100 + 30,400) / 2 = 30,250 (August). Non-GAAP EPS guidance midpoint (-0.65 + -0.30) / 2 = -0.475, plus 9.08 of acquired IPR&D and tax per share = 8.61. Additional: dividends paid 3,918 / 3,809 - 1 = +2.9% (2024), 4,003 / 3,918 - 1 = +2.2% (2025); gross product sales 48,868 / 46,386 - 1 = +5.4%, about 5%; Epclusa 1,966 / 3,510 - 1 = -44.0%; US HIV over US product sales 16,904 / 20,816 = 81.2%; European HIV over European product sales 2,392 / 4,617 = 51.8%; analyst target 158.65 / 144.74 - 1 = +9.6%, about 10%; market value 2025 over 2024 152.28 / 115.12 - 1 = +32.3%, a third. AmBisome 509 / 533 - 1 = -4.5%. Biktarvy over HIV: 4,738 / 16,438 = 28.8% (2019); 8,624 / 16,315 = 52.9% (2021); 11,850 / 18,175 = 65.2% (2023). Descovy + Vemlidy + Odefsey: 1,500 + 488 + 1,655 = 3,643 (2019); 1,700 + 814 + 1,568 = 4,082 (2021); 1,985 + 862 + 1,350 = 4,197 (2023); 2,113 + 959 + 1,288 = 4,360 (2024). Apretude Q1 2026 = H1 260 - Q2 140 = 120 (GBP M). Livdelzi Q1 2026 = H1 300 - Q2 167 = 133 - prices, deductions, customers, geography and exclusivity. — FY2015-Q2 2026 · publ. October 2026 · source ↗
    Method: Arithmetic on figures reported in Gilead Sciences Forms 10-K, 10-Q and results releases, SEC XBRL, stockanalysis.com market values, and the GSK and AbbVie filings cited; each operand is stated in the source line.
Sources
Generated October 4, 2026