Gilead's COVID-19 antiviral Veklury blew past sales estimates in late 2021 as omicron surged, vaccinations lagged

Just when it looked like Gilead’s COVID-19 medicine Veklury was destined to be crowded out of the market by antibody treatments and antiviral pills, the omicron variant helped spark a surge in sales.

In the fourth quarter of last year, with a late boost in demand in December, Veklury rang (PDF) up $1.4 billion in sales, far exceeding the Wall Street consensus estimate of $864 million.

Gilead reported the figure Tuesday when it presented its fourth quarter and 2021 earnings. The strong quarter brought Veklury sales up to $5.6 billion for the year and helped push Gilead’s revenue figure to $27.3 billion in 2021, an 11% increase from 2020 that the company attributed almost entirely to Veklury.

RELATED: Resurgent Veklury delivers Gilead $1.9B in sales and an earnings surprise

“In the December/January time frame we’ve really seen Veklury play a critical role,” Johanna Mercier, Gilead’s chief commercial officer, said during the company’s fourth quarter earnings conference call.

Mercier credited Veklury’s resurgence to the ineffectiveness of antibody drugs, such as those produced by Regeneron and Eli Lilly, against omicron. While omicron has generally produced a milder form of the virus, it still has landed more in the hospital, boosting demand for Gilead’s infused drug.

“We’ve seen that Veklury sales truly track to hospitalizations,” Mercier said. “We’ve seen that again with the omicron surge. Despite the fact that omicron seemed to have a less severe impact, unfortunately the number of cases were much greater—just the pure, absolute number of hospitalizations went up.”

Late last month, the FDA expanded Veklury's use to those with COVID-19 who are not in the hospital. The nod provides doctors with a much-needed additional tool with which to combat omicron.

One miscalculation made by the company, it said, was assuming that vaccination rates would increase, thereby decreasing hospitalizations. Instead, a stabilization of the vaccination rate between 60 and 65% in the U.S. has helped sustain Veklury’s demand.

Gilead believes that as the pandemic shifts into an endemic stage and as antiviral pills become more readily available that hospitalizations will decline, limiting the need for Veklury. Still, the company is projecting 2022 sales for the antiviral at $2 billion.

Gilead’s chief medical officer Merdad Parsey believes that oral antivirals will come to be used at an earlier stage of the virus while Veklury’s niche will be at a later stage.

RELATED: Gilead's Veklury expands FDA nod to patients outside the hospital as oral version heads to trial

“Many people may progress and/or not get treated early enough and end up in the hospital,” Parsey said. “I do think there will be a role for both of them.”

As for Gilead’s bread-and-butter HIV treatments, their total sales were up 7% for the fourth quarter over the same period in 2020. Biktarvy’s sales jumped in the quarter by 22%, year over year, while sales for Truvada and Atripia declined by 58% and 29% respectively, year over year in the quarter, owing to their loss of exclusivity in the U.S. in late 2020.